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New Amsterdam Hospital.

Angiology.
Protocol. Diabetic Foot.
Diabetic foot:
It is an Alteration

•Vascular
• infections
• neurotrophic
In the diabetic foot + neuropathy associate.
Diabetic foot

Classification:

1.Vascular.
2.Infections.
3.Neurotrophic
Vascular:
Diabetic micro angiopathy.
Diabetic macro angiopathy
Infections:
.Cellulites.
.Abscess.
.Lymphangitis.
.Diabetic Gangrene
Neurotrophic:

Neurotrophic ulcer.
Diabetic Osteoartopathy
VASCULAR
DIABETIC
FOOT
Diabetic micro angiopathy:

Arteriole mucous
polysaccharides deposit.
.
.
Treatment:

•Arterial Rest.
•Folic acid 5 mg I tab.
O.D.
•Aspirin 125 mg 1 tab
O.D.
•Buscopan 20 mg 1 tabs
B.D.
•Bicomplex 1 tab O.D.
•Sivastatine 20 mg 1
tab. O.D.
Diabetic macro
angiopathy.

Obliterate atherosclerosis .

Diagnosis:

Intermittent claudication
Pulse absence
rest pain
ischemia lesion.
Treatment:

1. Admission.
2. Arterial rest.
3. Aspirin 125 mg 1 tab O.D.
4. Heparin sodium 1 ml – 50
mg S/C B.D.
5. Vasoactive Infusion 6 am
– 6 pm. 500 mg 0,9% Na
CL and Buscopan 20 mg 2
amp.
6. Folic acid 5 mg 1 tab. O.
D.
7. Trental Pentoxiphilin 400
mg 1 tab B.D.
Infection diabetic foot.
Cellulites:
Lymphangitis:
Abscess:
Diabetic Gangrene:
Cellulites:
Infections and inflammatory processes S.C.T
with ant extension limit.

Diagnosis:
• Erythema
• Fever
• Pain
• Oedema
• Functional impotence.
Lymphangitis:
Infections and inflammatory processes
of lymphatic vessel.

Diagnosis:
Erythema,
Fever,
Pain,
Oedema,
Functional Impotence,
Blister,
Necrosis.
Abscess:
Infections and inflammatory processes,
tumour and fluctuate.

Diagnosis:
•Tumour
•Fluctuate
•Pus
•Erythema
•Fever
•Pain
•Oedema
Functional impotence
Diabetic Gangrene:
Tissue destruction and esphacelo formation.

DIAGNOSIS
• Esphacelo
• Pus
• Fluctuation
• Erythema
• Fever
• Pain
• Functional impotence.
Treatment
Infection diabetic foot.
Admission
• Bed rest.
• Diabetic diet.
• Metabolism control:(Lent Insulin, Soluble Insulin accor
Topic infusion: 0,9% NaCl 500 ml and 20 UI soluble insul
Antibiotic: Crystapen 1 mill 4 bb IV Q.I.D
• Flagyl 500 mg 1 bb IV TID
• Ciprofloxacin 500 mg / Norfloxacino 400 mg 1 tab. BD.
Antihistamine: Claritin
Loratidine 5 mg 1 tab O
Clorphenilamina 2 mg 1 tab. BD
• Anti- inflammatory: Ibuprophen ( Motrin 200 mg) 1 tab B
• Bicomplex 1 tab TID
• Tetanus Toxoide.
Nuerotrophic diabetic foot.

Nuerotrophic ulcer:

Ulcer plantar the foot profound, no pain ,


fetid,
infections frequency,
hiperqueratosis around up ulcer.

Diabetic Osteoartropaty:
•Osteoporose
•Osteolise
• Pathological fracture
• Skeletal Kidnapping
Treatment
Nuerotrophic Diabetic Foot.
Admission
• Bed rest.
• Diabetic diet.
• Metabolism control: lent insulin, Soluble insulin according to RBS.
• Topic infusion: 0,9% NaCl 500 ml and 20 UI soluble insulin.
• Antibiotic: Crystapen 1 mill 4 bb IV Q.I.D,
• Flagyl 500 mg 1 bb IV TID
• Ciprofloxacin 500 mg / Norfloxacino 400 mg 1 tab. BD.
• Antihistamine: Claritin
• Loratidine 5 mg 1 tab OD.
• Clorphenilamina 2 mg 1 tab. BD
• Anti- inflammatory: Ibuprophen ( Motrin 200 mg) 1 tab BD.
• Bicomplex 1 tab TID
• Titanic toxoide.
• Trental Pentoxiphilin 400 mg 1 tab B.D
• Heparin sodium 1 ml – 50 mg S/C B.D.
Thank Very much
For Your Attention

Dr. David Ortiz Limonta.


Angiology New Amsterdam Hospital.
28 / 06/2007.
ortizlimonta@yahoo.com
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