SALVAGING DIABETIC FOOT

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Locally devised topical vacuum therapy unit in a mission hospital

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SALVAGING DIABETIC FOOT: 

SALVAGING DIABETIC FOOT A new cost - effective method Dr. J. Gnanaraj MS, MCh, FARSI, FICS , FIAGES

DIABETIC FOOT: 

DIABETIC FOOT 15% of patients with Diabetes develop Foot ulcers {Harrisons p 2125 15 th Edition} After 25 years of Diabetes there is 11% risk of lower limb amputation

PATHOPHYSIOLOGY: 

PATHOPHYSIOLOGY Peripheral neuropathies- motor, sensory & autonomic Macrovascular Arteriopathies - athersclerosis obliterans producing ischemia

PowerPoint Presentation: 

Microangiopathies - arterioles and basement membrane Tissue glycosylation

PATHOGENESIS: 

PATHOGENESIS

Controlled Negative Pressure therapy: 

Controlled Negative Pressure therapy Moist protected environment Reduces peripheral edema Stimulates circulation of the wound bed Decreases bacterial colonization Increases rate of granulation

History: 

History Wake Forest University school of Medicine Salem NC (1990) While studying stress to tissues In 1997 3 articles by Morykwas and Argenta about VAC system

Mechanisms: 

Mechanisms Basic cellular functions like oxygen transport, cellular transduction signaling are at the cellular level Chronic wounds have impaired circulation and dead tissue

The commercial ones: 

The commercial ones

Mr. Vellangiri: 

Mr. Vellangiri Came with severe sepsis, gangrene and very sick Was initially planned for BK amputation

Topical vacuum therapy: 

Topical vacuum therapy Locally designed machine Longer cycles {from the recommended ones} Specially designed for placing the entire limb

The progress: 

The progress The sepsis settled down Sugars were well controlled Granulations appeared

Progress: 

Progress The proximal would healed Grafting was carried out

The result: 

The result Was able to avoid amputation Less expensive as less of dressing materials were used

The advantages: 

The advantages Less expensive Entire limb could be treated with vacuum therapy