Diabetic

Ulcers

Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)

 ULCER IN A
BEDRIDDEN
PATIENT WITH
BAD BLOOD
CIRCULATION
WHERE WE
CAN EVEN
SEE WORMS
IN THE
INJURE
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
 Colombia

Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)

Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
 Photodynamic therapy

Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)

Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
 DIABETIC FOOT PROTOCOL

ULCER
ON THE HEEL
WHY LASER?
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
 


ULCER ON THE
HEEL 6,2 cm
DIAMETER

Medical
diagnosis:
amputation
from knee
level
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
What do we treat?
-Ulcer
-Edema
-Poor circulation
-Nerve disorders
-Plantar pressure relief
-Recovery of tissues
-Improve the collagen metabolism
and oxygenation
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
 DIABETIC FOOT PROTOCOL:
Dr. Pilar Martín & Dr. Martiniano Francischetti


1.- CLEANING
2. Debride and eliminate membranes
3. Drainage
4. Anaerobic and aerobic Antibiotic: Clyndamycin
5. YSGG - Debride and eliminate membranes
6. Diode laser 940 nm: Increase flow, remove edemas, decontaminate ..
7. Visible diode laser 660 nm LLLT: PDT-Biomodulation-Nerve Injury
8. Hydrate healthy skin that is forming: hyaluronic gel, tea tree oil ... etc. no
covering the area
9. Foot Elevated, gentle massage, lymphatic drainage

Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)

 DIABETIC FOOT PROTOCOL:
Dr. Pilar Martín & Dr. Martiniano Francischetti





1.- CLEANING :
Only with a neutral soap, removing the granulation
tissue on the surface, membranes and also
draining.
On some occasions it would be necessary a local
anesthetic in spray
Everyday for 40 days, cleaning the WOUND twice
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
 DIABETIC FOOT PROTOCOL:
Dr. Pilar Martín & Dr. Martiniano Francischetti





2.- DIODE LASER:



940nm diode laser at 2.5W is applied for 300” with
a biomodulation handpiece, ie 2.8 cm2
In the second week the changes were very
noticeable


Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)

 INFRARED LASER
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Island
Islands (Spain)
2,5W for 300" with a biomodulation handpiece

Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)

 DIABETIC FOOT PROTOCOL:
Dr. Pilar Martín & Dr. Martiniano Francischetti



DIODE LASER 940 nm, Continuous wave

1 - 2,5 W for 300”: 750 Joules

DIODE LASER 660 nm:

100 mW
180 sec= 18 Joules of Energy

Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)

- Direct Applicator or Cone: the area of the laser
beam is 4.5 mm2 (yield of 82% and actual output
power of 100 mW). The cone surface is 200 x 30 x
23 mm.

100 mW for 180 sec

Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)

 !"#$%&'$()#*)++#$(),-'.*
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$34.#*5$'($6/7$%85$-%9.-:-$':);:)$;'<#&$
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Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)

- Fiber Applicator of 400 µm: 0.0013 cm2
(yield of 33% and maximum output power of 40 mW).

VISIBLE LASER
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
3 - Broad spectrum antibiotics

Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)

 DIABETIC FOOT PROTOCOL






After 40 days and for a period of one month, the same
parameter was used into the wound but twice per week
and on the sole we applied for the pain the laser with a
therapeutic applicator covering all the area with a spot of
30mm at a distance of 15mm and at 4w for 180 “, ie 720j
In a week, the pain completely disappeared and it was
not necessary to take any painkillers because the patient
was beginning to suffer from a gastric ulcer due to
medication

Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)

 DIABETIC FOOT PROTOCOL






The treatment continued after this sequence and
for 6 weeks we applied laser once a week with
the therapeutic tip at 3w for 180 “, ie 540J We
finished with a 660nm Laser for 180" with a spot
of 30 mm and twice a week for a month

TODAY, THE PATIENT IS WALKING…

Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)

Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)
TODAY………..

SHE IS WALKING

Dr. Mª Pilar Martín Santiago - Tenerife, Canary Islands (Spain)