ririРаны и раневые инфекции. Журнал имени проф. Б.М. КостючёнкаWounds and wound infections. The prof. B.M. Kostyuchenok journal2408-96132500-0594Regional non-governmental organization “Surgical society - Wounds and wound infections”10.17650/2408-9613-2016-3-2-59-70riri-93Research ArticleКЛИНИЧЕСКИЕ РЕКОМЕНДАЦИИCLINICAL GUIDELINESРуководство и документы Международной рабочей группы по диабетической стопе 2015 г. по профилактике и лечению заболеваний стопы при диабете: достижение доказательного консенсуса (сокращенная русскоязычная версия)Manual and documents of International Working Group on the Diabetic Foot 2015 for prevention and treatment of diabetic foot diseases: the achievement of argumentative consensus (Russian cut version)БаккерК.BakkerK.

MD, PhD, HeemsteedseDreef 90 2102 KN, Heemstede

karel.bakker@hetnet.nlАпельквистДж.ApelqvistJ.

Отделение эндокринологии,

Department of Endocrinology

ЛипскиБ. А.LipskyB. A.

Университетская клиника и факультет медицины;

Соединенное Королевство

Ван НеттенДж.Van NettenJ. J.

Отделение хирургии

The Department of Surgery

ШаперН. К.SchaperN. C.

Отделение эндокринологии, 

Маастрихт

Maastricht

МРГДСНидерландыIWGDFNetherlandsУниверситетская клиника МальмёШвецияthe Malmö University HospitalSwedenЖеневский университет; Оксфордский университетШвейцарияThe Geneva University Hospital and The Department of Medicine in University of Geneva; University of Oxford, the United KingdomSwitzerlandКлиники Алмело и ХенгелоНидерландыAlmelo Hospital and Hengelo HospitalNetherlandsИнституты MUMC+, CARIM и CAPHRIНидерландыDepartment of Endocrinology, MUMC+, CARIM and CAPHRI InstitutesNetherlands201609122016325970Copyright © Баккер К., Апельквист Д., Липски Б.А., Ван Неттен Д.J., Шапер Н.К., 20162016Баккер К., Апельквист Д., Липски Б.А., Ван Неттен Д., Шапер Н.К.Bakker K., Apelqvist J., Lipsky B.A., Van Netten J.J., Schaper N.C.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.riri.su/jour/article/view/93

Представлены рекомендации для врачей-эндокринологов, хирургов, травматологов, ортопедов, подиатров, разработанные Международной рабочей группой по диабетической стопе (МРГДС) и изложенные в «Руководстве и документах МРГДС 2015 г. по профилактике и лечению заболеваний стопы при диабете: достижение доказательного консенсуса».

Recommendations for endocrinologists, surgeons, traumatologists, orthopedists, podiatrists, developed by the International Working Group on the Diabetic Foot (IWGDF) and set out in “Manual and documents of IWGDF 2015 for prevention and treatment of diabetic foot diseases: the achievement of argumentative consensus”.

