Comparison of Diabetic Charcot Patients With and Without Foot Wounds

Wukich, Dane K.; Sadoskas, David; Vaudreuil, Nicholas J.; Fourman, Mitchell S.

doi:10.1177/1071100716673985

Cited by 49 publications

(42 citation statements)

References 46 publications

(65 reference statements)

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“…Diabetic foot is a form of macrovascular complications that is very dangerous if left untreated maybe because of the potential for loss of limbs or amputation (Shearman, 2015) that diabetics cause 1.5 million who die with complications of lower limb amputation in 2012. The possibility for amputation complications can occur which begins with the emergence of diabetic foot injuries with infection (Wukich, Sadoskas, Vaudreuil, & Fourman, 2017). A study of 249 people with type 2 diabetes mellitus with a risk factor for wounds was around 55.4% and for diabetic foot injuries around 12%, of which the predictors were daily foot examinations, including age, insulin, shoes and belief (Yusuf et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

The Behavior of Foot Care in Patients With Type 2 Diabetes Mellitus: Applying the Theory of Planned Behaviour

Narmawan

Syahrul

Erika

2018

PHI

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Background: Diabetes mellitus (DM) is a chronic non-infectious disease with complications such as diabetic foot, which has the potential for amputation if left untreated. Theory of Planned Behavior (TPB) is a behavior-based theory that can be applied to DM patients including foot care to minimize risk. Some studies related to TPB particularly about physical activity and diet have been explored, however, studies on foot care are still lacking.Objective: This study aims to apply the Theory of Planned Behavior (Intentions, Attitudes, Subjective Norms and Behavioral Control) on the patient's foot care.Methods: This was a cross sectional descriptive study. There were 93 patients diagnosed with type 2 DM recruited at 9 public health centers (Puskesmas) using accidental sampling on April 2018. TPB-based foot care questionnaire from the IWGDF (International Working Group on Diabetic Foot) Diabetic Foot guidelines was used. Data were analyzed in the form of frequency distribution.Results: Of the total number of respondents, 25 males and 68 females with average age of 53.05 ± 8.04 years, approximately 87.1% of them have the intention to wear footwear according to size. The majority of patients think that washing feet every day is a form of good and positive practice. They also agreed that the family expects the patient to examine the presence of bone / joint protrusions independently and believes that monitoring the foot deformities performed by other DM patients is very important as well as having control that the patient can check for signs of boils in the legs and there is a high likelihood of blisters / sores if the socks used are not suitable.Conclusion: The majority of respondents have good intentions, positive attitudes, social support and behavioral controls for foot care.

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Section: Introductionmentioning

confidence: 99%

The Behavior of Foot Care in Patients With Type 2 Diabetes Mellitus: Applying the Theory of Planned Behaviour

Narmawan

Syahrul

Erika

2018

PHI

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“…24 The presence of an ulcer is a poor prognostic factor regarding the risk of extremity amputation, since it increases in six times the chance of this occurrence in diabetic patients with CN. 25 There are three distinct phases of CN defined and popularized by Eichenholtz: 26 1) acute; 2) subacute or fragmentation with deformity development; and 3) chronic or consolidation with fixed deformities as sequelae (►Table 2). Clinical examination characterizes the acute phase of fragmentation as intense foot edema, increased local temperature and diffuse erythema.…”

Section: Charcot Neuroarthropathymentioning

confidence: 99%

Pé diabético. Parte 2: Neuroartropatia de Charcot

Ferreira

2020

Rev Bras Ortop (Sao Paulo)

