Diyabetik Ayakta Alt Ekstremite Re-ampütasyonları Kaçınılmaz mı?
Küçük Resim Yok
Tarih
2018
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Tüm dünyada insidansı artan diyabetin önemli bir komplikasyonu diyabetik ayak yarası (DAY) gelişimidir. DAY, hastalarda ciddi morbidite ve bazen de mortaliteye sebep olabilmektedir. DAY’larda medikal tedavinin yanı sıra genellikle cerrahi tedavi de gereklidir. Diyabetli hastalarda alt ekstremite ampütasyon oranları diyabeti olmayan hastalara göre çok daha fazladır. Altta yatan risk faktörleri nedeniyle tekrarlayan ampütasyonlar kaçınılmaz olabilir. Bu çalışmada DAY olan olgularda re-ampütasyon oranlarını belirlemek amaçlanmıştır. Materyal ve Metod: Ege Üniversitesi Tıp Fakültesi Diyabetik Ayak Konseyinde 2015 ila 2018 tarihleri arasında görülen olgular retrospektif olarak değerlendirildi. Bulgular: Bu dönemde Konseyde takip edilen 280 hastadan 50 (%17.9) hastaya re-ampütasyon yapılmıştır. Re-ampütasyon süresi ortalama ± SS olarak 1.7 ± 2.1 yıl, median (min-maks) olarak 1 (0.08-10.0) yıl hesaplandı. Başvuru sırasında yara evresi Wagner 4 ve 5 olan olgularda re-ampütasyon olasılık oranı sırasıyla 1.9 ve 2.3 kat artmış olarak saptandı. Sonuç: Diyabetik ayak infeksiyonları ve sonucunda gerçekleşen ekstremite ampütasyonları hastaların yaşam kalitesini ciddi anlamda azaltmaktadır. Ülserin Wagner evresinin artmış olduğu durumlarda re-ampütasyon riski artmaktadır. Ampütasyon oranlarını azaltabilmek için diyabet tanısı alan her hastaya doğru ayak bakımı eğitimi verilmesi, eğer ampütasyon kaçınılmaz ise operasyon sonrası risk faktörleri iyi tanımlanarak gerekli önlemler alınmalıdır.
Introduction: A major complication of diabetes, which is increasing in the World, is the development of diabetic foot wound. Diabetic foot wounds can cause serious morbidity and even mortality in patients. In the treatment of diabetic foot wounds, surgical treatment is usually necessary besides medical treatment. Lower limb amputation rates in diabetic patients are much higher than non-diabetic patients. Re-amputations may be unavoidable due to underlying risk factors. In this study, it was aimed to determine the re-amputation rates in diabetic foot wound cases. Materials and Methods: We reviewed retrospectively the medical records of diabetic patients admitted to the Diabetic Foot Care Center of Ege University Medical Faculty between 2015-2018. Results: In this period, re-amputation was performed on 50 patients (17.9%) from a total of 280 patients who were followed up at the center. Mean re-amputation time was calculated ± SD 1.7 ± 2.1 years, median (min-max) 1 (0.08-10.0) year. During admission, re-amputation odds ratio was found to be increased by 1.9 and 2.3 times in cases with Wagner 4 and 5, respectively. Conclusion: Diabetic foot infections and limb amputations as a result seriously reduce the quality of life of the patients. The risk of re-amputation increases when the ulcer Wagner’s grade is raised. In order to decrease the rate of amputations, it is necessary to provide foot care training to every patient diagnosed with diabetes, and if amputation is inevitable, it is also necessary to identify risk factors and take essential precautions after the operation.
Introduction: A major complication of diabetes, which is increasing in the World, is the development of diabetic foot wound. Diabetic foot wounds can cause serious morbidity and even mortality in patients. In the treatment of diabetic foot wounds, surgical treatment is usually necessary besides medical treatment. Lower limb amputation rates in diabetic patients are much higher than non-diabetic patients. Re-amputations may be unavoidable due to underlying risk factors. In this study, it was aimed to determine the re-amputation rates in diabetic foot wound cases. Materials and Methods: We reviewed retrospectively the medical records of diabetic patients admitted to the Diabetic Foot Care Center of Ege University Medical Faculty between 2015-2018. Results: In this period, re-amputation was performed on 50 patients (17.9%) from a total of 280 patients who were followed up at the center. Mean re-amputation time was calculated ± SD 1.7 ± 2.1 years, median (min-max) 1 (0.08-10.0) year. During admission, re-amputation odds ratio was found to be increased by 1.9 and 2.3 times in cases with Wagner 4 and 5, respectively. Conclusion: Diabetic foot infections and limb amputations as a result seriously reduce the quality of life of the patients. The risk of re-amputation increases when the ulcer Wagner’s grade is raised. In order to decrease the rate of amputations, it is necessary to provide foot care training to every patient diagnosed with diabetes, and if amputation is inevitable, it is also necessary to identify risk factors and take essential precautions after the operation.
Açıklama
Anahtar Kelimeler
Mikrobiyoloji, Enfeksiyon Hastalıkları
Kaynak
Flora İnfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
23
Sayı
4