синдром диабетической стопыдиабетическая язва стопыинфицированная диабетическая стопаишемическая диабетическая стопапрофилактикадиагностикалечениеобувьразгрузкареабилитацияпрогнозсопутствующая терапияdiabetic foot infections syndromediabetic foot ulcerinfected diabetic footischemic diabetic footpreventiondiagnosticstreatmentfootwearreliefrehabilitationprognosisconcomitant therapy«Takeda Pharmaceutical Company»; В.Б. Бреговский, О.В. Удовиченко, Ю.С. Пасхалова, Б.Г. Спивак, А.Ю. Токмакова, А.Г. БагдасарянReferencesBakker K., Apelqvist J., Lipsky B.A., Van Netten J.J., International Working Group on the Diabetic Foot. The 2015 IWGDF guidance documents on prevention and management of foot problems in diabetes: development of an evidence-based global consensus. Diabetes Metab Res Rev 2016;32(Suppl 1):2–6. DOI: 10.1002/dmrr.2694. PMID: 26409930.Bakker K., Apelqvist J., Lipsky B.A., Van Netten J.J., International Working Group on the Diabetic Foot. The 2015 IWGDF guidance documents on prevention and management of foot problems in diabetes: development of an evidence-based global consensus. Diabetes Metab Res Rev 2016;32(Suppl 1):2–6. DOI: 10.1002/dmrr.2694. PMID: 26409930.Boulton A.J., Vileikyte L., RagnarsonTennvall G., Apelqvist J. The global burden of diabetic foot disease. Lancet 2005;366(9498):1719–24. DOI: 10.1016/S0140-6736(05)67698-2. PMID: 16291066.Boulton A.J., Vileikyte L., RagnarsonTennvall G., Apelqvist J. The global burden of diabetic foot disease. Lancet 2005;366(9498):1719–24. DOI: 10.1016/S0140-6736(05)67698-2. PMID: 16291066.Дедов И.И., ШестаковаМ.В., Викулова О.К. Государственный регистр сахарного диабета в Российской Федерации: статус 2014 и перспективы развития. Сахарный диабет 2015;18(3):5–22. [Dedov I.I., Shestakova M.V., Vikulova O.K. The state register of a diabetes mellitus in the Russian Federation: status 2014 and prospects of development. Sakharnyy diabet = Diabetes Mellitus 2015;18(3):5–22. (In Russ.)].Дедов И.И., ШестаковаМ.В., Викулова О.К. Государственный регистр сахарного диабета в Российской Федерации: статус 2014 и перспективы развития. Сахарный диабет 2015;18(3):5–22. [Dedov I.I., Shestakova M.V., Vikulova O.K. The state register of a diabetes mellitus in the Russian Federation: status 2014 and prospects of development. Sakharnyy diabet = Diabetes Mellitus 2015;18(3):5–22. (In Russ.)].Armstrong D.G., Lavery L.A., Harkless L.B. Validation of a diabetic wound classification system. The contribution of depth, infection, and ischemia to risk of amputation. Diabetes Care 1998;21(5):855–9. PMID: 9589255.Armstrong D.G., Lavery L.A., Harkless L.B. Validation of a diabetic wound classification system. The contribution of depth, infection, and ischemia to risk of amputation. Diabetes Care 1998;21(5):855–9. PMID: 9589255.Cavanagh P., Attinger C., Abbas Z. et al. Cost of treating diabetic foot ulcers in five different countries. Diabetes Metab Res Rev 2012;28(Suppl 1):107–11. DOI: 10.1002/dmrr.2245. PMID: 22271734.Cavanagh P., Attinger C., Abbas Z. et al. Cost of treating diabetic foot ulcers in five different countries. Diabetes Metab Res Rev 2012;28(Suppl 1):107–11. DOI: 10.1002/dmrr.2245. PMID: 22271734.Международное соглашение по диабетической стопе. Пер. Е.Ю. Комелягиной и И.В. Гурьевой. Под ред. И.В. Гурьевой. М.: Берег, 2000. 97 с. [International agreement on diabetic foot. Transl. E.Yu. Komelyagina and I.V. Gur’eva. Ed. by I.V. Gur’eva. Moscow: Bereg, 2000. 