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Abstract(s)
A Diabetes Mellitus (DM) é uma doença crónica, que apresenta uma prevalência de 13,3% (na população dos 20 aos 79 anos) em Portugal, com tendência crescente. A esta doença estão associadas muitas complicações, sendo uma delas o pé diabético. Desta forma, é essencial fazer uma monotorização, avaliação de risco e aferir os tratamentos. Técnicas possíveis para fazer esta monotorização baseiam-se por exemplo na caraterização da imagem em espetro visível e de infravermelhos. A termografia por infravermelhos é uma modalidade de imagem utilizada para detetar alterações de temperatura nas úlceras diabéticas sem utilizar radiação ionizante nem pressupor qualquer contacto. A caraterização por imagem de espetro visível e utilização da ferramenta PUSH (Pressure Ulcer Scale for Healing) são também importantes métodos complementares, de imagem por espetro visível. Desta forma, a finalidade deste estudo é desenvolver uma métrica que consiga identificar a eficácia de um tratamento a úlceras diabéticas através da conjugação dos métodos: caraterização por imagem de espetro visível, escala PUSH e imagem térmica. A metodologia utilizada baseou-se na aquisição de imagens térmicas por infravermelhos e de espetro visível conjugada com o resultado da escala PUSH das úlceras diabéticas de pacientes do CHUP (Centro Hospital e Universitário do Porto) e posterior tratamento das mesmas. Mais especificamente, recolheu-se informação sobre a área, percentagem de tecidos (saudável, não saudável, infetado e necrótico) e diferença de temperatura nas úlceras diabéticas. Os resultados obtidos permitiram verificar a eficácia dos tratamentos para cada tipo de caraterização. Sendo que o tratamento mais eficaz pela caraterização termográfica é o “Antibiótico”, o menos eficaz na diminuição da área da úlcera diabética é “Pressão”, o menos eficaz na infeção é o “Gel Plaquetário” e no controlo do tecido necrótico são o “Curativo” e o “Cronocol”. Relativamente à escala PUSH, que permitiu avaliar de forma geral os tratamentos concluiu-se que os tratamentos menos eficazes são “Gel Plaquetário”, “Curativo”, “Octicet” e “Antibiótico”. Em suma, o tratamento que se mostrou mais eficaz, numa abordagem geral dos três métodos foi o “Inadine”. As correlações apresentadas nos resultados permitiram também concluir que a área é efetivamente um parâmetro que se correlaciona com a diferença de temperatura, uma vez que se verificou um rho = 0,39. Denota-se por fim, que, em alguns casos dever-se-ia fazer mais do que um tratamento ou tratamentos complementares de forma a não só atuar na cicatrização como também no tipo de tecido predominante na úlcera diabética.
Diabetes Mellitus (DM) is a chronic disease which has a prevalence of 13.3% (in the population aged 20 to 79 years) in Portugal, with an increasing tendency. There are many complications associated to this disease, one of which is the diabetic foot. Therefore, it is essential to monitor, assess risk and measure treatments. Some techniques for this monitoring are based for example on the characterization of visible and infrared spectrum image. Infrared thermography is an imaging modality used to detect temperature changes in diabetic ulcers without using ionizing radiation or assuming any physical contact. Visible spectrum imaging characterization and the use of the Pressure Ulcer Scale for Healing (PUSH) tool are also important complementary visible spectrum imaging methods. Thus, the purpose of this study is to develop a metric that can identify the effectiveness of a treatment for diabetic ulcers by combining the methods: visible spectrum image characterization, PUSH scale and thermal imaging. The methodology used was based on visible spectrum and infrared thermal imaging combined with the result of the PUSH scale of diabetic ulcers of CHUP patients and subsequent treatment. This consisted in the acquisition of information about area, tissue percentage (healthy, unhealthy, infected and necrotic) and temperature difference of the diabetic ulcers. The results allowed the verification of the effectiveness of the treatment for each type of characterization. The most effective treatment by thermographic characterization is “Antibiotic”, the least effective in reducing the area of the diabetic ulcer is “Pressure”, the least effective on the control of the infection is “Growth factors gel” and of the necrotic tissue is “Gauze” and “Cronocol”. Regarding the PUSH scale, which allowed to evaluate the treatments over general, it was concluded that the less effective treatments are “Growth factors gel”, “Gaze”, “Octicet” and “Antibiotic”. It follows that the most effective treatment based on the three methods together is “Inadine”. The correlations presented in the results also allowed to conclude that the area is effectively a parameter that correlates with the temperature difference, since rho = 0.39 was verified. Finally, it should be noted that, in some cases, more than one treatment or complementary treatments should be done in order not only to act on healing but also on the predominant type of tissue in diabetic ulcer.
Diabetes Mellitus (DM) is a chronic disease which has a prevalence of 13.3% (in the population aged 20 to 79 years) in Portugal, with an increasing tendency. There are many complications associated to this disease, one of which is the diabetic foot. Therefore, it is essential to monitor, assess risk and measure treatments. Some techniques for this monitoring are based for example on the characterization of visible and infrared spectrum image. Infrared thermography is an imaging modality used to detect temperature changes in diabetic ulcers without using ionizing radiation or assuming any physical contact. Visible spectrum imaging characterization and the use of the Pressure Ulcer Scale for Healing (PUSH) tool are also important complementary visible spectrum imaging methods. Thus, the purpose of this study is to develop a metric that can identify the effectiveness of a treatment for diabetic ulcers by combining the methods: visible spectrum image characterization, PUSH scale and thermal imaging. The methodology used was based on visible spectrum and infrared thermal imaging combined with the result of the PUSH scale of diabetic ulcers of CHUP patients and subsequent treatment. This consisted in the acquisition of information about area, tissue percentage (healthy, unhealthy, infected and necrotic) and temperature difference of the diabetic ulcers. The results allowed the verification of the effectiveness of the treatment for each type of characterization. The most effective treatment by thermographic characterization is “Antibiotic”, the least effective in reducing the area of the diabetic ulcer is “Pressure”, the least effective on the control of the infection is “Growth factors gel” and of the necrotic tissue is “Gauze” and “Cronocol”. Regarding the PUSH scale, which allowed to evaluate the treatments over general, it was concluded that the less effective treatments are “Growth factors gel”, “Gaze”, “Octicet” and “Antibiotic”. It follows that the most effective treatment based on the three methods together is “Inadine”. The correlations presented in the results also allowed to conclude that the area is effectively a parameter that correlates with the temperature difference, since rho = 0.39 was verified. Finally, it should be noted that, in some cases, more than one treatment or complementary treatments should be done in order not only to act on healing but also on the predominant type of tissue in diabetic ulcer.
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Keywords
Avaliação do tratamento Escala PUSH Pé diabético Termografia Úlceras diabéticas Diabetic foot Diabetic ulcers PUSH scale Thermography Treatment evaluation