The Treatment of Neuropatic Diabetic Ulcer at the Surgery Department and Diabetic Foot Centre
Rušavý Z., Čechurová D., Holubec L., Lacigová S., Jankovec Z., Třeška V.
I. interní klinika Lékařské fakulty UK a FN, Plzeň, přednosta prof. MUDr. K. Opatrný, jr., CSc. Chirurgická klinika Lékařské fakulty UK a FN, Plzeň, přednosta prof. MUDr. V. Třeška, DrSc. |
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Summary:
The aim of the study was to evaluate the treatment of neuropathic diabetic ulcer at the surgery
department and the treatment at the diabetic foot centre at dismissal time and 3 months after the
dismissal. Methods: For assessment of treatment success parameters of glucose control were used
(average of daily blood glucose values, glycosylated haemoglobin - HbAlC and glycosylated prote-
in), healing of ulcers (Wagner classification), hospitalisation time and number of amputations. 22
diabetic patients at the centre and l7 patients at the surgical department were observed in this
investigation. There was no difference between the groups as for the age, glucose control (HbAlC ),
and severity of diabetic ulcers (Wagner 3 - 4). Local and antibiotic therapies were the same ones.
Results as median and difference 75
th
and 25
th
percentile were evaluated by Wilcoxon test for
paired data within the groups and by Man-Whitney test between both of the groups. Results: In
the both group the diabetic control and ulcer healing were significantly improved during hospita-
lisation period, 3 months after discharge deteriorate diabetic control and ulcer healing stagnated,
however, only in the group treated at the surgical department. The hospitalisation time was
significantly longer in the surgical group in comparison with the centre group [median 52 days
(35)] vs. [median 31 days (38)], p < 0.01. Amount of transmetatarsal and higher amputations was
lower at the foot centre in comparison with the surgical group (1 vs. 7). Statistical evaluation was
not used for low amount of amputations. Conclusion: Team approach at the centre of diabetic foot
is effective in the treatment of diabetic foot ulcers, significantly shortened the hospital stay,
probably decrease amount of amputations. Three months after discharge the diabetic control and
ulcer healing were significantly better in patients treated at the diabetic foot centre.
Key words:
Diabetic foot - Diabetic foot centre - Hospitalisation time - Diabetic control
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