ABSTRACT
O paciente diabético e as complicações a que está sujeito säo motivos de reflexäo e atençäo, considerado mesmo um desafio por diversos especialistas.Na discussäo do tema pé diabético em um fórum nacional, foi citado que os pacientes diabéticos têm em torno de 15 vezes maior risco de sofrer amputações que os näo diabéticos, que 6 porcento da populaçäo dos USA é diabética, que 20 porcento dos amputados morrem em 2 anos.A discussâo em torno de condutas frente a aspectos infecciosos, meuropáticos, arteriais foi realizada nas diversas regionais e o resultados de um consenso säo apresentados a seguir.Foi dada ênfase à importância da profilaxia, do cuidado na orientaçäo do paciente, visando prevenir as complicações e reduzir o número de amputações.
Subject(s)
Humans , Abscess , Chronic Disease , Diabetic Neuropathies , Diabetic Foot/complications , Diabetic Foot/diagnosis , Diabetic Foot/physiopathology , Amputation, Surgical , Osteomyelitis , Prosthesis ImplantationABSTRACT
The Brazilian National Forum on Carotid Surgery gathered the consensus of 15 Regional Chapters of the Braziliam Society of Angiology an Vascular Surgery.Established diagnostic method and newly developed tecchiques were discusses.Concerning the method of anesthesia, there was a concensus that the surgical skills, rather tan the type of anesthesia, are the main factors for good or bad results.Local anesthesis does not avoid complications caused by inadequte technique.There was a concensus that utilization of a temporary shunt in select cases may lower the incidence of post-operative neurologic deficits, wich not surpas 3 porcents.Angioplasty and carotid stenting were considered experimental procedures and with no approval of the medical community so far, except when performed under research protocols, submitted to boards of ethics and with informed consent.Finally, it was emphasized that the carotid surgery is to be perfomed in regional centers to which patients should be referred in order to archieve the best results.