Diyabetik Ayak Yaralarında İnfeksiyon DurumuPencere Açılarak Uygulanan Total Temas Alçılamaİçin Hala Bir Kontrendikasyon mudur?


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Öztürk A. M. , Uysal S., Süer O. , Yıldırım Şimşir I. , Taşbakan M.

Flora, cilt.24, ss.37-45, 2019 (Diğer Kurumların Hakemli Dergileri)

  • Cilt numarası: 24
  • Basım Tarihi: 2019
  • Doi Numarası: 10.5578/flora.67833
  • Dergi Adı: Flora
  • Sayfa Sayısı: ss.37-45

Özet

Introduction: Foot ulcer is an undesirable result of diabetes. Alterations in the foot muscular structures with reduced pain sensation disrupt

the normal push mechanism of the foot and cause an increase in the plantar face pressure. In this case, plantar area ulcers occur.

Long-term and non-healing ulcers lead to infection and amputation. Many studies have shown that methods of reducing pressure and

load in the wound area are beneficial. Although it is shown that the gold standard application is total contact casting, circular closed

plaster application is not recommended because it cannot be followed in infected cases. Follow-up of the wound could be possible by

opening a window in the wound site on the casting. In this study, it was aimed to evaluate the efficacy of plastering by opening a

window at the lesion site in patients with infected diabetic foot wounds.

Materials and Methods: Between 01 February 2012-01 June 2018, cases of plantar ulceration, no wound healing by other methods

and follow-up total contact casting were screened retrospectively among the cases that applied to the Diabetic Foot Council of Ege

University Medical Faculty. Wound area, wound discharge and infection scores of the wound were identified before and after the application

of the cast. Total contact cast complications were recorded.

Results: There were a total of 21 cases on whom total contact cast was performed (6 female, 15 male). Mean duration of DM was

16.9 ± 7.7 years. The average duration of cast for all patients was 31.9 ± 22.6 days and the average number of applications was 3.2

± 2.2. Wound drainage before casting was serous in 17 patients (81%) and purulent in 4 patients (19%). Before total contact cast,

wound area was 22.5 ± 14.6 cm2. Mean post-casting wound area was 8.6 ± 16.9 cm2 (p=0.001). Sixteen (76.2%) cases’s wounds

were completely closed after casting.

Conclusion: The most feared outcome of diabetic foot injuries after insufficient and improper care is amputation. The effective reduction

of pressure and burden in the wound area with total contact casting is extremely important in the healing of diabetic wounds. Total

contact cast applied with a window on the ulcer site is a useful method for healing both the lesion and infection in infected diabetic

foot ulcers.