Rev Med UAS
Vol. 13: No. 4. Octubre-Diciembre 2023
ISSN 2007-8013

Colgajos surales de flujo reverso y terapia de oxígeno hiperbárico en heridas complejas del pie diabético: Optimizando la supervivencia y cicatrización

Reverse sural flap and hyperbaric oxygen therapy in complex diabetic foot wounds: Optimizing survival and healing

Mireya N. Vega-Campos1, Arturo Hernández-Reyes1, Valentín Rodríguez-Ayala2, Miriam Galindo-Domínguez2, Manuel Castillejos-López3, Bianca S. Romero-Martínez4, Edgar Flores-Soto4*

  1. Escuela de Posgrado en Sanidad Naval, Universidad Naval, Secretaría de Marina de México, 04800 Veracruz, México.
  2. Hospital Naval de Especialidades de Veracruz, Especialista en Nefrología, 91700 Veracruz, México.
  3. Departamento de Epidemiología e Infectología Hospitalaria, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas (INER), 14080 CDMX, México.
  4. Departamento de Farmacología, Facultad de Medicina, Universidad Nacional Autónoma de México, 04510 CDMX, México.

*Autor de correspondencia: Dr. Edgar Flores-Soto.
Universidad Nacional Autónoma de México.
Av. Universidad 3004, Copilco Universidad, Coyoacán. C. P. 04510 Ciudad de México, CDMX.
Tel (55)56232279. Correo electrónico: edgarfloressoto@yahoo.com.mx

DOI http://dx.doi.org/10.28960/revmeduas.2007-8013.v13.n4.003

Texto Completo PDF

Recibido 07 de agosto 2023, aceptado 02 de octubre 2023

RESUMEN
Objetivo: Evaluar la eficacia y el impacto de la combinación de la técnica quirúrgica de colgajos surales de flujo reverso y la terapia con oxígeno hiperbárico (OHB) en el tratamiento de heridas complicadas en pacientes con pie diabético. --- Material y Métodos: Se admitieron pacientes diabéticos con lesiones en el pie que cumplían con los criterios de selección para la aplicación de un colgajo sural de flujo reverso, evaluado mediante la clasificación Wifi. Se administró terapia con OHB en una cámara a una presión de 2.3 ATA durante 60 minutos en 20 sesiones. Se realizaron evaluaciones Wifi y Doppler al inicio del estudio, antes de la colocación del colgajo junto con 10 sesiones de OHB, y después de la colocación del colgajo seguida de 20 sesiones de OHB. --- Resultados: Mostraron una mejora significativa en la perfusión tisular y cicatrización de las heridas en el grupo tratado con OHB (Grupo A) en comparación con el grupo de control (Grupo B). Además, se presentaron dos casos clínicos detallados que ilustran la diferencia en la evolución de las heridas entre los dos grupos, destacando la importancia de intervenciones tempranas y adaptadas para mejorar el manejo de heridas crónicas en pacientes diabéticos. --- Conclusiones: La combinación de colgajos surales de flujo reverso y terapia hiperbárica es más efectiva en mejorar la perfusión tisular, la cicatrización de heridas y la dinámica circulatoria en pacientes diabéticos con heridas complicadas en el pie, en comparación con el tratamiento estándar.
Palabras clave: Pie diabético, colgajos surales de flujo reverso, tratamiento con oxigeno hiperbárico

ABSTRACT
Objective: To evaluate the efficacy and impact of the combination of the reverse flow sural flap surgical technique and hyperbaric oxygen (HBO) therapy in the treatment of complicated wounds in patients with diabetic foot. --- Material and Methods: diabetic patients with foot lesions who met the selection criteria for the application of a reverse flow sural flap were included, evaluated using the Wifi classification. HBO therapy was administered in a chamber at a pressure of 2.3 ATA for 60 minutes in 20 sessions. Wifi and Doppler assessments were performed at baseline, before flap placement along with 10 HBO sessions, and after flap placement followed by 20 HBO sessions. --- Results: They showed a significant improvement in tissue perfusion and wound healing in the HBO treated group (Group A) compared to the control group (Group B). In addition, two detailed clinical cases were presented illustrating the difference in wound progression between the two groups, highlighting the importance of early and adapted interventions to improve the management of chronic wounds in diabetic patients. --- Conclusions: The combination of reverse flow sural flaps and hyperbaric therapy is more effective in improving tissue perfusion, wound healing and circulatory dynamics in diabetic patients with complicated foot wounds, compared to standard treatment.
Keywords: Diabetic foot, reverse flow sural flaps, hyperbaric oxygen treatment

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