重症下肢虚血患者におけるフットケアの基本
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概要
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One of the causes of foot amputation is foot ulcers, making it important to prevent foot ulcers in patients with critical limb ischemia. Foot care of critical limb ischemia patients is based on control of peripheral vascular disease. Ischemic symptoms such as pain and claudication as well as blood flow such as the ankle brachial index and the toe brachial index need to be monitored, while smoking cessation, physical exercise and pharmacotherapy are also vital. Education regarding the importance of recognizing the risks of ulcers and the significance of treatment of peripheral arterial disease is also important. In addition, traumatic injury, which can cause ulcers, needs to be prevented. In addition to using appropriate footwear and loose socks, attention must be paid to skin injuries resulting from onychopathies and lesions caused during care for toenails. If ulcers develop, even though the basics of topical treatment are the same as those for other chronic ulcers, removal of necrotic tissues and moist wound healing before revascularization should be avoided. Caution must be also exercised regarding compression therapy for venous ulcers and pressure reduction (excessive elevation of feet) applied to regions with pressure ulcers. Recently, the wellbeing of patients with chronic wounds has been receiving increasing attention. Patients with critical limb ischemia may suffer a decline of mental wellbeing due to fear of foot amputation and pain. Care must also be improved for the mental wellbeing of patients suffering critical limb ischemia.
- 一般社団法人日本インターベンショナルラジオロジー学会の論文
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