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2019, Número 3

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Cir Gen 2019; 41 (3)


Exploración quirúrgica segmentaria para el control de la infección profunda de tejidos blandos en el pie diabético complicado

Rebollar-González RC, Torres-López E

Idioma: Ingles.
Referencias bibliográficas: 34
Paginas: 157-167
Archivo PDF: 413.76 Kb.


RESUMEN

México ocupa el sexto lugar en diabetes tipo 2 en el mundo; el primer lugar en obesidad infantil y adulta considerando esto como el principal factor de riesgo de desarrollar diabetes, con especial importancia de pie diabético, ya que uno de cada seis pacientes presentará pie diabético complicado por una úlcera plantar, el cual representa el principal factor de riesgo de pérdida de la extremidad. El paciente que presenta pie diabético complicado por infección profunda de tejidos blandos es susceptible al salvamento de la extremidad, siempre y cuando su diagnóstico sea oportuno, cumpla con criterios de inclusión adecuados y la cirugía sea completa y resolutiva. En el siguiente estudio se hace una propuesta de tratamiento quirúrgico con base en la exploración completa del pie, a fin de evitar incisiones amplias que devascularicen los tejidos y que además permitan el drenaje completo de las colecciones purulentas o abscesos, teniendo hasta este momento una tasa de éxito alta con un costo menor que el tratamiento estandarizado.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Hernández AM, Gutiérrez JP, Reynoso NN. Diabetes mellitus en México. El estado de la epidemia. Salud Pública de Mex. 2013; 55: S129-S136.

  2. Malone M, White JM, Taylor L, Schembri AM, Lazzarini P, Lau NS, et al. Update on the Inaugural Sydney Diabetic Foot Conference 2013. Int J Low Extrem Wounds. 2013; 12: 242-244.

  3. Bakker K, Apelqvist J, Schaper NC; International Working Group on Diabetic Foot Editorial Board. Practical guidelines on the management and prevention of the diabetic foot 2011. Diabetes Metab Res Rev. 2012; 28: 225-231.

  4. Atlanta: Centers for Disease Control. National Diabetes Fact Sheet, 2007.

  5. Georgia: US Centers for Disease Control and Epidemiology; 2007.

  6. Lipsky BA, Berendt AR, Cornia PB, Pile JC, Peters EJ, Armstrong DG, et al. 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2012; 54: e132-e173. doi: 10.1093/cid/cis346.

  7. Armstrong DG, Lipsky BA. Diabetic foot infections: stepwise medical and surgical management. Int Wound J. 2004; 1: 123-132.

  8. Fuji M, Terashi H, Yokono K. Surgical treatment strategy for diabetic forefoot osteomyelitis. Wound Repair Regen. 2016; 24: 447-453.

  9. Ito R, Suami H. Overview of lymph node transfer for lymphedema treatment. Plast Reconstr Surg. 2014; 134: 548-556.

  10. Bennett MS. Lower extremity management in patients with diabetes. J Am Pharm Assoc (Wash). 2000; 40: S40-eS41.

  11. Watkins PJ. The diabetic foot. BMJ. 2003; 326: 977-e979.

  12. Kato H, Takada T, Kawamura T, Hotta N, Torii S. The reduction and redistribution of plantar pressures using foot orthoses in diabetic patients. Diabetes Res Clin Pract. 1996; 31: 115-118.

  13. Hong JP, Oh TS. An algorithm for limb salvage for diabetic foot ulcers. Clin Plastic Surg. 2012; 39: 341-352.

  14. Lavery LA, Armstrong DG, Wunderlich RP, Mohler MJ, Wendel CS, Lipsky BA. Risk factors for foot infections in individuals with diabetes. Diabetes Care. 2006; 29: 1288-1293.

  15. Malik RA, Tesfaye S, Ziegler D. Medical strategies to reduce amputation in patients with type 2 diabetes. Diabet Med. 2013; 30: 893-900.

  16. Sohn MW, Budiman-Mak E, Stuck RM, Siddiqui F, Lee TA. Diagnostic accuracy of existing methods for identifying diabetic foot ulcers from inpatient and outpatient datasets. J Foot Ankle Res. 2010; 3: 27.

  17. Kerr M, Rayman G, Jeffcoate WJ. Cost of diabetic foot disease to the National Health Service in England. Diabet Care. 2014; 31: 1498-1504.

