New method for evaluation of cutaneous sensibility in diabetic feet: preliminary report.
Diabetic neuropathy is an important complication of the disease, responsible for ulceration and amputation of the foot. Prevention of these problems is difficult mainly because there is no method to correctly access sensibility on the skin of the foot. The introduction of the Pressure-Specified Sensory Device (PSSD) in the last decade made possible the measurement of pressure thresholds sensed by the patient, such as touch, both static and in movement, on a continuous scale. This paper is the first in Brazil to report the use of this device to measure cutaneous sensibility in 3 areas of the foot: the hallux pulp, the calcaneus, and the dorsum, which are territories of the tibial and fibular nerves.


METHODS
Non-diabetic patients were measured as controls, and 2 groups of diabetic patients - with and without ulcers - were compared. The PSSD was used to test the 3 areas described above. The following were evaluated: 1 PS (1-point static), 1 PD (1-point dynamic), 2 PS (2-points static), 2 PD (2-points dynamic).


RESULTS
The diabetic group had poorer sensibility compared to controls and diabetics with ulcers had poorer sensibility when compared to diabetics without ulcers. The differences were statistically significant (P <.001).


CONCLUSIONS
Due to the small number of patients compared, the results should be taken as a preliminary report.
Ferreira
Marcus Castro
MC
Division of Plastic Surgery, Hospital das Clínicas, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
Rodrigues
Leandro
L
Fels
Klaus
K
D000328:Adult; D003920:Diabetes Mellitus / Q000503:physiopathology*; D017719:Diabetic Foot / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000295:instrumentation / Q000379:methods*; D011312:Pressure; D012677:Sensation; D012684:Sensory Thresholds; D012867:Skin / Q000294:innervation*