การรักษาแผลที่เท้าในผู้ป่วยเบาหวานด้วยวิธีลดแรงดันที่แผล ในโรงพยาบาลกระทุ่มแบน

บทคัดย่อ

Objective : To study off-loading method at feet ulcer in diabetic patients

Methods : This study is based on descriptive study design. The samples (28) were patients at Kra-tumban Hospital who had sent to diabetic foot clinic during September 2008 to September 2009

Results : There were 28 patients ; 11 males and 17 females. The ulcers have recovered in 5 patients; 2 patients used total contact cast and 3 patients used alternative off loading technique with modified off-loading insole at the ulcerated region, adhesive backed felt, toe-pillow and healing shoe. The recurrent ulcers have not been reported in these 5 patients. There were 4 patients who had no feet ulcer but were classified in 3^rd level of risk. These 4 patients had abnormal feet and needed special shoes. There were also 4 patients who lost follow up, one of them used removable cast and clinical got worse led to below knee amputation. Three other patients had better ulcers but they denied using special shoes. There were 8 patients who had got special shoe and their ulcers were better. Another 7 patients were waiting for special shoes at Rachprachasamasai foundation. 

Conclusion : There are many important factors for feet ulcer management in diabetic patients. The feet pressure reduction (off-loading) must be concerned after infection and vascular obstruction have been already treated. The proper special shoes were the method of choice for feet pressure reduction. Finally, regularly care and follow up were need for good results.