Diyabetik Ayak Ülserlerinin Klinik ve Mikrobiyolojik Verileri

Amaç Diyabetik ayak enfeksiyonları önemli morbidite ve mortalite nedenidir. Tanı ve tedavide gecikmeler ve yetersizlikler hastanede yatış süreleriniuzatmakta, iş gücü kaybı, sakatlık ve psikososyal travmaya neden olmakta, tedavi masrafl arı hastaya ve ülkeye ciddi mali yük getirmektedir.Bu çalışmada, multidisipliner yaklaşımla takip edilen diyabetik ayak tanılı hastaların klinik ve mikrobiyolojik verilerinin değerlendirilmesiamaçlandı. ( Sakarya Tıp Dergisi, 2018, 8(3):531-537 )Gereç veYöntemBu çalışma, 2011-2018 yıllarında Endokrinoloji Kliniği’mizde diyabetik ayak konseyinde takip edilen 36 diyabetik ayak olgusu verileriretrospektif olarak incelendi. Hastalar medikal tedavi ve cerrahi tedavi olarak iki gruba ayrıldı.Bulgular Çalışmaya 24 (%66.6) erkek, 12 (%33.3) kadın toplam 36 hasta alındı. Medikal tedavi ve cerrahi tedavi grubu hastalar karşılaştırıldığında,cerrahi tedaviye gidiş ile hipertansiyon, hiperlipidemi, kültürde bakteri üremesi, sigara kullanımı, lökositoz, cinsiyet, oral antidiyabetik ilaçya da insülin kullanımı gibi parametreler arasında istatistiksel olarak anlamlı fark bulunamadı. Cerrahi tedaviye gidiş ile periferik damarhastalığı, kötü glisemik kontrol, osteomiyelit, sedimantasyon >70 mm/s, nöropati, retinopati, nefropati varlığı arasında anlamlı istatistikselfarklılık saptandı.Sonuç Diyabetik ayak ülserlerinin önlenmesi için eğitim, nöropatinin erken saptanması ve iyi glisemik kontrol ile mümkündür. Diyabetik ayak ülserigelişen olguları amutasyondan korumak için hastalar multidisipliner bir şekilde değerlendirilmeli, donanımlı bir ekip tarafından tedavi vetakibi yapılmalıdır.

Clinical and Microbiological Data of Diabetic Foot Ulcers

Objective Diabetic foot infections are important causes of morbidity and mortality in diabetic patients. Patients’ hospitalization periods are prolonged because of delays and ineffi ciency intreatment. Also, psychosocial trauma and disability are observed, and treatment costs bring serious fi nancial burden to the patient and country. In this study, we aimed to evaluate clinical and microbiological data of diabetic foot patients who were followed up with multidisciplinary approach. ( Sakarya Med J, 2018, 8(3):531-537 ). Materials and Methods In this study, we retrospectively examined 36 diabetic foot cases who were followed-up between 2011and2018 in our Endocrinology Clinic. The patients were divided into two groups as Medical and Surgical Treatment Groups. Results Twenty-four of thepatients (66.6%) were male, and12 (33.3%) were female. No statistically signifi cant difference was found between the patients in terms of undergoing surgical treatment and parameters as hypertension, hyperlipidemia, bacterial overgrowth in culture, smoking, leukocytosis, sex, using oral antidiabetics or insulin, when Medical Treatment and Surgical Treatment Groups were compared. Statistically signifi cant difference was found between the Study Groups in terms of undergoing surgical treatment and peripheral vascular disease, poor glycemic control, osteomyelitis, sedimentation being>70 mm/hr, presence of neuropathy, retinopathy and nephropathy. Conclusion Preventing diabetic foot ulcers is possible with training patients, detecting neuropathy early and providing a good glycemic control. Patients who develop diabetic foot ulcers should be evaluated in a multidisciplinary manner, and the treatment and follow-up should be made by a specialized team.

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