Abstract
Diyabetik ayak ülserleri diyabetin en sık görülen ve ciddi bir kronik komplikasyonudur. Diyabetik ayak ülserleri morbidite artışına, hayat kalitesinin bozulmasına, yüksek tedavi maliyetlerine ve yüksek oranda alt ekstremite ampütasyonlarına neden olmaktadır. Diyabetik ayak ülserlerinin tedavisinde hasta eğitimi, koruyucu önlemler,eşlik eden enfeksiyonun tedavisi, lokal cerrahi debridman yapılmaktadır..Diyabetik ayak ülserinin tedavisi amacıyla ekstrakorporeal şok dalga tedavisi (ESWT) uyguladığımız hastamızı sunmak istedik. 65 yaşında 15 yıldır diyabeti olan ve insülin kullanan erkek hastanın 6 aydır mevcut olan sağ ayak lateralindeki 2,3x3,8 cm boyutundaki yarasının tedavisi için gün aşırı toplam 9 seans ESWT tedavisi uyguladık. Tedavi her bir seansta yaranın her cm2’si için 100 atım, 4 Hz, 2 bar olacak şekilde uygulandı. Tedaviden sonra 3. ay kontrolünde ağrının belirgin azaldığı ve yara boyutunun 1,5 x 2,2cm’ye gerilediği ve derinliğinin azaldığı saptandı. Tedavisi zor, maliyeti yüksek olan ve çoğu hastada amputasyona gerek duyulan diyabetik ayak ülseri tedavisinde ESWT’nin ucuz, kolay uygulanabilir ve etkin bir tedavi olduğunu düşünüyoruz
Keywords
References
- Moretti B, Notarnicola A, Maggio G. The management of neuropathic ulcers of the foot in diabetes by shock wave therapy. BMC Musculoskelet Disord 2009;10:54.
- Demir T, Akıncı B, Yeşil S. Diyabetik ayak ülserlerinin tanı ve tedavisi. Dokuz Eylül Tıp Fakültesi Dergisi 2007;21:63-70.
- Meltem T, Bengü GT, Derya A. Diyabetik yak gelişen ve üriner sistem kandidozu olan bir olgu sunumu. Ege Tıp Dergisi 2009;48(1):57-60.
- Gülman B. Diyabetik ayak. TOTBİD (Türk Ortopedi ve Travmatoloji Birliği Derneği) Dergisi 2003;2(1-2):27-36.
- Yazdanpanah L, Nasiri M, Adarvishi S. Literature review on the management of diabetic foot ulcer. World J Diabetes 2015;6(1):37-53.
- Romeo P, Lavanga V, Pagani D, Sansone V. Extracorporeal shock wave therapy in musculoskeletal disorders: a review. Med Princ Pract 2014;23(1):7-13.
- Wang CJ. An overview of shock wave therapy in musculoskeletal disorders .Chang Gung Med J 2003;26(4):220-32.
- Wang CJ, Wu RW, Yang YJ. Treatment of diabetic foot ulcers:a comparative study of extracorporeal shockwave therapy and hyperbaric oxygen therapy. Diabetes Res Clin Pract 2011;92(2):187-93.
- Omar MT, Alghadir A, Al-Wahhabi KK et al. Efficacy of shock wave therapy on chronic diabetic foot ulcer: a single blinded randomized controlled clinical trial. Diabetes Res Clin Pract 2014;106(3):548-54.
- Wang CJ, Wu CT, Yang YJ et al. Long-term outcomes of extracorporeal shockwave therapy for chronic foot ulcers. J Surg Res 2014:189(2):366-72.
- -72.
Abstract
Diabetic foot ulcers are the most common chronic and serious complication of diabetes. Diabetic foot ulcers are associated with increased morbidity, impaired quality of life, substantial treatment costs and high rates of lower extremity amputations. Management of diabetic foot ulcers include conventional treatments such as patient education, preventive measures, treatment of concomitant infection, local surgical debridement as well as alternative treatments such as hyperbaric oxygen therapy and negative-pressure wound therapy. Here, we report a case of diabetic foot ulcer treated with extracorporeal shock wave therapy (ESWT). We applied ESWT every other day for a total of 9 sessions to a 65-year-old male patient with a history of diabetes mellitus for 15 years and insulin use for treatment of a 2.3 x3.8 cmwound in the lateral side of his right foot which was present for six months. ESWT was applied with 100 shocks per session for each square centimeter of the wound with a frequency of 4 Hz at 2 bar pressure. No serious adverse reactions or complications occurred during the course of treatment. At the post-treatment follow-up visit at 3 months, a significant reduction in perceived pain and a decrease in the wound size (to 1.5 x2.2 cm) and depth were observed. We believe that ESWT is an inexpensive, easy to administer and effective treatment modality for management of diabetic foot ulcers which are associated with high costs, treatment challenges, and require amputation in most patients.
Keywords
References
- Moretti B, Notarnicola A, Maggio G. The management of neuropathic ulcers of the foot in diabetes by shock wave therapy. BMC Musculoskelet Disord 2009;10:54.
- Demir T, Akıncı B, Yeşil S. Diyabetik ayak ülserlerinin tanı ve tedavisi. Dokuz Eylül Tıp Fakültesi Dergisi 2007;21:63-70.
- Meltem T, Bengü GT, Derya A. Diyabetik yak gelişen ve üriner sistem kandidozu olan bir olgu sunumu. Ege Tıp Dergisi 2009;48(1):57-60.
- Gülman B. Diyabetik ayak. TOTBİD (Türk Ortopedi ve Travmatoloji Birliği Derneği) Dergisi 2003;2(1-2):27-36.
- Yazdanpanah L, Nasiri M, Adarvishi S. Literature review on the management of diabetic foot ulcer. World J Diabetes 2015;6(1):37-53.
- Romeo P, Lavanga V, Pagani D, Sansone V. Extracorporeal shock wave therapy in musculoskeletal disorders: a review. Med Princ Pract 2014;23(1):7-13.
- Wang CJ. An overview of shock wave therapy in musculoskeletal disorders .Chang Gung Med J 2003;26(4):220-32.
- Wang CJ, Wu RW, Yang YJ. Treatment of diabetic foot ulcers:a comparative study of extracorporeal shockwave therapy and hyperbaric oxygen therapy. Diabetes Res Clin Pract 2011;92(2):187-93.
- Omar MT, Alghadir A, Al-Wahhabi KK et al. Efficacy of shock wave therapy on chronic diabetic foot ulcer: a single blinded randomized controlled clinical trial. Diabetes Res Clin Pract 2014;106(3):548-54.
- Wang CJ, Wu CT, Yang YJ et al. Long-term outcomes of extracorporeal shockwave therapy for chronic foot ulcers. J Surg Res 2014:189(2):366-72.
- -72.
Details
| Journal Section | Case Reports |
|---|---|
| Authors | |
| Publication Date | May 20, 2016 |
| Published in Issue | Year 2016 Volume: 16 Issue: 2 |