Reduction of Gangrene and Amputations in Diabetic Renal Transplant Patients: the Role of a Special Foot Clinic
Autor: | A.V.M. Foster, A. Grenfell, S. Snowden, P.J. Watkins, Michael Edmonds |
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Rok vydání: | 1995 |
Předmět: |
medicine.medical_specialty
Endocrinology Diabetes and Metabolism Documentation Ambulatory Care Facilities Amputation Surgical Gangrene Endocrinology Diabetes mellitus Arthropathy Internal Medicine medicine Humans Diabetic Nephropathies Prospective Studies Kidney transplantation Wound Healing business.industry Podiatry Middle Aged medicine.disease Kidney Transplantation Diabetic Foot Surgery Transplantation Peripheral neuropathy Kidney Failure Chronic Morbidity business Foot (unit) Follow-Up Studies |
Zdroj: | Diabetic Medicine. 12:632-635 |
ISSN: | 1464-5491 0742-3071 |
Popis: | This 4-year prospective study investigated the reasons for high levels of gangrene and major amputation in diabetic renal transplant patients and whether regular multidisciplinary foot care could reduce morbidity. All foot lesions were documented and investigated in 50 diabetic patients, mean age 49.2 +/- 11.0 (SD) years, duration of diabetes 25.3 +/- 9.0 years, time since renal transplantation 60.2 +/- 35.1 months, who attended a special foot clinic monthly for education, vascular and neurological assessment, podiatry and footwear. Foot lesions included: neuropathic ulcers, ischaemic ulcers, traumatic lesions, Charcot's arthropathy, pathological fracture. Treatment included antibiotics, podiatry, footwear, and angioplasty or distal bypass where appropriate. Only 13 patients were deemed ischaemic but peripheral neuropathy was a very common finding (mean VPT 24.8 +/- 12.9 V). Gangrene and major amputations showed a decrease on previous years and healing times for lesions were similar to those previously reported in diabetic patients without renal transplants. The majority of foot lesions, both in soft tissue and bone, were related to neuropathy and trauma and responded well to optimal foot care within the renal unit. Gangrene and major amputations were usually preventable. |
Databáze: | OpenAIRE |
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