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DR. Gh.O . SERBU- BQCT (Board Qualified Clinical Thermographer ). ROLUL TERMOGRAFIEI IN DIAGNOSTICAREA SI EVALUAREA TRATAMENTULUI IN PICIORUL DIABETIC.

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dr gh o serbu bqct board qualified clinical thermographer
DR. Gh.O. SERBU- BQCT

(Board Qualified Clinical Thermographer)

ROLUL TERMOGRAFIEI IN DIAGNOSTICAREA SI EVALUAREA TRATAMENTULUI IN PICIORUL DIABETIC

slide2

“ Utilizarea termografiei ca metoda de investigare neinvaziva se va dezvolta in mod spectaculos in urmatorii 15 ani, medici de toate specialitatile o vor utiliza pentru a vizualiza si localiza anomalii cum ar fi tumorile si blocajele in circulatia singelui, anomalii invizibile cu alte tehnologii

Jerry Williams (profesor de oncologie la J.Hopkins University)

eco doppler angiografia cu substante de contrast
Eco-doppler

Angiografia cu

substante de contrast

Diagnosticultulburarilormacrocirculatorii in piciorul diabetic

diagnosticul modificarii microcirculatiei si a viabilitatii tisulare

Metode indirecte

- masurarea transcutanata a oxigenului tisular

-determinarea saturatiei in oxigen

Diagnosticulmodificariimicrocirculatieisi a viabilitatiitisulare
diagnosticul modificarii microcirculatiei si a viabilitatii tisulare1

Metode directe

- angiografia cu fluoresceina

- clearance radioizotopic

- termografia

Diagnosticulmodificariimicrocirculatieisi a viabilitatiitisulare
slide6

Termography or imaging heat generated by tissues using highly sophisticated infrared camera systems can be used to assess tissue viability.

Such systems generated thermal maps with a color to indicate “hot” spots and are incredibly helpful in managing soft tissues disease

Diabetic Foot Amputation:The Need For an Objective Assessment Tool2003 Health Management Publicatons
evaluarea termografica a piciorului diabetic

Tulburari de circulatie superficiala

Tulburari ale circulatiei capilare

Determinarea viabilitatii tisulare

Diagnosticarea osteomielitei in caz de gangrena

Stabilirea liniei de amputatie

Intraoperator – viabilitatea lamboului cutanat

Urmarirea eficientei tratamentului medicamentos

Evaluareatermografica a piciorului diabetic
slide9

: Eco doppler periferic = «  la nivelul membrului inferior drept - fluxuri normale cu semnal trifazic de la femurala comuna pina la tibiala posterioara proximala unde indicele gamba/brat este nedeterminabil dat fiind faptul ca artera este necomprimabila la presiunea de 200 mmHg ».

slide12

S-a intervenit chirurgical si s-a practicat debridarea leziunii pina in tesutul sanatos, cu indepartarea tendonului achilean. Se reconstruieste tendonul cu manson recoltat din fascia lata.

Se practica arteriotomie cu trombarteriotomie la nivelul arterei poplitee si cateterizarea cu sonda Fogarty a arterei femurale superficiale retrograd si arterei poplitee posterioare. Se practica transfer liber muscular cu lambou compus din muschi dorsal prima digitatie a dintatului anterior. Muschiul dintat anterior este plasat in jurul tendonului reconstruit iar muschiul dorsal mare acopera defectul tegumentar

slide19

THERMOGRAPHY and later the clearance of radioisotope were successfully used to determine the viability of skin flaps for below-knee amputations.

  • The combination of these techniques yielded a success rate of 93 percent for transfibial amputation.
Diabetic Foot Amputation:The Need For an Objective Assessment Tool2003 Health Management Publicatons
slide20

Despite these success in Scotland, these techniques either singly or in combination are not reported in use in current literature, witch may be because both methods need specialist skills and techniques

Such as study would be worthwhile to the literature; the demonstrated potential suggests the need for it.

slide21

THERMOGRAPHIC IMAGING AND SKIN

OXYGEN SATURATION MEASUREMENTS

APPLIED TO ROUTINE CLINICAL

VIABILITY

DK Harrison, JM Hanson, IE Hawthorn

Regional Medical Physics Department and

†Surgical Directorate, University Hospital of North Durham,

Durham DH1 5TW, UK.

slide22

THERMAL IMAGINGIN DIABETIC FOOT ULCERATION

JR Harding DF Wertheim

RJ Williams,

JM Melhuish, KG Harding

X-Ray Department of Clinical Radiology, Royal Gwent & St

Woolos Hospitals, Newport, Gwent.

School Of Electronics, University of Glamorgan,

Pontypridd, Mid Glamorgan.

Wound Healing Research Unit, University of Wales College

Of Medicine, Cardiff, South Glamorgan

slide23

THERMOCHROMIC LIQUID CRYSTAL

THERMOGRAPHY: APPLICATION IN NEUROPATHIC

ASSESSMENT OF THE DIABETIC FOOT

Bharara, M.1, Cobb, J.E. 1, Claremont, D.J. 1 , Anderson, A.M2

1Academic Biomedical Engineering Research Group, Bournemouth

University, UK. 2Mechanical Engineering Department, Union College,

Schenectady, NY, USA

slide24

Thermography and Thermometry in the Assessment of Diabetic Neuropathic Foot: A Case for Furthering the Role of Thermal Techniques

M. Bharara, MSc Academic Biomedical Engineering Research Group, Bournemouth University, Bournemouth, UK, J. E. Cobb, PhD, CEng Academic Biomedical Engineering Research Group, Bournemouth University, Bournemouth, UK D. J. Claremont, MSc, DPhil, FIPEM Academic Biomedical Engineering Research Group, Bournemouth University, Bournemouth, UK

slide25

BOALA ARTERIALĂ PERIFERICĂ LA PACIENŢII DIABETICI

A. Pletea1, C.Pleşa2, C.N. Neacşu2, Noemi Pletea3, Paula Popa2

Jurnalul de Chirurgie, Iasi, 2006, Vol. II, Nr. 3 [ISSN 1584 – 9341]