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Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular

2008, Number 1

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Rev Mex Angiol 2008; 36 (1)

Síndrome mano del diabético. Reporte de casos, Toluca, Estado de México

Montes de Oca NJ, Córdoba GH, Mondragón CMA, Jaramillo GA, López OE, Torres CML, Ochoa GG, Rogel RJ

Language: Spanish
References: 26
Page: 14-20
PDF size: 399.20 Kb.


ABSTRACT

Objetive: To determine the behavior clinical, diagnosis, and therapeutic used in the Medical Center "Lic. Adolfo Lopez Mateos" on the Syndrome Hand of the diabetic.
Patients and method: Prospective study of 20 patients entered to the Service of Angiology and Vascular Surgery of the period of 1 of September from 2005 to the 30 of March of 2007, with vascular alterations, infectious and neuropathic of the superior extremities.
Seat: Medical Center "Lic. Adolfo Lo pez Mateos" of the Instituto de Salud del Estado de Mexico, Toluca, Mexico.
lnclusion criteria: Diabetic patients with vascular alterations, infectious and neuropathics of the superior extremities.
Criteria of no inclusion: Noncarrying patients of diabetes mellitus.
Results: Of the 20 patients, 11 patients of masculine sex and nine of feminine sex, with an average of age of 51.8 years, with a predominance ofthe diabetes mellitus type II in 16 patients (80%); the average of evolution of the diabetes mellitus was 17 years approximately, with manifestations of dibetic neuropathy and peripheral vascular disease in 75% of the patients; the traumatism like factor predecessor of infectious process with direct injury on the skin in 13 patients; another important factor is the metabolic uncontrol with one hyperglycemia central 251 average of mg/dL and with a percentage of 10.4 of hemoglobin glicosilada; the isolated germ of the wounds in a 55% is estafilococo aureus; the time average from the injury to the valuation of our service was of 7.9 days, with a 50% of medical surgical handling with fascitomy and debridement of the infected weave and only in two cases (10%) requiring greater amputation at forearm level. By the type of population that goes to our hospitable center they belong to rural and suburban populations with low socioeconomic and cultural means. They were not counted on death during the pursuit.
Conclusions: The syndrome of hand of the diabetic appears frequently in adult young people in productiue stage, with diabetes mellitus type ll, with chronic metabolic uncontrol, alredy with delayed complications of the diabetes like neuropathies and arterial disease, the specialized consultation is delayed with advanced infectious process with high risk of amputation and elevated rate of morbimortality.


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