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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2020; 55(04): 389-396
DOI: 10.1055/s-0039-3402462
Artigos de Atualização
Tornozelo e Pé

Pé diabético. Parte 1: Úlceras e Infecções*

Article in several languages: português | English
Ricardo Cardenuto Ferreira 
1   Grupo de Cirurgia do Pé e Tornozelo, Departamento de Ortopedia e Traumatologia da Santa Casa de Misericórdia de São Paulo, Sâo Paulo SP, Brasil
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Resumo

As úlceras e infecções são complicações comuns nos pés dos pacientes diabéticos que já se encontram na fase tardia desta doença sistêmica que se tornou uma verdadeira epidemia do mundo moderno. Neste grupo específico de pacientes, são as infecções que constituem o principal fator envolvido na sequência de eventos que resultam na amputação do membro inferior. A neuropatia periférica (NC) constitui fator determinante na perda da sensibilidade protetora dos pés na fase tardia da doença e, por sua vez, favorece o desenvolvimento das úlceras plantares de pressão (UPP) e a destruição osteoarticular causado pela neuroartropatia de Charcot (NC). A obesidade, a doença arterial periférica (DAP) e a deficiência no sistema imunológico devida aos distúrbios metabólicos do diabetes desempenham papel adicional importante na morbidade desta doença, principalmente no que se refere à amputação dos membros inferiores. É importante para o médico ortopedista compreender que para tentar evitar estas complicações que costumam resultar na amputação da extremidade é necessário estabelecer estratégias de prevenção direcionadas, principalmente, para a educação do paciente diabético e também para medidas protetoras profiláticas.

Palavras-chave

diabetes - pé - úlcera - infecção - amputação

* Trabalho desenvolvido no Grupo de Cirurgia do Pé e Tornozelo, Departamento de Ortopedia e Traumatologia da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil.




Publication History

Received: 25 June 2019

Accepted: 13 September 2019

Article published online:
27 April 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil

 

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