Percutaneous Chemical Lumbar Sympathectomy In Diabetic Foot

Abstract

Objective: Diabetic foot is a common in outpatient pain management, usually it is complicated with foot ulcer, soft tissue infection, osteomyelitis and wet gangrene which sometimes necessitates wound debridement or amputation of the dead infected part to save the limb and the life of the patient. In this trial we want to find whether chemical lumbar sympathectomy can accelerate ulcer and wound healing, reduce the incidence of amputation.

Material and methods: We select 53 patients with diabetic foot and foot ulcer in this double-blind study, their age ranging between and their weight between, all have rest pain and claudication. All those patients underwent ultrasound guidance percutaneous chemical lumbar sympathectomy using 5 ml of lignocaine 2% at one vertebral level as a diagnostic agent and 5 ml phenol 7% in another vertebral level as a therapeutic agent. We follow our patients in 3 months, 6 months and 1 year in sense of pain scores, skin temperature, walking distance and rate of wound healing.

Results: We found Pain scores decreased, skin temperature increase, walking distance till claudication also increased and there is acceleration of ulcer wound healing.

Conclusion: USG percutaneous chemical lumbar sympathectomy may reduce neuropathic left rest pain, increase skin temperature and accelerate ulcer healing.