Prevención primaria heridas neuropáticas en diabéticos: una revisión narrativa
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2015-06-24
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Jaén: Universidad de Jaén
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[ES]La diabetes mellitus es una enfermedad metabólica que afecta a los niveles de glucosa en sangre. De entre los muchos problemas crónicos que se derivan de la diabetes este trabajo va encaminado hacia la prevención primaria de las úlceras neuropáticas.
Se localizan en pies o piernas y su aparición está causada por la combinación de la neuropatía diabética, la vasculopatía periférica y ciertos agentes biomecánicos. Son el principal causante de amputación. Por ello son causa de un gran impacto social y económico por la elevada morbilidad y mortalidad que tienen asociadas.
Ante esta situación, la primera actuación enfermera es atajar el problema antes de que aparezcan los primeros síntomas de ulceración. Por ello, nuestro objetivo es dilucidar las actuaciones de enfermería en la prevención del pie diabético, basándonos en la evidencia científica. Metodología: hemos realizado una revisión narrativa, para ello efectuamos la búsqueda de artículos en varias bases de datos: PubMed, CINAHL, CUIDEN PLUS, LiLacs y Cuidatge a continuación concretamos cinco criterios de inclusión para ayudarnos en la selección de los documentos.
Tras la revisión de dichos documentos hemos podido obtener una serie de medidas para la prevención de este mal. Hemos ordenado estas por campos de actuación y son: detección, examen diario de los pies, recomendaciones sobre la indumentaria y la higiene, no usar objetos calientes, no andar descalzo, control metabólico y de los factores de riesgo cardiovascular y realizar ejercicio físico, para con ellas, poder facilitar a profesionales y pacientes la tarea de prevención del problema que es a, día de hoy, el pie diabético.
[EN] Diabetes mellitus is a metabolic disease that affects blood glucose levels. Among the many chronic problems stemming from diabetes this work aims towards the primary prevention of neuropathic ulcers. They are located in feet or legs and they are caused by the combination of the diabetic neuropathy, peripheral vascular disease and certain biomechanical agents. They are the main cause of amputation. They have a big social and economic impact because of the high morbidity and mortality that they have associated. A nurse first action is to solve the problem before of ulceration first symptoms appear. Therefore our goal is to elucidate the actions of nursing in the prevention of the diabetic foot, based on scientific evidence. Methods: we conducted a narrative review, so we made the search in several databases: PubMed, CINAHL, LiLacs and care PLUS, Cuidatge. We define five inclusion criteria to help us in the selection of documents. Following a review of these documents we have been able to obtain a series of measures for the prevention of this disease. We ordered them by fields of action: detection, daily examination of the feet, clothing and hygiene recommendations, do not use any hot objects, not walking barefoot, metabolic and cardiovascular risk factors control and physical exercise. Our main goal is to use them to make it easier for professionals and patients the task of preventing the problem which is, today, the diabetic foot.
[EN] Diabetes mellitus is a metabolic disease that affects blood glucose levels. Among the many chronic problems stemming from diabetes this work aims towards the primary prevention of neuropathic ulcers. They are located in feet or legs and they are caused by the combination of the diabetic neuropathy, peripheral vascular disease and certain biomechanical agents. They are the main cause of amputation. They have a big social and economic impact because of the high morbidity and mortality that they have associated. A nurse first action is to solve the problem before of ulceration first symptoms appear. Therefore our goal is to elucidate the actions of nursing in the prevention of the diabetic foot, based on scientific evidence. Methods: we conducted a narrative review, so we made the search in several databases: PubMed, CINAHL, LiLacs and care PLUS, Cuidatge. We define five inclusion criteria to help us in the selection of documents. Following a review of these documents we have been able to obtain a series of measures for the prevention of this disease. We ordered them by fields of action: detection, daily examination of the feet, clothing and hygiene recommendations, do not use any hot objects, not walking barefoot, metabolic and cardiovascular risk factors control and physical exercise. Our main goal is to use them to make it easier for professionals and patients the task of preventing the problem which is, today, the diabetic foot.
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