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March 07-08, 2019 | London, UK
Journal of Diabetology | Volume 3
Annual Summit on
Diabetes, Obesity & Heart
Diabetes, Endocrinology and Metabolic Syndrome
International Conference on
Joint Event
&
Diagnosis and treatment of the postnecrotic phenomenon such as putrefaction and omificafion of the
lower extremities in diabetic patients avoiding amputations
Elias Victor Chammah
University of Buenos Aires, Argentina
T
he necrotic pathology and postnecrotic phenomenon such
as putrefaction (gangrene) is a serious problem in the world
public health. 75-85% of surgical amputations are caused due
to vascular complications of diabetes. From the patients that
undergo amputatios, only 50% survive the first 3 years. By
studying and classifying the temporal structural conformation
of the necrotic pathology and postnecrotic phenomenons,
using firstly anatomo-clinic macroscopic evidence in vivo, and
then through serial macroscopic images valoration by computer
scanning. It was possible to certify that kinetic progresion of
necrotic phenomenons post-ischemia is not cyclic, regular,
neither uniform. Therefore, once the ischemic focus has
developed, thenecrotic phenomenondoes not affect the totality
of the site at once, as little vascularization in the necrotic region
is mantained for a short time. These regions can be repaired,
and afterwards, revascularization can be carried out, reaching
postnecrotic epidermization and avoiding surgical amputation.
A patient R J Age 86, diabetic patient type II. Necrotic pathology
of mixed types 1 and 3 in calcaneous region of the left foot.
Recent necrotic tissue, infiltrated with a bacterial infectious
complication,withfluctuation,withoutcrepitation.Inflammatory
phenomenon around necrotic tissue can be observed. The end
result after applying the surgical intranecrotic windows and total
necrosectomy techniques, amputation was avoided.
Discussion:
Necrotic pathology can not be studied through
histopathology because it causes the destruction of vital
tissues. In order to perform a non-invasive surgical procedure,
it is necessary to recognize exactly the temporal structural
conformation of the necrotic pathology and its topography.
Otherwise an invasive procedure can cause complications. The
serial macroscopic images valoration by computer scanning
method, has proved to be fitting for the observation of
important temporal structural modifications of the necrotic
pathology and postnecrotic phenomenons and it allows to
carry out Intranecrotic non-invasive interventions.
e:
drevchammah@gmail.com