RESUMO
AIM OF THE STUDY: Based on their experience using Versajet for debridement of chronic wounds, the Authors set up a study protocol to verify whether the hydro-surgical cleansing could offer the possibility of taking tissue specimens suitable for diagnostic microbiological evaluation. The aims of the study were the following: MAIN PURPOSE: To evaluate the efficacy of hydro-surgery in detecting the presence of microorganisms and measuring their load, as an alternative to conventional tissue sampling methods; SECONDARY PURPOSE: To set up an easier and less invasive diagnostic modality than surgical biopsy, even though likewise significant. RESULTS: The results of this study show that tissue specimen collection by hydro-aspiration using Versajet is comparable to biopsy sampling (and in some cases it can be even more reliable); moreover, it is not more time-consuming and is certainly less invasive. Compared to surgical biopsy, with such a method a greater amount of tissue may be collected; moreover, tissue specimens can be taken from a broader surface or, depending on the needs, from a more focused area on the margin or at the bottom of the wound.
Assuntos
Infecções Bacterianas/diagnóstico , Desbridamento/instrumentação , Desbridamento/métodos , Hidroterapia/métodos , Úlcera da Perna/microbiologia , Úlcera da Perna/cirurgia , Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Biópsia/métodos , Desenho de Equipamento , Humanos , Úlcera da Perna/tratamento farmacológico , Úlcera da Perna/patologia , Estudos Retrospectivos , Úlcera Cutânea/microbiologia , Úlcera Cutânea/cirurgia , Resultado do TratamentoRESUMO
OBJECTIVE: To assess the efficacy of propionyl-carnitine (PC) in patients with type 2 diabetes and peripheral arterial disease (PAD). PATIENTS AND METHODS: This was an open pharmacodynamic study. Twenty-four obese patients with type 2 diabetes and PAD (stage IIb) were enrolled in the study. After an initial run-in period of 7 days on a low-calorie diet (1600 +/- 150 kcal/day), patients received intravenous PC (600mg in 100mL saline solution Na/K 0.9%) twice daily for 10 days (T1). RESULTS: Treatment with PC produced statistically significant increases in maximal walking distance (30%; p < 0.05) and initial claudication distance (15%; p < 0.05) in 15 and eight patients, respectively. In addition, a decrease in dosage of oral antihyperglycaemic agents was observed in 21 patients at T1. No PC-related adverse effects were reported. CONCLUSIONS: This study showed that acute intravenous administration of PC in patients with type 2 diabetes with PAD improved PAD-related symptoms as well as glycaemic control.