Algoritmos de diagnóstico, manejo y tratamiento de pacientes con enfermedad de pie diabético basados en revisión bibliográfica
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2019
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Objetivo: Establecer y realizar algoritmos de diagnóstico, manejo y tratamiento de los pacientes con enfermedad de pie diabético. Métodos: Revisión bibliográfica de bases de datos electrónicas, PUBMED y COCHCRANE, de estudios o protocolos de diagnóstico, manejo y tratamiento de pacientes con pie diabético. Resultados: Se analizaron un total de 50 referencias bibliográficas donde se discuten diferentes abordajes para el diagnóstico, manejo y tratamiento del pie diabético. Conclusiones: Es de suma importancia realizar un diagnóstico adecuado y pronto de los pacientes portadores de enfermedad de pie diabético, determinar con eficacia la etiología que ha provocado la patología para de esta manera enfocar el manejo y el tratamiento de la misma.El abordaje eficaz basado en protocolos y algoritmos de manejo puede ayudar a disminuir la morbimortalidad en estos pacientes y a su vez mejorar las tasas de amputación mayor.El avance de las técnicas quirúrgicas como el hecho de realizar amputaciones menores asociado a procedimientos podoplásticos para mantener la longitud mayor del pie, la utilización de terapias se revascularización tanto endovasculares como quirúrgicas, asociado a la uso de descargas, ortesis y calzados adecuados, además de la terapia física orientada hacia cada paciente, puede llevar a una reinserción más pronta del paciente a la sociedad, además de una disminución en la recurrencia de úlceras en el pie de los pacientes diabéticos.Por todo lo expuesto anteriormente el paciente con pie diabético debe ser abordado de una forma interdisciplinaria; donde juegan un rol muy importante el cirujano vascular, el ortopedista, el podiatra, el endocrinólogo, el fisiatra, el terapeuta físico, el técnico de ortopedia además de todo el personal de enfermería y administrativo.
Inglés: Objetive: Establish and make an algorithm of diagnostic, management and treatment of diabetic foot disease patients. Methods: Bibliographic review of electronic database PUBMED y COCHCRANE, of studies and protocols diagnostic, management and treatment of diabetic foot disease patients. Results:Analysis of 50 bibliographic references where are discuss different assessments for the diagnostic, management and treatment of diabetic foot disease patients. Conclusions: Is very important to make an adequate and prompt diagnosis of the patients with diabetic foot disease, effectively establish the etiology to in this way focus the management and treatment of the same. The effective approach based on protocols and management algorithms can help to reduce morbidity and mortality in these patients and at the same time improve rates of major amputation. The advance surgical techniques such as the fact of performing minor amputations associated with podoplastic procedures to maintain the major length of the foot, the use of both endovascular and surgical revascularization techniques, associated with the use of offloading, orthotics and appropriate footwear, in addition the directed physical therapy for each patient, can lead to a faster reintegration of the patient into society, in addition to decrease in the recurrence of diabetic foot ulcers. For all of this, the patient with diabetic foot disease should management by a interdisciplinary group; where the vascular surgeon, orthopedist, podiatrist, endocrinologist, physiatrist, physical therapist, orthopedic technician and all the nursing and administrative personnel play a very important role.
Inglés: Objetive: Establish and make an algorithm of diagnostic, management and treatment of diabetic foot disease patients. Methods: Bibliographic review of electronic database PUBMED y COCHCRANE, of studies and protocols diagnostic, management and treatment of diabetic foot disease patients. Results:Analysis of 50 bibliographic references where are discuss different assessments for the diagnostic, management and treatment of diabetic foot disease patients. Conclusions: Is very important to make an adequate and prompt diagnosis of the patients with diabetic foot disease, effectively establish the etiology to in this way focus the management and treatment of the same. The effective approach based on protocols and management algorithms can help to reduce morbidity and mortality in these patients and at the same time improve rates of major amputation. The advance surgical techniques such as the fact of performing minor amputations associated with podoplastic procedures to maintain the major length of the foot, the use of both endovascular and surgical revascularization techniques, associated with the use of offloading, orthotics and appropriate footwear, in addition the directed physical therapy for each patient, can lead to a faster reintegration of the patient into society, in addition to decrease in the recurrence of diabetic foot ulcers. For all of this, the patient with diabetic foot disease should management by a interdisciplinary group; where the vascular surgeon, orthopedist, podiatrist, endocrinologist, physiatrist, physical therapist, orthopedic technician and all the nursing and administrative personnel play a very important role.
Descripción
Tesis (especialista en vascular periférico)--Universidad de Costa Rica. Sistema de Estudios de Posgrado, 2019
Palabras clave
ALGORITMOS - USO TEAPEUTICO, ARTERIAS - ENFERMEDADES - TRATAMIENTO, PIE DIABETICO - CLASIFICACION, PIE DIABETICO - DIAGNOSTICO, PIE DIABETICO - ETIOLOGIA, PIE DIABETICO - TRATAMIENTO, PIE DIABETICO - ULCERAS