No abstract

RESUMENDesde que en 1863 se demostró que la pérdida de fluidos era la causa de decesos de los pacientes quemados, se ha establecido un sinfín de fórmulas y opciones terapéuticas con la idea de mejorar la sobrevida de estos pacientes. La fórmula de Parkland y la utilización de lactato de Ringer, han sido las dos medidas que mejores resultados han obtenido. La utilización de coloides y soluciones hipertónicas así como gelatinas, han sido objeto de análisis, sin embargo no han demostrado mejorar la sobrevida de los pacientes, por el contrario los efectos adversos han quedado plasmados en distintas revisiones y ensayos médicos. ABSTRACTSince it was proven in 1863 that fluid loss was the cause of death in burnt patients, a number of formulas and therapeutic options have been established with the aim of improving the patients' survival. The Parkland´s formula and the use of Ringer's lactate have been the two methods with the best results. The use of colloids and hypertonic solutions as well as gelatins have been analyzed however, there hasn't been an improvement in the patient's survival on the contrary, the adverse effects have been documented in various revisions and clinical trials.

The following review describes how posterior tibial nerve compression, as it passes through the tarsal tunnel, constitutes a "second crush" compression in patients with diabetic neuropathy (endoneural edema secondary to increased sorbitol levels within the peripheral nerve in diabetes is the "first crush" compression), increasing diabetic foot´s associated pathology. Tinel´s sign is present when striking the posterior tibial nerve at the tarsal tunnel in these patients. According to literature, tarsal tunnel decompression, with septum resection, if patients are carefully selected, showed some benefits regarding: Pain, sensibility, ulcer prevention and lower extremity amputations. However there still is a need for randomized controlled clinical trials for statistical evidence of the benefits for such intervention and universal acceptance for these principles.