97 p. (In Russ.)].Международное соглашение по диабетической стопе. Пер. Е.Ю. Комелягиной и И.В. Гурьевой. Под ред. И.В. Гурьевой. М.: Берег, 2000. 97 с. [International agreement on diabetic foot. Transl. E.Yu. Komelyagina and I.V. Gur’eva. Ed. by I.V. Gur’eva. Moscow: Bereg, 2000. 97 p. (In Russ.)].Практические рекомендации по лечению и профилактике диабетической стопы, основанные на Международном консенсусе по диабетической стопе. Под ред. И.В. Гурьевой. М.: МАИ-ПРИНТ, 2012. 40 с. [The practical references on treatment and prevention of diabetic foot based on the International consensus on diabetic foot. Ed. by I.V. Gur’eva. Moscow: MAI-PRINT, 2012. 40 p. (In Russ.)].Практические рекомендации по лечению и профилактике диабетической стопы, основанные на Международном консенсусе по диабетической стопе. Под ред. И.В. Гурьевой. М.: МАИ-ПРИНТ, 2012. 40 с. [The practical references on treatment and prevention of diabetic foot based on the International consensus on diabetic foot. Ed. by I.V. Gur’eva. Moscow: MAI-PRINT, 2012. 40 p. (In Russ.)].Bus S.A., Van Netten J.J., Lavery L.A. et al. IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes. Diabetes Metab Res Rev 2016;32(Suppl 1): 16–24. DOI: 10.1002/dmrr.2696. PMID: 26334001.Bus S.A., Van Netten J.J., Lavery L.A. et al. IWGDF guidance on the prevention of foot ulcers in at-risk patients with diabetes. Diabetes Metab Res Rev 2016;32(Suppl 1): 16–24. DOI: 10.1002/dmrr.2696. PMID: 26334001.Bus S.A., Armstrong D.G., Van Deursen R.W. et al. IWGDF guidance on footwear and offloading interventions to prevent and heal foot ulcers in patients with diabetes. Diabetes Metab Res Rev 2016;32(Suppl 1):25–36. DOI: 10.1002/dmrr.2697. PMID: 26813614.Bus S.A., Armstrong D.G., Van Deursen R.W. et al. IWGDF guidance on footwear and offloading interventions to prevent and heal foot ulcers in patients with diabetes. Diabetes Metab Res Rev 2016;32(Suppl 1):25–36. DOI: 10.1002/dmrr.2697. PMID: 26813614.Hinchliffe R.J., Brownrigg J.R., Apelqvist J. et al. IWGDF guidance on the diagnosis, prognosis and management of peripheral artery disease in patients with foot ulcers in diabetes. Diabetes Metab Res Rev 2016;32(Suppl 1): 37–44. DOI: 10.1002/dmrr.2698. PMID: 26332424.Hinchliffe R.J., Brownrigg J.R., Apelqvist J. et al. IWGDF guidance on the diagnosis, prognosis and management of peripheral artery disease in patients with foot ulcers in diabetes. Diabetes Metab Res Rev 2016;32(Suppl 1): 37–44. DOI: 10.1002/dmrr.2698. PMID: 26332424.Lipsky B.A., Aragón-Sánchez J., Diggle M. et al. IWGDF guidance on the diagnosis and management of foot infections in persons with diabetes. Diabetes Metab Res Rev 2016;32(Suppl 1):45–74. DOI: 10.1002/dmrr.2699. PMID: 26386266.Lipsky B.A., Aragón-Sánchez J., Diggle M. et al. IWGDF guidance on the diagnosis and management of foot infections in persons with diabetes. Diabetes Metab Res Rev 2016;32(Suppl 1):45–74. DOI: 10.1002/dmrr.2699. PMID: 26386266.Game F.L., Attinger C., Hartemann A. et al. IWGDF guidance on use of interventions to enhance the healing of chronic ulcers of the foot in diabetes. Diabetes Metab Res Rev 2016;32(Suppl 1):75–83. DOI: 10.1002/dmrr.2700. PMID: 26340818.Game F.L., Attinger C., Hartemann A. et al. IWGDF guidance on use of interventions to enhance the healing of chronic ulcers of the foot in diabetes. Diabetes Metab Res Rev 2016;32(Suppl 1):75–83. DOI: 10.1002/dmrr.2700. PMID: 26340818.Schaper