Avtor/Urednik | Rakovec, Slavko; Gaberšek, Ivan | |
Naslov | Kirurška oskrba razjed in mrtvin na diabetični nogi | |
Prevedeni naslov | Surgical management of diabetic foot ulcers and gangrenous changes | |
Tip | članek | |
Vir | Med Razgl | |
Vol. in št. | Letnik 40, št. Suppl 3 | |
Leto izdaje | 2001 | |
Obseg | str. 119-25 | |
Jezik | slo | |
Abstrakt | Since the causal mechanisms are very heterogenous the pathologic changes in diabetic foot are extremely different. Sometimes there is a prevalence of microvascular and/or macrovasctzlar disease, sometimes again neuropathy (autonomic, motor, or sensory). There are other important factors: diabetic metabolism itself, limited joint mobility, and infection which is the main reason for the progress of lesions. So, especially in elder diabetics, foot ulcers and also gangrenous changes often occur. They are resistant to treatment and often the only possible solution is amputation. The proper prevention and management must be multidisciplinary and the treatment should preserve as much tissue of the foot as possible. There are many important ways of treatment: the revascularisation procedures (if feasible), the provision of proper footwear, the antibiotic treatment, and the healing promoting procedures. But the most important measure is to remove the deep infection focus and the devitalised tissues by a broad excision allowing free drainage from the wound. | |
Izvleček | Bolezenske spremembe na spodnjem udu bolnikov s sladkorno boleznijo se zelo razlikujejo med seboj, kar je posledica učinkovanja mnogih dejavnikov na različnih organskih sistemih. Včasih je bolj prizadeto žilje (drobno ali večje), drugič bolj živčevje (avtonomno, ali motorično, ali senzorično). Med vzroke za bolezensko dogajanje moramo prišteti še sistemske diabetične presnovne spremembe, slabšo gibljivost udov in zlasti okužbo, ki pogosto prevzame glavno vlogo pri razvoju in napredovanju okvar. Tako se, zlasti pri starejših bolnikih s sladkorno boleznijo, pogosto srečujemo z razjedami in mrtvinami, ki predstavljajo znatno nevarnost, saj velikokrat privedejo do amputacij. S pravilno in multidisciplinarno obravnavo jih skušamo preprečiti ali pa jih odpraviti na čim bolj oddaljenem delu uda. Ukrepi, ki so potrebni, so številni in različni, najpomembnejši pa je gotovo izrez mrtvin in žarišča okužbe ter vzpostavitev proste drenaže. Med pomembnimi velja omeniti še ustrezno obuvalo, postopke za izboljšanje prekrvitve, če so le izvedljivi in smiselni, antibiotično zdravljenje ter ukrepe za pospeševanje celjenja | |
Deskriptorji | DIABETIC FOOT LEG ULCER GANGRENE |