Local intravenous therapy in chronic inflammatory and vascular disorders of the foot.
BACKGROUND
Chronic inflammatory and vascular disorders of the foot frequently present 2 problems: slow improvement, resulting in long-term therapy, and episodes of critical complications that may seriously threaten the foot. Particularly in a foot with compromised perfusion, the systemic administration of therapeutic agents may be insufficient. Retrograde venous perfusion, RVP, is a new approach that was recently employed for treatment of diabetic neuropathic pedal ulcers.


METHODS
In this paper, RVP was utilized in 24 patients with diabetic or non-diabetic foot disorders (infection, ulcers and critical pedal ischemia). Employed agents were infused according to predetermined regimens and included: antibiotics, deproteinized hemodialysate and PGE1.


RESULTS
The target lesions were eliminated in 20 patients and improved in the others.


CONCLUSIONS
The presented therapy proved to be a useful adjunct to conservative or surgical treatment in the studied disorders. Its main impact was in shortening the duration of therapy and overcoming critical complications threatening the foot.
el-Sarky M el-S
Department of Surgery, Faculty of Medicine, Cairo University, Egypt.
D000527:Alprostadil / Q000008:administration & dosage; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002417:Cattle; D010478:Chemotherapy, Cancer, Regional Perfusion; D002908:Chronic Disease; D017719:Diabetic Foot / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D005528:Foot / Q000098:blood supply*; D016523:Foot Ulcer / Q000188:drug therapy* / Q000503:physiopathology; D005839:Gentamicins / Q000008:administration & dosage; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007511:Ischemia / Q000188:drug therapy* / Q000503:physiopathology; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008833:Microcirculation / Q000187:drug effects / Q000503:physiopathology; D008875:Middle Aged; D012039:Regional Blood Flow / Q000187:drug effects / Q000502:physiology
D000900:Anti-Bacterial Agents; D005343:Fibrinolytic Agents; D005839:Gentamicins; D006493:Heparin; D008012:Lidocaine; D000527:Alprostadil