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ment of the feet and reports the contents to the doctor. The doctor requests the necessary tests based on the report of the nurse and proceeds to diagnosis and treatment, but in cases outside the specialty, he or she will refer a specialized doctor in the field (Figure 4). Since podiatry medicine is not a specialized academic field in Japan, most of Japa-nese doctors in this field are familiar with podiatry disease outside their specific field. Therefore, doctors study at their own interest and augment their knowledge by experience and support by other specialists and nurses.By sharing the specialized knowledge of foot diseases in each department and combining, exam-ining, and practicing cutting-edge technologies, we will pave the way for cutting-edge medical care (such as regenerative medicine3)) from foot care to treatment of intractable diseases. Furthermore, the cooperation between departments will make it possible to provide safe and optimal treatment for diseases that each department has previously dealt with individually.Significance and role of the Podiatry Center from the standpoint of plastic surgeryWound care is an important field of Plastic Surgery. However, there are many foot wound diseases that cannot be treated by plastic surgery alone and require the cooperation of other depart-ments depending on the symptoms. By centralizing the treatment for foot disease, multidisciplinary treatment, which includes cardiovascular medicine, Figure 4　The figure shows the medical examination flow in the Podiatry Center at Juntendo University Hospital processed by the physician and the nurses.orthopedics, dermatology, rehabilitation, and internal medicine (nephrology, rheumatology, and diabe-tology) becomes easier to perform. With the coop-eration of each department, it will be possible to provide safe and optimal treatment for diseases that each department has previously handled indi-vidually. In addition, foot deformities often occur after surgical treatment of foot disease. Continuous care with shoes, orthoses, and foot care is required to prevent the recurrence of foot disease, and we are actively working to prevent recurrence even after treatment is completed4).Studies have been conducted on how team medical care can avoid lower limb amputation rates for diabetic ulcers, and the results have been reported. Riaz et al reported that prior to team medical care to treat diabetic wounds, lower limb amputation rates decreased from a high baseline of 27.5% to 3.9%5) In Denmark, it was reported that the lower limb amputation rate of 27.2% was reduced to 6.9% for a population of 100,0004, and in the UK, it was reported that it was possible to cause a reduction of lower limb amputation to about 2%6, 7). In the future, I think it will be ideal for us to be involved in the treatment of a wide range of foot diseases that is at par with Western podia-trists without being bound by specialized fields.There is a wide range of diseases related to foot disease, and in Japan, where podiatry does not exist, there are some diseases for which medical 99Future direction