Öz
Giriş
Diyabetik ayak enfeksiyonları (DAE), diyabetes mellitus tedavisindeki ilerlemelere rağmen önemli bir klinik sorun olmaya devam etmektedir. Bu çalışmada, DAE tanılı hastaların epidemiyolojik özellikleri, tedavi süreçleri ve sonuçlarını değerlendirerek bu alandaki bilgi birikimine katkı sağlanması amaçlanmıştır.
Gereç ve Yöntem
Bu retrospektif çalışmada, Ekim 2020-Kasım 2023 tarihleri arasında kliniğimizde DAE tanısıyla yatırılarak takip ve tedavi edilen hastaların demografik, klinik ve laboratuvar verileri, tedavi yöntemleri ve sonuçları kaydedildi. Tüm veriler SPSS 22.0 programı kullanılarak analiz edildi ve istatistiksel anlamlılık düzeyi p < 0,05 olarak kabul edildi.
Bulgular
Çalışmaya dahil edilen 129 hastanın yaş ortalaması 61,27 ± 9,75 yıl olup %74,4’ü erkekti. Diyabetik ayak ülserlerinin %90,7’si perfüzyon, yaygınlık, derinlik, enfeksiyon ve duyu (PEDIS) 3 ve 4 idi. Yara yüzeyel sürüntü/derin doku kültür üremesi olan hastalarda en sık Staphylococcus aureus saptandı. Hastaların %85,3’ünde osteomiyelit saptandı ve olguların %55,8’inin amputasyon uygulanmaksızın antibiyotik tedavisi ve/veya debritman ile tedavi edildiği belirlendi. Cerrahi tedavi uygulanan osteomiyelit hastalarında piperasilin-tazobaktam kullanım oranı anlamlı düzeyde daha yüksekti. PEDIS skoru yüksek olan hastalarda daha yüksek oranda cerrahi tedavi uygulandığı bulundu (p = 0,004).
Sonuç
Çalışmamızın en dikkat çekici sonucu, hastaların çoğunun amputasyon uygulanmadan antibiyotik tedavisi ve/veya debritman ile iyileşmiş olmasıdır. Bu bulgular, ağır DAE ve osteomiyeliti olan hastalarda tedavi stratejilerinin iyileştirilmesine katkıda bulunabilir.
Anahtar Kelimeler:
Amputasyon, diyabetik ayak enfeksiyonu, osteomiyelit, tedavi
Kaynaklar
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