N.C., Van Netten J.J., Apelqvist J. et al. Prevention and management of foot problems in diabetes: a Summary Guidance for Daily Practice 2015, based on the IWGDF Guidance Documents. Diabetes Metab Res Rev 2016;32(Suppl 1):7–15. DOI: 10.1002/dmrr.2695. PMID: 26335366.Schaper N.C., Van Netten J.J., Apelqvist J. et al. Prevention and management of foot problems in diabetes: a Summary Guidance for Daily Practice 2015, based on the IWGDF Guidance Documents. Diabetes Metab Res Rev 2016;32(Suppl 1):7–15. DOI: 10.1002/dmrr.2695. PMID: 26335366.Van Netten J.J., Price P.E., Lavery L.A. et al. Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review. Diabetes Metab Res Rev 2016;32(Suppl 1):84–98. DOI: 10.1002/dmrr.2701. PMID: 26340966.Van Netten J.J., Price P.E., Lavery L.A. et al. Prevention of foot ulcers in the at-risk patient with diabetes: a systematic review. Diabetes Metab Res Rev 2016;32(Suppl 1):84–98. DOI: 10.1002/dmrr.2701. PMID: 26340966.Brownrigg J.R., Hinchliffe R.J., Apelqvist J. et al. Effectiveness of bedside investigations to diagnose peripheral artery disease among people with diabetes mellitus: a systematic review. Diabetes Metab Res Rev 2016;32 (Suppl 1):119–27. DOI: 10.1002/dmrr.2703. PMID: 26342170.Brownrigg J.R., Hinchliffe R.J., Apelqvist J. et al. Effectiveness of bedside investigations to diagnose peripheral artery disease among people with diabetes mellitus: a systematic review. Diabetes Metab Res Rev 2016;32 (Suppl 1):119–27. DOI: 10.1002/dmrr.2703. PMID: 26342170.Brownrigg J.R., Hinchliffe R.J., Apelqvist J. et al. Performance of prognostic markers in the prediction of wound healing and/or amputation among patients with foot ulcers in diabetes: a systematic review. Diabetes Metab Res Rev 2016;32(Suppl 1):128–35. DOI: 10.1002/dmrr.2704. PMID: 26342129.Brownrigg J.R., Hinchliffe R.J., Apelqvist J. et al. Performance of prognostic markers in the prediction of wound healing and/or amputation among patients with foot ulcers in diabetes: a systematic review. Diabetes Metab Res Rev 2016;32(Suppl 1):128–35. DOI: 10.1002/dmrr.2704. PMID: 26342129.Hinchliffe R.J., Brownrigg J.R., Andros G. et al. Effectiveness of revascularisation of the ulcerated foot in patients with diabetes and peripheral artery disease: a systematic review. Diabetes Metab Res Rev 2016;32(Suppl 1):136–44. DOI: 10.1002/dmrr.2705. PMID: 26342204.Hinchliffe R.J., Brownrigg J.R., Andros G. et al. Effectiveness of revascularisation of the ulcerated foot in patients with diabetes and peripheral artery disease: a systematic review. Diabetes Metab Res Rev 2016;32(Suppl 1):136–44. DOI: 10.1002/dmrr.2705. PMID: 26342204.Bus S.A., Van Deursen R.W., Armstrong D.G. et al. Footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in patients with diabetes: a systematic review. Diabetes Metab Res Rev 2016;32(Suppl 1):99–118. DOI: 10.1002/dmrr.2702. PMID: 26342178.Bus S.A., Van Deursen R.W., Armstrong D.G. et al. Footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in patients with diabetes: a systematic review. Diabetes Metab Res Rev 2016;32(Suppl 1):99–118. DOI: 10.1002/dmrr.2702. PMID: 26342178.Peters E.J., Lipsky B.A., Aragon-Sanchez J. et al. Interventions in the management of infection in the foot in diabetes: a systematic review. Diabetes Metab Res Rev 2016;32 (Suppl 1):145–53. DOI: 10.1002/dmrr.2706. PMID: 26344844.Peters E.J., Lipsky B.A., Aragon-Sanchez J. et al. Interventions in the management of infection