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publicado em 04/01/2012 às 14h16:00
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SBACV launches manual of diagnosis and prevention of diabetic foot

Between 14% and 24% of diabetic foot ulcers can progress to amputation; book will be distributed to medical specialists

 
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Foto: SBACV
Paciente diabético passa por teste de sensibilidade nos pés como monofilamento
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About 15% of diabetic foot ulcers are present throughout life and from 14% to 24% of chronic wounds that will evolve to amputation, according to a study of the American Podiatry Medical Association. About 50% of those who have suffered amputation risk of dying in five years.

After two years of joint efforts by the country to address the problem and verify that the data in Brazil are similar or even worse, the Brazilian Society of Angiology and Vascular Surgery (SBACV) is distributing the first manual of integrated care to the diabetic foot. With 40 pages, 10,000 copies will be handed over to specialists who work with diabetics in order to help in early diagnosis and guidance of foot problems.

In addition to publishing the SBACV repeats with the Ministry of Health proposal to implement a program of prevention of disease in all public, personally delivered in October to the Minister of Health, Alexandre Padilha. Implemented in Rio de Janeiro between 2002 and 2003, the program reduced by 50% to amputation of the thigh and legs of patients with the disease by 2006.

Specialized centers were established in the treatment of diabetic foot, leading to a 90% reduction in the public hospital. Unfortunately, the program was discontinued and the index amputation returned to what they were before the program, says the coordinator of social programs and SBACV responsible for the project in Rio, Jackson Caiafa. The goal of the proposal delivered to the Minister is to reduce 50% of amputations in the country in three years.

According to him, with a team of trained primary care and also to guide the early diagnosis of diabetic non-healing wounds greatly reduces the number of hospitalizations. Our goal is to disseminate knowledge about the disease in primary care in order to reduce the number of amputations of lower limbs by the disease. In general throughout the country, the patient reaches the hospital in very advanced stage of disease, leaving only the amputation as a solution, Caiafa explains.

As president of the SBACV, William Pitta, one of the main problems is the patient not knowing they have diabetes. About 50% of diabetics are undiagnosed, thus undermining prevention of the consequences of the disease which includes, among others, diabetic foot ulcers, renal failure with hemodialysis, an increased risk of stroke, and even blindness, says Pitta. The diabetic foot is a disease that can affect nerves and blood circulation in the legs. Damage to nerves can cause tingling, stinging, burning and numbness of the feet up.

SBACV The manual explains how to prevent injuries in the feet, the necessary tests to diagnose diabetic foot, warns that diabetics can lose the sensitivity of the feet and thus, attention should be doubled at the bottom shows the categories of risk, suggests a pamphlet with tips for prevention to be distributed to the lay population, among others.

The material is all illustrated with real images and in the end there is an objective exercise to see if any message was taken. The text has been produced by vascular surgeons: Jackson Caiafa, Castro Aldemar, Cicero Fides, Vanessa Santos, Erasmo Simão da Silva and Sitrângulo Cid Jr., and reviewed by the president of SBACV, William Pitta, and the general secretary, Marcelo Araujo.

<b> costs of the disease and amputations numbers </ b>

In the past two years, SBACV held a series of task forces in the country to raise awareness and also to treat advanced cases. The action came to Rio de Janeiro (RJ), Itabuna (BA), Arapiraca (AL), Amapá (AP), João Pessoa (PB), Brasilia, among other cities. In such event, realize that you need an urgent intervention in the management of public health. The prophylaxis program will generate savings for the government. American studies show that the cost of a hospital with diabetic leg ulcer ranges from U $ 4,775 to U.S. $ 14,881, while the cost of the examination of debridement of calluses goes for $ 200 a year, Caiafa said.

Survey of Regional River SBACV in district hospitals showed that the number of amputations is increasing annually. In 2008 there were 914 amputations, while in 2009 the number rose to 935 amputations. Observing only the month of January, 2008, 2009 and 2010, for comparison, there was respectively 31, 71 and 84 amputations. The amputation can be avoided by other measures of the disease. According to data from the Date / UHS from 2005 to 2011, it is estimated that the rate of amputations in Brazil is 42 thousand a year.

<b> Varicose Veins </ b>

Besides the program of the diabetic foot, the SBACV delivered to the Ministry of Health suggested a program of prevention of varicose veins, another serious problem in public health care centers. According to doctors, the queues for varicose vein surgery in SUS only grow. In Rio Branco, Acre, when it happened Mutirão SBACV of varices in November, the queue had 250 patients. The Company's estimate is that varicose veins affect about 50% of women and 37% of men.

The main risk factor for varicose veins is heredity. But studies have shown that other factors have contributed to its emergence, such as obesity (being overweight increases the pressure on the veins and impedes venous return), sex (women are more likely due to hormonal factors), age ( the older, the more likely), sedentary lifestyle (the movement of the legs is very important to pump blood from the veins and facilitate the return of blood to the heart), hormone replacement or birth control pills. In severe cases, varicose veins can lead to eczema, dermatitis, phlebitis, thrombosis, darkening of the skin, bleeding and ulcers.

Clique aqui para ver o manual.

Source: SBACV
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