Introducere. Riscul de fractura a piciorului la persoanele cu diabet zaharat este legat de existenta neuropatiei
diabetice periferice, ce reprezintă un factor important in dezvoltarea defectelor piciorului, infecțiilor si
amputațiilor de membre inferioare
Scop. Analiza defectelor posttraumatice in asociere cu polineuropatia diabetica a membrului pelvin si posibilități
de acoperire a acestora.
Material și metodă. Cei 15 pacienți au fost împărțiți in 4 categorii: lambouri de vecinătate, lambouri la distanta,
plastie cu piele libera despicata, amputație. Parametrii urmăriți sunt: vârsta, sex, tipul diabetului zaharat,
localizarea.
Rezultate. 4 femei si 11 bărbați au fost repartizați in 4 categorii după tipul intervențiilor chirurgicale: plastii
cu lambouri de vecinătate 4, lambouri la distanta 2, plastie cu piele libera despicata 7, amputație 2. Din lotul
total de pacienți cu diabet zaharat tip II au fost 12 pacienți, iar 3 pacienți cu diabet zaharat insulin-dependent.
Cei 15 pacienți, care au beneficiat de reconstrucții prin lambouri, au avut defecte la gamba distala si picior, iar
pacienții care au suferit amputație per primam, au avut leziuni la nivelul gambei proximale, care au constat in
necroze tegumentare si de părți moi, cu afectare osoasa si osteita, semn al gradului avansat al afectării vasculare.
La pacienții care au beneficiat de plastie cu piele libera despicata, majoritatea defectelor au fost la nivelul gambei
si erau prezente leziuni tegumentare.
Concluzii. Defectele posttraumatice la pacienții cu polineuropatii diabetice a membrului pelvin pot fi rezolvate
prin plastie cu piele libera despicata, reconstrucții prin lambouri, astfel rata amputațiilor scade.
Introduction. Leg fracture risk at people with diabetes is related to the existence of diabetic peripheral
neuropathy, which is an important factor in the development of foot defects, infections and amputations of
lower limb.
Purpose. Analysis of the posttraumatic damage coupled with diabetic polyneuropathy of the pelvic limb and
possibilities of healing the defects.
Material and methods. The 15 patients were divided in 4 subgroups according to the type of surgical procedure
performed: split skin grafts, the neighboring flaps, distant flaps, amputation at different levels. The descriptive
parameters included: age, gender, the presence of type I or type II diabetes, the location.
Results. 15 patients included in this study, out of which 4 women and 11 men were divided into four subgroups
based on type of performed surgeries: the neighboring flaps - 4, distant flaps - 2, split skin grafts - 7, amputation
in 2 cases. 12 patients had diabetes of type II, and the remaining 3 patients were insulin dependent. The 6
patients who had reconstruction through flaps, had distal defects (foot or ankle), whereas the patients who
suffered per primam amputation had lesions at the ankle which were skin and soft tissue necrosis, with bone
disease and osteitis, with signs of severe vascular disease. The majority of patients who had benefited from split
skin grafts, suffered from skin lesion at the ankle level.
Conclusions. Posttraumatic defects in patients with diabetic polyneuropathy of the pelvic limb can be treated
through flaps or split skin grafts, so the amputation rate decreases significantly.
