Transcript Diagnosticul tulburarilor macrocirculatorii in piciorul

ROLUL TERMOGRAFIEI IN DIAGNOSTICAREA
SI EVALUAREA TRATAMENTULUI IN PICIORUL
DIABETIC
DR. Gh.O. SERBU- BQCT
(Board Qualified Clinical Thermographer)
7/6/2015
“ Utilizarea termografiei ca metoda de
investigare neinvaziva se va dezvolta in mod
spectaculos in urmatorii 15 ani, medici de
toate specialitatile o vor utiliza pentru a
vizualiza si localiza anomalii cum ar fi tumorile
si blocajele in circulatia singelui, anomalii
invizibile cu alte tehnologii
 Jerry Williams (profesor de oncologie la
J.Hopkins University)
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DIAGNOSTICUL TULBURARILOR
MACROCIRCULATORII IN PICIORUL DIABETIC
Eco-doppler
Angiografia cu
substante de contrast
DIAGNOSTICUL MODIFICARII MICROCIRCULATIEI
SI A VIABILITATII TISULARE
Metode indirecte
 - masurarea transcutanata a oxigenului
tisular
 -determinarea saturatiei in oxigen
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DIAGNOSTICUL MODIFICARII MICROCIRCULATIEI
SI A VIABILITATII TISULARE
Metode directe
 - angiografia cu fluoresceina
 - clearance radioizotopic
 - termografia
DIABETIC FOOT AMPUTATION:THE NEED FOR AN OBJECTIVE
ASSESSMENT TOOL
2003 HEALTH MANAGEMENT PUBLICATONS
Termography or imaging heat generated by
tissues using highly sophisticated infrared
camera systems can be used to assess tissue
viability.
 Such systems generated thermal maps with a
color to indicate “hot” spots and are incredibly
helpful in managing soft tissues disease
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EVALUAREA TERMOGRAFICA A PICIORULUI
DIABETIC
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Tulburari de circulatie superficiala
Tulburari ale circulatiei capilare
Determinarea viabilitatii tisulare
Diagnosticarea osteomielitei in caz de gangrena
Stabilirea liniei de amputatie
Intraoperator – viabilitatea lamboului cutanat
Urmarirea eficientei tratamentului medicamentos
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: Eco doppler periferic = « la nivelul membrului
inferior drept - fluxuri normale cu semnal
trifazic de la femurala comuna pina la tibiala
posterioara proximala unde indicele
gamba/brat este nedeterminabil dat fiind
faptul ca artera este necomprimabila la
presiunea de 200 mmHg ».
ARTERIOGRAFIE
 trunchi
tibio-peronier sever ateromatos,
stenotic pe toata lungimea
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S-a intervenit chirurgical si s-a practicat debridarea leziunii pina
in tesutul sanatos, cu indepartarea tendonului achilean. Se
reconstruieste tendonul cu manson recoltat din fascia lata.
Se practica arteriotomie cu trombarteriotomie la nivelul arterei
poplitee si cateterizarea cu sonda Fogarty a arterei femurale
superficiale retrograd si arterei poplitee posterioare. Se
practica transfer liber muscular cu lambou compus din muschi
dorsal prima digitatie a dintatului anterior. Muschiul dintat
anterior este plasat in jurul tendonului reconstruit iar muschiul
dorsal mare acopera defectul tegumentar
DIABETIC FOOT AMPUTATION:THE NEED FOR AN OBJECTIVE
ASSESSMENT TOOL
2003 HEALTH MANAGEMENT PUBLICATONS
THERMOGRAPHY and later the clearance of
radioisotope were successfully used to
determine the viability of skin flaps for belowknee amputations.
 The combination of these techniques yielded a
success rate of 93 percent for transfibial
amputation.
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Despite these success in Scotland, these
techniques either singly or in combination are
not reported in use in current literature, witch
may be because both methods need specialist
skills and techniques
 Such as study would be worthwhile to the
literature; the demonstrated potential suggests
the need for it.
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THERMOGRAPHIC IMAGING AND SKIN
OXYGEN SATURATION MEASUREMENTS
APPLIED TO ROUTINE CLINICAL
VIABILITY
DK Harrison, JM Hanson, IE Hawthorn
Regional Medical Physics Department and
†Surgical Directorate, University Hospital of North
Durham,
Durham DH1 5TW, UK.
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THERMAL IMAGING IN DIABETIC FOOT ULCERATION
 JR Harding DF Wertheim
 RJ Williams,
 JM Melhuish, KG Harding
X-Ray Department of Clinical Radiology, Royal Gwent & St
 Woolos Hospitals, Newport, Gwent.
 School Of Electronics, University of Glamorgan,
 Pontypridd, Mid Glamorgan.
Wound Healing Research Unit, University of Wales College
 Of Medicine, Cardiff, South Glamorgan
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THERMOCHROMIC LIQUID CRYSTAL
THERMOGRAPHY: APPLICATION IN NEUROPATHIC
ASSESSMENT OF THE DIABETIC FOOT
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Bharara, M.1, Cobb, J.E. 1, Claremont, D.J. 1 , Anderson, A.M2
1Academic Biomedical Engineering Research Group, Bournemouth
University, UK. 2Mechanical Engineering Department, Union College,
Schenectady, NY, USA
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Thermography and Thermometry in the Assessment of Diabetic
Neuropathic Foot: A Case for Furthering the Role of Thermal
Techniques
M. Bharara, MSc Academic Biomedical Engineering Research
Group, Bournemouth University, Bournemouth, UK, J. E. Cobb,
PhD, CEng Academic Biomedical Engineering Research Group,
Bournemouth University, Bournemouth, UK D. J. Claremont,
MSc, DPhil, FIPEM Academic Biomedical Engineering Research
Group, Bournemouth University, Bournemouth, UK
BOALA ARTERIALĂ PERIFERICĂ LA PACIENŢII
DIABETICI
 A. Pletea1, C.Pleşa2, C.N. Neacşu2, Noemi
Pletea3, Paula Popa2
 Jurnalul de Chirurgie, Iasi, 2006, Vol. II, Nr. 3
[ISSN 1584 – 9341]
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