Diabetic Foot
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New Amsterdam Hospital. Angiology. Protocol. Diabetic Foot.
Diabetic foot: It is an Alteration
Vascular infections neurotrophic the diabetic foot + neuropathy associate.
Diabetic foot Classification: 1.Vascular. 2.Infections. 3.Neurotrophic
Vascular: iabetic micro angiopathy iabetic macro angiopath
Infections: .Cellulites. .Abscess. .Lymphangitis. .Diabetic Gangrene
Neurotrophic: Neurotrophic ulcer. Diabetic Osteoartopathy
VASCULA R DIABETIC FOOT
Diabetic micro angiopathy: Arteriole mucous polysaccharides deposit. .
.
Treatment: •Arterial Rest. •Folic acid 5 mg I tab. O.D. •Aspirin 125 mg 1 tab O.D. •Buscopan 20 mg 1 tabs B.D. •Bicomplex 1 tab O.D. •Sivastatine 20 mg 1
Diabetic macro angiopathy. Obliterate atherosclerosis
.
Diagnosis:
Intermittent claudication Pulse absence rest pain ischemia lesion.
Treatment: 1. Admission. 2. Arterial rest. 3. Aspirin 125 mg 1 tab O.D. 4. Heparin sodium 1 ml – 50 mg S/C B.D. 5. Vasoactive Infusion 6 am – 6 pm. 500 mg 0,9% Na CL and Buscopan 20 mg 2 amp. 6. Folic acid 5 mg 1 tab. O. D. 7. Trental Pentoxiphilin
Infection diabetic foot. Cellulites: Lymphangitis: Abscess: Diabetic Gangrene:
Cellulites: Infections and inflammatory processes S.C.T with ant extension limit.
Diagnosis: • • • • •
Erythema Fever Pain Oedema Functional impotence.
Lymphangitis: Infections and inflammatory processes of lymphatic vessel.
Diagnosis: Erythema, Fever, Pain, Oedema, Functional Impotence, Blister, Necrosis.
Abscess:
Infections and inflammatory processes, tumour and fluctuate.
Diagnosis: •Tumour •Fluctuate •Pus •Erythema •Fever •Pain •Oedema
Functional impotence
Diabetic Gangrene: Tissue destruction and esphacelo formation.
DIAGNOSIS • • • • • • •
Esphacelo Pus Fluctuation Erythema Fever Pain Functional impotence.
Treatment Infection diabetic foot.
Admission • Bed rest. • Diabetic diet. • Metabolism control :(Lent Insulin, Soluble Insulin ac Topic infusion : 0,9% NaCl 500 ml and 20 UI soluble Antibiotic: Crystapen 1 mill 4 bb IV Q.I.D • •
Flagyl 500 mg 1 bb IV TID Ciprofloxacin 500 mg / Norfloxacino 400 mg 1 tab. BD.
Antihistamine :
Claritin
Loratidine 5 mg 1 tab O Clorphenilamina 2 mg 1 tab. BD
• Anti- inflammatory : • Bicomplex 1 tab TID • Tetanus Toxoide .
Ibuprophen ( Motrin 200 mg) 1 ta
Nuerotrophic diabetic foot. Nuerotrophic ulcer: Ulcer plantar the foot profound, no pain , fetid, infections frequency, hiperqueratosis around up ulcer.
Diabetic Osteoartropaty: •Osteoporose •Osteolise • Pathological fracture • Skeletal Kidnapping
Treatment Nuerotrophic Diabetic Foot.
Admission • Bed rest. • Diabetic diet. • Metabolism control: lent insulin, Soluble insulin according to R • Topic infusion: 0,9% NaCl 500 ml and 20 UI soluble insulin. • Antibiotic: Crystapen 1 mill 4 bb IV Q.I.D,
• •
Flagyl 500 mg 1 bb IV TID Ciprofloxacin 500 mg / Norfloxacino 400 mg 1 tab. BD.
• Antihistamine: Claritin
• •
Loratidine 5 mg 1 tab OD. Clorphenilamina 2 mg 1 tab. BD
• Anti- inflammatory: Ibuprophen ( Motrin 200 mg) 1 tab BD. • Bicomplex 1 tab TID • Titanic toxoide. • Trental Pentoxiphilin 400 mg 1 tab B.D • Heparin sodium 1 ml – 50 mg S/C B.D.
Thank Very much For Your Attention
Dr. David Ortiz Limonta. Angiology New Amsterdam Hospital. 28 / 06/2007. [email protected]
QUESTION & COMENTS PLEASE
?
