[Necessary multidisciplinary management of diabetic foot]

The pathogenesis of diabetic foot is multifactorial and optimal management requires a multidisciplinary team. In most cases, the diabetic foot complication is seen as a wound subsequent to trauma, less often as an acute neuroarthropathy or cellulitis without any apparent skin lesion. Patients look for medical care more or less rapidly, depending on the information received previously concerning foot problems. The patient may consult a general practitioner or sometimes directly attend a diabetic foot clinic. The efficiency of treatment depends on early diagnosis, a specific etiology-guided approach to wound care and management of diabetes mellitus. A multidisciplinary team is needed to provide optimal care for foot wounds and neurological, vascular and infections complications, and to control blood glucose in a global approach to management of the diabetic patient. The team must coordinate the actions of its different members, the goal for all being to obtain not only foot healing but also optimal foot function. This requires experience in surgery of the diabetic foot. Creation of special diabetic foot units has been proposed to manage diabetic patients with foot pathologies as outpatients or inpatients when necessary.