This study reports on the case of an elderly patient, with diabetes, and a bullous wound on the left big toe that led to an amputation of the first and second left toes. The amputation was because of deep injury as it was not able to heal with a conventional treatment. After completing the normal treatment and the removal of a bacterial infection in the lesion, the patient underwent a treatment that was based on a hydrogel gel (0.9% saline solution) and hyperbaric oxygen therapy (HBOT). After 60 sessions of the therapy, almost complete closure of the wound was observed. There were no reports of discomfort or infection during the treatment. After seven months of treatment almost complete healing was observed with no infection. This treatment appears to be effective and should be recommended for the treatment of DFUs.
Objective: To apply an intensive and multidisciplinary education protocol in order to decrease, improve, delay or cancel the beginning of neuropathy and the manifestation of lesions in diabetic patients. Methodology: This is a cross-sectional descriptive study carried out at the Diabetes Mellitus Outpatient Clinic and Ward of Santa Marcelina Hospital in Porto Velho. This research was based on cases of patients with Diabetes and Diabetics with Leprosy. The criteria used to include the patients were: being treated with insulin therapy, not to be amputated, being on high medication of the leprosy at the moment of the evaluation and to present nutritional risk classification by the screening. The population was divided into two groups of fifteen patients: eight diabetic patients, four male and four female. Seven diabetics associated with leprosy were 4 males and 3 females. The monofilament test (SemmesWeinstein 10 g) was used as the classification basis. Results and Discussion: Group A, called the intensive care group, began diabetes education work with medical, nutritional and rehabilitation guidelines by a multidisciplinary team for an average period of 15 days in the ward and after discharged with biweekly monitoring. Group B, called conventional care, received the same guidelines in outpatient care and the monitoring followed the quarterly protocol. Both groups were evaluated and reassessed for a period of 180 days in the outpatient clinic. Group A consisted of 8 (100%) patients, 4 (50%) diabetics and 4 (50%) diabetics and leprosy patients. Conclusion: Intensive education in diabetes showed an improvement in the sensitivity, healing and nutritional status of the patients, leading to an improvement in quality of life and disability level, reducing or delaying the beginning of neurological complications. The protocol intensive method demonstrated a 100% improvement in How to cite this paper: Leite, O., Oliveria,
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