Clinical Results in the City Hospital Model for the Treatment of Diabetic Foot Infections: Mutlidisciplinary Approach in the Diabetic Wound Service

Abstract

Objectives: We herein aimed to present the clinical findings of diabetic patients who were followed up and treated with a multidisciplinary approach in the Diabetic Foot and Pressure Sore Care Clinic. Patients and Methods: Between July 2018 and 2018, 91 (19 males, 72 females; mean age 59.26,14 years) patients under prospectively followed-up with diabetic foot infection were retrospectively screened and included in the study. All cases were selected according to higher and/or grade 2 Wagner Classification with documented diabetic foot infection. The data, obtained by the same surgical team pre- and post-operatively in patients who had administered to the Diabetic Foot and Pressure Sore Care Clinic; age, sex, education level, blood glucose level, biomarkers of infection, co-morbidities, complications, applied surgical treatment options, length of hospital stay, follow-up period. Results: According to Wagner's diabetic wound classification, half of the cases were in grade IV. It was noteworthy that almost half of the patients with an average hospital stay of 36.8 ± 23.01 days were only literate. Similar data were obtained in terms of neuropathy, vasculopathy, Charcot arthropathy, and smoking. Satisfactory results were obtained with 42.2% amputation without limb-sparing surgical treatment methods. Conclusion: In the treatment of diabetic foot infection, which is the most common complication it is possible to achieve satisfactory results by approaching the disease multidisciplinary.

Keywords

• Diabetes Mellitus,Diabetic Foot,Infection,Foot Ulcers

Diyabetik Ayak Enfeksiyonlarının Tedavisine Dair Şehir Hastanesi Modelinde Klinik Sonuçlarımız: Diyabetik Yara Servisi’nde Mutlidisipliner Yaklaşım

Abstract

Amaç: Bu çalışmada, Diyabetik Ayak ve Bası Yarası Servisi’nde yatırılarak multidisipliner yaklaşımla takip ve tedavileri yapılan diyabetik hastaların klinik bulgularını sunmayı amaçladık. Gereç ve Yöntem: Temmuz 2018 ile Aralık 2019 tarihleri arasında diyabetik ayak enfeksiyonu tanısı ile kliniğimizde yatarak tedavi edilen prospektif takipli hastaların verileri retrospektif olarak kaydedildi. Wagner evre 2 ve üzeri diyabetik ayak enfeksiyonu ile başvuran ve kriterleri sağlayan 91 olgu çalışmaya dahil edildi. Olgular, demografik (yaş, cinsiyet, eğitim durumu vb.) ve klinik (anamnez, kan glukoz seviyesi, enfeksiyon belirteçleri, ek morbiditeler, postoperatif komplikasyonlar, uygulanan cerrahi tedaviler, hastanede kalış süresi ve takip süresi) olarak değerlendirilerek verileri kaydedildi. Bulgular: Olguların 72’si kadın, 19’u erkek iken yaş ortalaması 59.26.14 yıl ve ortalama takip süresi 12.52±4.98 ay idi. Wagner diyabetik yara sınıflamasına göre olguların yarısı evre IV idi. Ortalama hastanede kalış süresi 36.8±23.01 gün olan hastaların neredeyse yarısının sadece okur-yazar olması dikkat çekiciydi. Nöropati, vaskülopati, charcot artropatisi ve sigara kullanımı yönünden benzer veriler elde edildi. %42.2 oranında ampütasyon yapılmadan uzuv koruyucu cerrahi tedavi yöntemleri ile tatmin edici sonuçlar elde edildi. Sonuç: Kronik bir hastalığın en sık komplikasyonu olan diyabetik ayak enfeksiyonunun tedavisinde, hastalığa multidisipliner yaklaşarak yüz güldürücü sonuçlar elde etmek mümkündür.

Keywords

• Diyabetes Mellitus,Diyabetik Ayak,Enfeksiyon,Ayal Ülseri

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