Diabetic foot: It is an Alteration
Vascular infections neurotrophic the diabetic foot + neuropathy associate.
Diabetic foot Classification: 1.Vascular. 2.Infections. 3.Neurotrophic
Vascular: iabetic micro angiopathy iabetic macro angiopath
Infections: .Cellulites. .Abscess. .Lymphangitis. .Diabetic Gangrene
Neurotrophic: Neurotrophic ulcer. Diabetic Osteoartopathy
VASCULA R DIABETIC FOOT
Diabetic micro angiopathy: Arteriole mucous polysaccharides deposit. .
.
Treatment: •Arterial Rest. •Folic acid 5 mg I tab. O.D. •Aspirin 125 mg 1 tab O.D. •Buscopan 20 mg 1 tabs B.D. •Bicomplex 1 tab O.D. •Sivastatine 20 mg 1
Diabetic macro angiopathy. Obliterate atherosclerosis
.
Diagnosis:
Intermittent claudication Pulse absence rest pain ischemia lesion.
Treatment: 1. Admission. 2. Arterial rest. 3. Aspirin 125 mg 1 tab O.D. 4. Heparin sodium 1 ml – 50 mg S/C B.D. 5. Vasoactive Infusion 6 am – 6 pm. 500 mg 0,9% Na CL and Buscopan 20 mg 2 amp. 6. Folic acid 5 mg 1 tab. O. D. 7. Trental Pentoxiphilin
Infection diabetic foot. Cellulites: Lymphangitis: Abscess: Diabetic Gangrene:
Cellulites: Infections and inflammatory processes S.C.T with ant extension limit.
Diagnosis: • • • • •
Erythema Fever Pain Oedema Functional impotence.
Lymphangitis: Infections and inflammatory processes of lymphatic vessel.
Diagnosis: Erythema, Fever, Pain, Oedema, Functional Impotence, Blister, Necrosis.
Abscess:
Infections and inflammatory processes, tumour and fluctuate.
Diagnosis: •Tumour •Fluctuate •Pus •Erythema •Fever •Pain •Oedema
Functional impotence
Diabetic Gangrene: Tissue destruction and esphacelo formation.
DIAGNOSIS • • • • • • •
Esphacelo Pus Fluctuation Erythema Fever Pain Functional impotence.
Treatment Infection diabetic foot.
Admission • Bed rest. • Diabetic diet. • Metabolism control :(Lent Insulin, Soluble Insulin ac Topic infusion : 0,9% NaCl 500 ml and 20 UI soluble Antibiotic: Crystapen 1 mill 4 bb IV Q.I.D • •
Flagyl 500 mg 1 bb IV TID Ciprofloxacin 500 mg / Norfloxacino 400 mg 1 tab. BD.
Antihistamine :
Claritin
Loratidine 5 mg 1 tab O Clorphenilamina 2 mg 1 tab. BD
• Anti- inflammatory : • Bicomplex 1 tab TID • Tetanus Toxoide .
Ibuprophen ( Motrin 200 mg) 1 ta
Nuerotrophic diabetic foot. Nuerotrophic ulcer: Ulcer plantar the foot profound, no pain , fetid, infections frequency, hiperqueratosis around up ulcer.
Diabetic Osteoartropaty: •Osteoporose •Osteolise • Pathological fracture • Skeletal Kidnapping
Treatment Nuerotrophic Diabetic Foot.
Admission • Bed rest. • Diabetic diet. • Metabolism control: lent insulin, Soluble insulin according to R • Topic infusion: 0,9% NaCl 500 ml and 20 UI soluble insulin. • Antibiotic: Crystapen 1 mill 4 bb IV Q.I.D,
• •
Flagyl 500 mg 1 bb IV TID Ciprofloxacin 500 mg / Norfloxacino 400 mg 1 tab. BD.
• Antihistamine: Claritin
• •
Loratidine 5 mg 1 tab OD. Clorphenilamina 2 mg 1 tab. BD
• Anti- inflammatory: Ibuprophen ( Motrin 200 mg) 1 tab BD. • Bicomplex 1 tab TID • Titanic toxoide. • Trental Pentoxiphilin 400 mg 1 tab B.D • Heparin sodium 1 ml – 50 mg S/C B.D.
Thank Very much For Your Attention
Dr. David Ortiz Limonta. Angiology New Amsterdam Hospital. 28 / 06/2007. [email protected]
QUESTION & COMENTS PLEASE
?
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