BUERGER'S DISEASE (THROMBOANGITIS OBLITERANS)
It is characterized by recurring inflammation in the arteries and veins of the lower and upper extremities and results in thrombus formation and occlusion of the vessels. Generally the lower extremities are affected.
Causes
- Unknown
- Occurs in men who are 20-35 years and those who smoke heavily.
Clinical Manifestations
- Pain; cramps in the feet or legs after exercise, burning pain that ts aggravated by emotional disturbances, smoking or chilling. Rest pain in the digits, feeling of coldness or sensitivity to cold.
- Paresthesia may develop and pulse may be diminished or absent
- As the disease progresses, definite redness or cyanosis occurs.
- Ulceration with gangrene may occur,
Medical Management:
- Rest
- Adequate hydration
- Cleanliness is essential
- Regional sympathetic block of ganlionectomy produces vasodilatation and this increases blood flow. If gangrene of a toe develops and worsens, amputation is done (below knee).
Nursing Management:
- Daily washing of feet with bland soap and warm water.
- Avoid trauma to extremity of infection..
- Advise that shoes and stockings must fit accurately and feet must be protected adequately from cold.
- Caustic antiseptics such as iodine or phenol and its derivatives should not be applied to the feet if the peripheral circulation is inadequate.
