[Systemic infusion therapy versus retrograde intravenous perfusion: comparative results in patients with diabetic neuropathic plantar ulcer].
Concerning the resistance of diabetic neuropathic plantar ulcers (DNPU) against systemically applied drugs, the "Retrograde Venous Perfusion" (RVP) was introduced as a therapeutic alternative by C. P. Ferreira in 1988. An isotonic saline solution containing gentamycin, buflomedil, dexamethasone, heparin and lignocain is injected into a dorsal foot vein under arterial occlusion of the lower leg. In the present study RVP treatment was done in 20 patients with DNPU and the results were compared to a group treated with systemic intravenous infusions (SVI; n = 20). After 10 days of treatment, 8 out of 20 ulcers were closed (SVI: 4). In 9 ulcers (SVI: 4) size had diminuted by > 30%. Non responders were not observed under RVP in contrast to SVI (7/20 cases). In 4 of 5 patients with osteolytic bone lesions (SVI: 0/7), partial restoration was observed. Rate of toe amputation dropped to 0% (SVI: 20%). Considering the striking differences between either regimen, RVP can be recommended for treatment of DNPU especially when complicated by osteomyelitis.
Dermatologischen Universitätsklinik Erlangen, Deutschland.
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Seidel
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Bühler-Singer
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Richter
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Hornstein
D000328:Adult; D000765:Anesthesia, Conduction; D010478:Chemotherapy, Cancer, Regional Perfusion; D003907:Dexamethasone / Q000008:administration & dosage*; D003929:Diabetic Neuropathies / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D016523:Foot Ulcer / Q000188:drug therapy*; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D011759:Pyrrolidines / Q000008:administration & dosage*; D014665:Vasodilator Agents / Q000008:administration & dosage*
D005839:Gentamicins; D011759:Pyrrolidines; D014665:Vasodilator Agents; D003907:Dexamethasone; D008012:Lidocaine; C010651:buflomedil