DİYABETİK AYAK TEDAVİSİNDE BÜTÜNSEL YAKLAŞIM

ABSTRACT

Diabetic foot infections are an important health problem and have serious consequences for both the patient

and the health system. Due to wound nutrition, immune functions and polyneuropathy, the wound healing

process is considerably longer compared to normal patients. The long recovery period, on the other hand,

causes additional problems such as hospital infections and drug toxicities as well as various psychological

problems. Despite effective treatments, it may be resulted in tissue or limb loss, worsening sepsis and death.

In addition to the loss of labor for months, the economic burden is also very heavy as it causes significant

diagnosis, treatment, medication and hospitalization costs. Therefore, wound care and drug therapy alone are

not sufficient to shorten the duration of diabetic foot treatment. All-round treatment is required to evaluate the

patient holistically and to accelerate wound healing. Patient education, diet regulation and blood sugar

regulation are essential. It is possible to increase the immune system response with nutritional support. Protein,

vitamins and trace elements, which are the elements of wound healing, should be replaced. Adequate levels of

albumin and zinc should be ensured. In order to increase wound oxygenation, the hemoglobin level should be

kept at a normal level. Hyperbaric oxygen therapy provides an important contribution to wound healing by

carrying the oxygen it needs. After the wound infection is corrected with appropriate antimicrobial therapy

and wound care based on culture antibiogram, the wound should be re-evaluated with a multidisciplinary

approach, and it should be planned that the patient transition to home care with applications such as

epithelization accelerating and grafting. For all these applications a good hospital organization, a

multidisciplinary team including all support systems with the relevant clinics and treatment guidelines

developed with a holistic approach are required.

Key Words: Diabetic foot, hyperbaric oxygen, nutrition, holistic approach