SURGICAL ASPECT OF DIABETIC FOOT (diagnosis , sign, symptoms, and management ) / komplikasi diabetes melitus pada kaki dan penanganannya.

DIABETIC FOOT SURGERY TREATMENT

A. Definition

Diabetes Mellitus (DM) is a hereditary metabolic disease that mostly, demham signs of hyperglycemia and glucosuria, accompanied by clinical symptoms or absence of acute or chronic, as a result of the lack of effective insulin in the body, lies in the primary disorder of carbohydrate metabolism that is usually accompanied too fat and protein metabolism disorders. (Askandar, 2000).

Gangrene is the process or condition that is characterized by the presence of dead or necrotic tissue, but a microbiological process of necrosis is caused by infection. (Askandar, 2001).

B. Classification

A. Diabetes Mellitus

a. Type I diabetes mellitus (IDDM)

Patients are very dependent on insulin due to an autoimmune process that attacks the insulin. IDDM is the type of DM-derived (Inherited).

b. Type II diabetes mellitus (NIDDM)

Type of DM is influenced by both heredity and environmental factors. A person has a substantial risk of suffering from NIDDM if their parents are people with DM and adopt the wrong lifestyle.

c. Gestational DM

DM of this type tend to occur in pregnant women and the family members who are also suffering from DM. Risk factor is overweight or obese.

d. Secondary DM

DM is associated with other conditions or syndromes (pancreatitis, hormonal abnormalities, and drugs).

DIGESTIVE SURGERY SERIE : APPENDICITIS (SIGN, SYMPTOMS, ETIOLOGY, DEFINITION, DIAGNOSIS AND MANAGEMENT)

Appendix Definitions
Appendix appendix is ​​called an organ found in the cecum located in the proximal colon, a hitherto unknown function.

Anatomy
Appendix is ​​a tube-shaped organ with a length of approximately 10 cm (range 3-15 cm) and stem from the cecum. The appendix has a narrow lumen of the proximal section and wide in the distal. At birth, short and wide dipersambungan appendix with the cecum. During the children, growth is usually rotates into the intraperitoneal retrocaecal but still. At 65% of cases, the appendix is ​​intraperitoneal. It is possible to move the position of the appendix and the motion depends on the length of mesoapendiks lynchings. In the remaining cases, the appendix lies peritoneal, which is behind the ascending colon, or the lateral edge of the ascending colon. Clinical symptoms of appendicitis are known by the location of the appendix. In the appendix there are 3 tanea dipersambungan caecum coli are fused and can be useful in indicating where to detect the appendix. The position of the appendix is ​​most Retrocaecal (74%) and then following the Pelvic (21%), Patileal (5%), Paracaecal (2%), subcaecal (1.5%) and preleal (1%).

Appendix diperdarahi by apendicular arteries that branch from the bottom of the arteries ileocolica. Artery appendix includes end arteries. The appendix has more than 6 lymph channels leading to obstruct mesoapendiks ileocaecal lymph nodes.