in the foot in diabetes: a systematic review. Diabetes Metab Res Rev 2016;32 (Suppl 1):145–53. DOI: 10.1002/dmrr.2706. PMID: 26344844.Game F., Apelqvist J., Attinger C. et al. Effectiveness of interventions to enhance healing of chronic ulcers of the foot in diabetes: a systematic review. Diabetes Metab Res Rev 2016;32(Suppl 1):154–68. DOI: 10.1002/dmrr.2707. PMID: 26344936.Game F., Apelqvist J., Attinger C. et al. Effectiveness of interventions to enhance healing of chronic ulcers of the foot in diabetes: a systematic review. Diabetes Metab Res Rev 2016;32(Suppl 1):154–68. DOI: 10.1002/dmrr.2707. PMID: 26344936.Whiting P., Rutjes A.W., Reitsma J.B. et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol 2003;3:25–7. DOI: 10.1186/1471-2288-3-25. PMID: 14606960.Whiting P., Rutjes A.W., Reitsma J.B. et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol 2003;3:25–7. DOI: 10.1186/1471-2288-3-25. PMID: 14606960.Hayden J.A., Van der Windt D.A., Cartwright J.L. et al. Assessing bias in studies of prognostic factors. Ann Intern Med 2013;158(4):280–6. DOI: 10.7326/0003-4819-158-4-201302190-00009. PMID: 23420236.Hayden J.A., Van der Windt D.A., Cartwright J.L. et al. Assessing bias in studies of prognostic factors. Ann Intern Med 2013;158(4):280–6. DOI: 10.7326/0003-4819-158-4-201302190-00009. PMID: 23420236.Guyatt G.H., Oxman A.D., Vist G.E. et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336(7650):924–6. DOI: 10.1136/bmj.39489.470347.AD. PMID: 18436948.Guyatt G.H., Oxman A.D., Vist G.E. et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336(7650):924–6. DOI: 10.1136/bmj.39489.470347.AD. PMID: 18436948.Дедов И.И., Шестакова М.В., Галстян Г.Р. Распространенность сахарного диабета 2 типа у взрослого населения России (исследование NATION). Сахарный диабет 2016;19(2):105–12. [Dedov I.I., Shestakova M.V., Galstyan G.R. The prevalence of type 2 diabetes mellitus in the adult population of Russia (NATION study). Sakharnyy diabet = Diabetes Mellitus 2016;19(2):105–12 (In Russ.)].Дедов И.И., Шестакова М.В., Галстян Г.Р. Распространенность сахарного диабета 2 типа у взрослого населения России (исследование NATION). Сахарный диабет 2016;19(2):105–12. [Dedov I.I., Shestakova M.V., Galstyan G.R. The prevalence of type 2 diabetes mellitus in the adult population of Russia (NATION study). Sakharnyy diabet = Diabetes Mellitus 2016;19(2):105–12 (In Russ.)].Галстян Г.Р., Токмакова А.Ю., Егорова Д.Н. и др. Клинические рекомендации по диагностике и лечению синдрома диабетической стопы. Раны и раневые инфекции. Журнал им. проф. Б.М. Костючёнка 2015;2(3):63–83. [Galstyan G.R., Tokmakova A.Yu., Egorova D.N. et al. Clinical guidelines for diagnosis and treatment of diabetic foot syndrome. Rany i ranevye infektsii. Zhurnal im. prof. B.M. Kostyuchenka = Wounds and Wound Infections. The Prof. B.M. Kostyuchenok Journal 2015;2(3):63–83. (In Russ.)].Галстян Г.Р., Токмакова А.Ю., Егорова Д.Н. и др. Клинические рекомендации по диагностике и лечению синдрома диабетической стопы. Раны и раневые инфекции. Журнал им. проф. Б.М. Костючёнка 2015;2(3):63–83. [Galstyan G.R., Tokmakova A.Yu., Egorova D.N. et al. Clinical guidelines for diagnosis and treatment of diabetic foot syndrome. Rany i ranevye infektsii. Zhurnal im. prof. B.M. Kostyuchenka = Wounds and Wound Infections. The Prof. B.M. Kostyuchenok Journal 2015;2(3):63–83. (In Russ.)].

The authors declare that there are no conflicts of interest present.