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ResumoA neuropatia de Charcot (NC) é uma complicação lamentável e comum de pacientes com diabetes, provavelmente resutlante de uma falta de entendimento adequado dessa condição, que leva ao diagnóstico tardio.A confusão diagnóstica com quadro infeccioso contribui para que o tratamento inicialmente indicado seja equivocado ao prescrever medicação antibiótica ou, eventualmente, drenagem cirúrgica. Não é infrequente que a drenagem inadvertida do suposto abcesso revele que na verdade seu conteúdo é formado apenas de partículas provenientes da destruição osteoarticular. A educação adequada, tanto dos pacientes diabéticos quanto dos médicos responsáveis por prestar atendimento primário a estes pacientes, é fundamental para a correta compreensão das principais características relacionadas ao desenvolvimento da NC. O ortopedista geral é quem, na maioria das vezes, recebe no pronto atendimento os pacientes que se encontram na fase aguda inicial da doença. Por esta razão, esses profissionais devem estar extremamente alertas e serem capazes de identificar os primeiros sinais que permitem diagnosticar precocemente a NC. Em tese, isto possibilitaria reduzir a morbidade desta afecção na medida em que o tratamento adequado venha a ser precocemente instituído.

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“…A perda da sensibilidade protetora dos pés decorrente da neuropatia periférica (5,8,9) e a deformidade óssea desencadeada pela AC podem levar a uma série de consequências que geram impacto negativo na qualidade de vida dos pacientes, dentre elas, as úlceras de pressão (10,11) .…”

Section: Introductionunclassified

“…Quando se leva em conta a localização da lesão, os ossos e articulações do mediopé costumam ser os mais frequentemente afetados (4,5,9,10,16) . As lesões mais comuns no mediopé comprometem as articulações tarsometatarsais (Lisfranc) e recebem a denominação anatômica de lesões do tipo I (14) .…”

Section: Introductionunclassified

“…Caracteristicamente, as lesões do tipo II levam ao colapso do arco plantar, resultando na formação de proeminências ósseas localizadas nas áreas de apoio do pé (17) , relacionadas à seguinte sequência de eventos: 1) proeminência óssea plantar; 2) ausência de sensibilidade protetora; 3) úlcera de pressão; 4) infecção secundária das úlceras; 5) amputação da extremidade; 6) septicemia; e 7) óbito por falência de múltiplos órgãos (10,16) . O objetivo deste estudo é avaliar a eficácia do protocolo sistematizado desenvolvido na nossa instituição para o tratamento da artropatia de Charcot (AC), do tipo II.…”

Section: Introductionunclassified

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Systematic treatment of charcot arthropathy of the midfoot

Fernandes

Costa

2018

Sci J Foot Ankle

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Objective: The objective of this study was to evaluate the efficacy of the systematic protocol developed in our institution for the treatment of Charcot arthropathy (CA) of the midfoot, specifically for cases anatomically classified as Brodsky type II. Methods: Sixty patients with type II CA were treated in the period between 1997 and 2017 following a systematic protocol adopted at our institution. Two patients (3%) were lost to follow-up, leaving a total of 58 patients with 64 feet (six had bilateral involvement). The mean follow-up time was 31 months (range 12 to 150), and the mean age was 55 years (range 27 to 73). Conservative treatment was indicated in 41/64 of the extremities (64%), and surgical treatment was indicated in 23/64 of the extremities (36%). We considered the result as satisfactory when the patient was able to walk independently, placing full body weight on the foot. The result was considered unsatisfactory when the affected extremity presented clear instability and was deformed to the point that it was not possible to fit it in a stabilizing orthosis or for the patient to place their weight on the foot during walking as well as when it was necessary to perform an amputation. Results: We obtained a satisfactory outcome in 54/60 patients (90%) and in 58/64 feet (91%). In 19/23 of the operated feet (83%) and 39/41 of the conservatively treated feet (95%), the result was atisfactory. Conclusion: The systematic treatment protocol developed at our institution allows achievement of a favorable prognosis regarding the clinicalfunctional outcome of type II CA, with conservative treatment being sufficient in most cases. Level of Evidence IV; Prognostic Study; Retrospective study.

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Comparison of Diabetic Charcot Patients With and Without Foot Wounds

Abstract: Level III, retrospective, case-control study.

Cited by 49 publications

References 46 publications

The Behavior of Foot Care in Patients With Type 2 Diabetes Mellitus: Applying the Theory of Planned Behaviour

The Behavior of Foot Care in Patients With Type 2 Diabetes Mellitus: Applying the Theory of Planned Behaviour

Pé diabético. Parte 2: Neuroartropatia de Charcot

Systematic treatment of charcot arthropathy of the midfoot

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