Is surgical debridement necessary in the diabetic foot treated with photodynamic therapy?

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dc.citation.issue1
dc.citation.volume8
dc.contributor.authorTardivo, Joao Paulo
dc.contributor.authorSerrano, Rodrigo
dc.contributor.authorZimmermann, Livia Maria
dc.contributor.authorMatos, Leandro Luongo
dc.contributor.authorBaptista, Mauricio S.
dc.contributor.authorSilva Pinhal, Maria Aparecida
dc.contributor.authorAtallah, Alvaro N. [UNIFESP]
dc.coverageAbingdon
dc.date.accessioned2020-08-04T13:40:11Z
dc.date.available2020-08-04T13:40:11Z
dc.date.issued2017
dc.description.abstractBackground: Diabetic patients are susceptible to developing foot ulcerswith serious complications such as osteomyelitis and amputations. Treatment approaches are still empirical and the benefit of usual procedures such as surgical debridement has not been properly evaluated. Photodynamic Therapy (PDT) is a non-invasive and highly efficient method for the treatment of the diabetic foot, being able to eradicate the infection and to stimulate healing, decreasing considerably the amputation risk. In the day-to-day practice of our service, we have been faced with the question whether debridement is necessary before PDT. In here, we designed a study to answer that question. Methods: Patients were divided in two groups: In one of the groups (n = 17), debridement was performed before PDT and in the other (n = 40) only PDT treatment was performed. PDT sessions were performed once a week in all patients until healing was achieved, as indicated by visual inspection as well as by radiographic and laboratory exams. At the start of the study, the two groups had no statistical differences concerning their clinical features: average age, gender, insulin use, diabetes mellitus onset time and previous amputations. Results: PDT was effective in the treatment of 100% of the patients showing no relapses after one year of follow up. The group submitted to PDT without previous debridement had a statistically significant (p = 0.036, Mann-Whitney) shorter cure time (29 days, similar to 27%). Conclusion: Our data indicates that debridement is not necessary in the treatment of diabetic foot in patients that have enough peripheral arterial perfusion. In addition, we reproduced previous studies confirming that PDT is an efficient, safe, simple and affordable treatment method for the diabetic foot.en
dc.description.affiliationHosp Anchieta, Fac Med ABC, Sao Bernardo Do Campo, Brazil
dc.description.affiliationFac Med ABC, Dept Bioquim, Santo Andre, Brazil
dc.description.affiliationUniv Sao Paulo, Dept Bioquim, Sao Paulo, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Dept Med, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Dept Med, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipFundacao de Amparo a Pesquisa do Estado de Sao Paulo
dc.description.sponsorshipCNPq
dc.description.sponsorshipIDFAPESP: 12/50680-5
dc.description.sponsorshipIDFAPESP: 13/07937-8
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.1080/2000625X.2017.1373552
dc.identifier.citationDiabetic Foot & Ankle. Abingdon, v. 8, n. 1, p. -, 2017.
dc.identifier.doi10.1080/2000625X.2017.1373552
dc.identifier.fileWOS000424705200001.pdf
dc.identifier.issn2000-625X
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/57352
dc.identifier.wosWOS:000424705200001
dc.language.isoeng
dc.publisherTaylor & Francis Ltd
dc.relation.ispartofDiabetic Foot & Ankle
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectDiabetic footen
dc.subjectdebridementen
dc.subjectosteomyelitisen
dc.subjectamputationen
dc.subjectphotodynamic therapyen
dc.titleIs surgical debridement necessary in the diabetic foot treated with photodynamic therapy?en
dc.typeinfo:eu-repo/semantics/article
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