The document discusses a clinical study on diabetic hand ulcers, focusing on their prevalence, characteristics, and outcomes among 34 patients in Iran. It highlights a significant co-occurrence of hand and foot ulcers, as well as co-morbid conditions like chronic kidney disease (CKD). The study concludes that diabetic hand ulcers are rare but critical, particularly in dialysis patients who face higher amputation rates and require specialized management.

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