Diyabetik Ayak Yaralarında İnfeksiyon DurumuPencere Açılarak Uygulanan Total Temas Alçılamaİçin Hala Bir Kontrendikasyon mudur?
Makaleler > Tam Makale · 2019
Yazarlar: Anıl Murat ÖZTÜRK, Serhat Uysal, ONUR SÜER, Ilgın YILDIRIM ŞİMŞİR, Meltem TAŞBAKAN
Flora, ESCI İndekslerine Giren Dergi, Uluslararası, Emerging Sources Citation Index (ESCI), 2019, cilt 24, ss 37-45
DOI: 10.5578/flora.67833
Özet
<p>Introduction: Foot ulcer is an undesirable result of diabetes. Alterations in the foot muscular structures with reduced pain sensation disrupt</p><p>the normal push mechanism of the foot and cause an increase in the plantar face pressure. In this case, plantar area ulcers occur.</p><p>Long-term and non-healing ulcers lead to infection and amputation. Many studies have shown that methods of reducing pressure and</p><p>load in the wound area are beneficial. Although it is shown that the gold standard application is total contact casting, circular closed</p><p>plaster application is not recommended because it cannot be followed in infected cases. Follow-up of the wound could be possible by</p><p>opening a window in the wound site on the casting. In this study, it was aimed to evaluate the efficacy of plastering by opening a</p><p>window at the lesion site in patients with infected diabetic foot wounds.</p><p>Materials and Methods: Between 01 February 2012-01 June 2018, cases of plantar ulceration, no wound healing by other methods</p><p>and follow-up total contact casting were screened retrospectively among the cases that applied to the Diabetic Foot Council of Ege</p><p>University Medical Faculty. Wound area, wound discharge and infection scores of the wound were identified before and after the application</p><p>of the cast. Total contact cast complications were recorded.</p><p>Results: There were a total of 21 cases on whom total contact cast was performed (6 female, 15 male). Mean duration of DM was</p><p>16.9 ± 7.7 years. The average duration of cast for all patients was 31.9 ± 22.6 days and the average number of applications was 3.2</p><p>± 2.2. Wound drainage before casting was serous in 17 patients (81%) and purulent in 4 patients (19%). Before total contact cast,</p><p>wound area was 22.5 ± 14.6 cm2. Mean post-casting wound area was 8.6 ± 16.9 cm2 (p=0.001). Sixteen (76.2%) cases’s wounds</p><p>were completely closed after casting.</p><p>Conclusion: The most feared outcome of diabetic foot injuries after insufficient and improper care is amputation. The effective reduction</p><p>of pressure and burden in the wound area with total contact casting is extremely important in the healing of diabetic wounds. Total</p><p>contact cast applied with a window on the ulcer site is a useful method for healing both the lesion and infection in infected diabetic</p><p>foot ulcers.</p>