  18. Cavanagh P, Attinger C, Abbas Z, Bal A, Rojas N, Xu ZR. Cost of treating diabetic foot ulcers in five different countries. Diabetes Metab Res Rev. 2012; 28: 107-111.

  19. Gaskin DJ, Thorpe RJ Jr, McGinty EE, Bower K, Rohde C, Young JH, et al. Disparities in diabetes: The nexus of race, poverty, and place. Am J Pub Health. 2014; 104: 2147-2155.

  20. Skrepnek GH, Mills JL, Armstrong DG. Foot-in-Wallet Syndrome: Tripped up by "cost saving" reductions. Diabetes Care. 2014; 7: e196-e197.

  21. Skrepnek GH, Mills JL Sr, Armstrong DG. A diabetic emergency one million feet long: disparities and burdens of illness among diabetic foot ulcer cases within emergency departments in the United States, 2006-2010. PLoS One. 2015; 10: e0134914.

  22. Pickwell KM, Siersma VD, Kars M, Holstein PE, Schaper NC, and on behalf of the Eurodiale consortium. Diabetic foot disease: impact of ulcer location on ulcer healing. Diabetes Metab Res Rev. 2013; 29: 377-383.

  23. Gaspari R, Dayno M, Briones J, Blehar D. Comparison of computerized tomography and ultrasound for diagnosing soft tissue abscesses. Crit Ultrasound J. 2012; 4: 5. https://doi.org/10.1186/2036-7902-4-5.

  24. Giurato L, Meloni M, Izzo V, Uccioli L. Osteomyelitis in diabetic foot: a comprehensive overview. World J Diabetes. 2017; 8: 135-142. https://doi.org/10.4239/wjd.v8.i4.135.

  25. Hietbrink F, Bode LG, Riddez L, Leenen LP, van Dijk MR. Triple diagnostics for early detection of ambivalent necrotizing fasciitis. World J Emerg Surg. 2016; 11: 51. https://doi.org/10.1186/s13017-016-0108-z.

  26. Kaafarani HM, King DR. Necrotizing skin and soft tissue infections. Surg Clin North Am. 2014; 94: 155-163. https://doi.org/10.1016/j.suc.2013.10.011.

  27. Ndosi M, Wright-Hughes A, Brown S, Backhouse M, Lipsky BA, Bhogal M, et al. A. Prognosis of the infected diabetic foot ulcer: a 12-month prospective observational study. Diabet Med. 2018; 35: 78-88. https://doi.org/10.1111/dme.13537.

  28. Nelson EA, O'Meara S, Craig D, Iglesias C, Golder S, Dalton J, et al. A series of systematic reviews to inform a decision analysis for sampling and treating infected diabetic foot ulcers. Health Technology Assessment (Winchester, England). 2006; 10: 12. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/16595081.

  29. Nissen N, Balachandran P, Chennai AH, Friedrich JB, Misiakos EP, Bagias G, et al. Early diagnosis and surgical treatment for necrotizing fasciitis: a multicenter study. 2017; 4: 5. https://doi.org/10.3389/fsurg.2017.00005.

  30. Peters EJ. Pitfalls in diagnosing diabetic foot infections. Diabetes/Metabolism Research and Reviews. 2016; 32: 254-260. https://doi.org/10.1002/dmrr.2736.

  31. Rudkjøbing VB, Thomsen TR, Xu Y, Melton-Kreft R, Ahmed A, Eickhardt S, et al. Comparing culture and molecular methods for the identification of microorganisms involved in necrotizing soft tissue infections. BMC Infectious Diseases. 2016; 16: 652. https://doi.org/10.1186/s12879-016-1976-2.

  32. Verhoeven S, van Ballegooie E, Casparie AF. Impact of late complications in type 2 diabetes in a Dutch population. Diabet Med. 1991; 8: 435-438. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/1830527.

  33. Rodríguez BR, Reynales SL, Jiménez RJ, Juárez MS, Hernández AM. Costos directos de atención médica en pacientes con diabetes mellitus tipo 2 en México: análisis de microcosteo. Rev Panam de Salud Pública. 2010; 28: 412-420.

  34. Lavery LA, Armstrong DG, Wunderlich RP, Tredwell J, Boulton AJ. Diabetic foot syndrome: evaluating the prevalence and incidence of foot pathology in Mexican Americans and non-Hispanic whites from a diabetes disease management cohort. Diabetes Care. 2003; 26: 1435-1438. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12716801.




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