ZohrehAnnabestani1, ShahrzadMohseni2, Mohammad Reza Mohajeri-Tehrani2, HosseinAllahgholi3, BagherLarijani1

1. DIABETIC HAND ULCER :A BRIEF
REPORT FROM IRAN
Zohreh Annabestani 1, Shahrzad Mohseni 2, Mohammad Reza Mohajeri-Tehrani 2,
Hossein Allahgholi 3, Bagher Larijani 1
1-Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute , Endocrinology and Metabolism Research
Institute, Tehran University of Medical Sciences, Tehran, Iran
2- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism clinical Sciences Institute, Endocrinology and
Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
3 - Iranian Nursing Organization, Iran

2. INTRODUCTION
Different features of diabetic hand ulcer

3. STUDY AIM
■ Evaluate different features of hand ulcer
■ Prevalence in diabetic population
■ Amputation rate
■ Co-morbidity with CKD
■ Co-incidence rate with foot ulcer
■ Prevalence of hand ischemia

4. CLINICAL STUDY SET UP
Prospective,
Observational
■ History & physical examination
■ Ulcer characteristics evaluation
■ Vascular supply assessment
■ Wound bed preparation

5. RESULTES
Patients
N:34
M:15
F:12
■ Mean age : 63.4 Y (33-85)
■ Foot ulcer simultaneous :13 (48.1%)
24 (70.5%):■ Neuropathic
■ CKD : 9 (33.3%)
■ Mean HbA1c : 8.3±1.7%
■ Amputation: 3 (11.5%)
■ Wound healing: 20 (74.1%)

6. CLINICAL CASES
C
CASE 1 : 33Y ,F
Post fracture
CASE 2 : 80Y ,M
Burning
After 3 month After 2 month

7. CASE REPORT1
Before Angioplasty After Angioplasty
A:Proximal part of Lt Radial artery
B:Distal part of Radial artery
Ischemic hand ulcer in dialysis patient
1 month later 2month later
A: Post dilation of proximal part of Radial artery
B: Post dilation of distal part of Radial artery
A B
1-Zohreh Annabestani, Seyed Ebrahim Kassaian, *Mohammad Reza Mohajeri Tehrani,Shahrzad Mohseni, Sepideh Saroukhani, Bagher Larijani. Retrograde Trans-
Femoral Approach for Successful Percutaneous Angioplasty in a Diabetic Patient with Ischemic Hand Ulcer: A case report . Journal of Tehran heart center

8. MANAGEMENT
Similar to foot ulcer
■ Treat The Cause
■Patient Centered Concerns
■ Local Wound Care
Wound Bed Preparation

9. CONCLUSION
■ Hand ulcer is an uncommon complication of
diabetes but : Important
■ Dialysis cases are more prone to amputation, and
need to accurate management
■ Consider special care and management in hand
ischemia