Učinki udarnih globinskih valov na celjenje zapletenih ran pri sladkornih bolnikih : diplomsko delo

Zdolšek, Nina (author), Jakovljević, Miroljub (mentor), Weber, Daša (comentor)

Uvod: Zapletena rana je opredeljena kot povrhnja, delna ali popolna poškodba strukture in funkcije kože. Prihaja do prekinitev kože in tkiv, ki lahko segajo globlje in poškodujejo kite, mišice, živce ter kosti. Za celjenje zapletenih ran se uporabljajo fokusni udarni globinski valovi, ki se glede na vir izvora delijo na elektrohidravlične, piezoelektrične in elektromagnetne. Fokusni udarni globinski valovi prodrejo skozi mehka tkiva do globine 15 cm in neposredno vplivajo na tkivo preko mehanotransdukcije in kavitacije, kar naj bi izboljšalo regeneracijo celic in tkiv ter zmanjšalo bolečino. Namen: Na osnovi pregleda objavljene strokovne in znanstvene literature predstaviti učinke udarnih globinskih valov na celjenje zapletenih ran pri sladkornih bolnikih. Metode dela: Pri izdelavi diplomskega dela je bila uporabljena deskriptivna metoda dela. Literatura je bila iskana v podatkovnih zbirkah Science Direct, PubMed v obdobju od novembra 2018 do marca 2019. Članke smo analizirali glede na velikost vzorca posameznih raziskav, doziranje zdravljena z UGV in glede na uporabljene metode dela ter obliko raziskave. Rezultati: V analizo je bilo vključenih sedem znanstvenih člankov. V petih člankih so raziskovalci obravnavali kronično diabetično razjedo stopala. V enem članku so obravnavali diabetične razjede, ki so nastale po področjih celotnega spodnjega uda ter članek v katerem so raziskovalci obravnavali nevropatsko razjedo stopala. V vseh raziskavah so ugotavljali učinkovitost terapije z udarnimi globinskimi valovi na celjenje kroničnih ran. Razprava in zaključek: Terapija z udarnimi globinskimi valovi se je pri večini izkazala za učinkovito, ne invazivno in hitro metodo, ki pripomore k celjenju zapletenih ran pri sladkornih bolnikih, ne glede na izbrane parametre terapije, število terapij in razmik med terapijami. Da bi rezultate potrdili, bo v prihodnje treba opraviti več naključnih kontrolnih raziskav, ki bi vključevale večje število preiskovancev in trajale daljše časovno obdobje. Prav tako so potrebne dodatne raziskave za ugotovitev učinkov fokusnih in nefokusnih udarnih globinskih valov na celjenje kroničnih ran.

• Language: Slovenian
• Keywords: kronična diabetična razjeda stopala, diabetična rana, kronična razjeda, udarni globinski valovi »ESWT«, fokusni udarni globinski val »F-SW«
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2020
• PID: 20.500.12556/RUL-113764
• COBISS.SI-ID: 5775723
• Publication date in RUL: 01.02.2020

Secondary language

• Language: English
• Title: The effects of extracorporeal shockwave therapy in the treatment of complex wounds in diabetics : diploma work

Abstract

Introduction: A complex wound may be defined as a superficial, partial or full-thickness skin loss wound. This can range from a simple break in the epithelial integrity of the skin or it can be deeper, extending into subcutaneous tissue with damage to other structures such as tendons, muscles, and even bone. To heal complex wounds, focused shockwave therapy may be used. These shockwaves can be divided into electrohydraulic, piezoelectric and electromagnetic waves, depending on the type of source. Focused shockwaves penetrate through soft tissues, reaching a depth of 15 cm, boosting the regeneration process of cells through mechanotransduction and cavitation and consequently minimizing the sensation of pain. Purpose: To carry out a systematic review of professional and academic literature and to present the effects of extracorporeal shockwave therapy in the treatment of complex diabetic wounds. Methods: In this bachelor’s thesis, we shall use a descriptive method of work. The literature was searched in Science Direct, PubMed databases in November 2018 to March 2019. The articles were analysed according to the size of the sample of individual studies, the dosage treated with UGV and according to the working methods used and the form of the research. Results: We analysed seven scientific articles, out of which five articles discussed chronic diabetic ulcers. One article dealt with a chronic lower limb wound, and one reflected on neuropathic ulcers. All of them compared the effectiveness of extracorporeal shockwave therapy in the treatment of chronic wounds. Discussion and conclusion: In most studies, extracorporeal shockwave therapy turned out to be a positive, non-invasive and rapid method of treating complex diabetic wounds, regardless of the parameters of the therapy, number of therapeutic sessions or the time frame between sessions. In order to confirm our results, more long-term randomized controlled trials should be carried out, including a larger number of participants. Moreover, additional research is needed to assess the effects of focused and non-focused extracorporeal shockwaves on treating chronic wounds.

• Keywords: chronic diabetic foot ulcer, diabetic wound, chronic ulcer, extracorporeal shockwave therapy or »ESWT«, focused shockwave therapy or »F-SW«