Diabetic foot syndrome. Replacement for inpatient treatment technique based on the fast track surgery

The aim: To conduct a comparative analysis of clinical data, laboratory results, and pain intensity in patients using developed by us device for offloading the foot and plaster splint during inpatient treatment of purulent-necrotic complications of diabetic foot syndrome. Materials and methods: We examined 76 patients with purulent-necrotic complications of diabetic foot syndrome, who used a plaster splint and a device for offloading the foot. We evaluated the clinical indicators of the healing process, laboratory data and pain intensity. Results: Comparing the results of using the device for offloading the foot and the plaster splint showed that the developed by us device had a positive effect on the dynamics of the healing process: the edema disappeared on average 1.5 days earlier; the redness vanished on average 2.5 days earlier. We observed granulation and epithelialization significantly earlier (p <0.05) than in the group where the plaster splint was used. The number of recorded surgical interventions was statistically significant and less (p <0.05) in the group where our device was used. Low pain rates were in patients using a device for offloading the foot due to minimal contact of the wound surface with the floor. Conclusions: According to the results of comparative using the device for offloading the foot and plaster splint, we found out that using the device for offloading the foot allows creating statistically significant better conditions to accelerate wound healing in patients and reduce the duration of inpatient treatment.

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Effectiveness of the concept of fast-trak surgery for simultaneous laparoscopic hernioplastics and cholecistectomy

The Journal of V. N. Karazin Kharkiv National University, Series "Medicine" ◽

10.26565/2313-6693-2021-41-10 ◽

2021 ◽

Keyword(s):

Postoperative Period ◽

Inpatient Treatment ◽

Fast Track ◽

Early Postoperative Period ◽

Wound Complications ◽

Fast Track Surgery ◽

Surgical Interventions ◽

Group I ◽

Laparoscopic Hernioplasty ◽

Group Ii

The aim of the research was to study the feasibility and effectiveness of simultaneous laparoscopic hernioplasty and cholecystectomy in patients with combined abdominal pathology. Material and methods. Simultaneous laparoscopic hernioplasty and cholecystectomy during 2015–2019 performed on 70 patients, including 49 (70 %) women, mean age 57.3 ± 6.5 g. In 37 patients the principles of Fast-track surgery were applied (group I), including thorough examination for diagnostics of combined abdominal pathology and clinically significant general somatic pathology; if necessary a course of therapy for full compensation of general somatic pathology was prescribed; during the operation of epidural prolonged anesthesia; choice in favor of laparoscopic technology; at the end of the operation – irrigation of the subdiaphragmatic space with local anesthetic; postoperatively: early drainage removal; withdrawal from opioids by prescribing parenteral paracetomol; activation of the patient 6-8 hours after surgery; on the day of surgery – use of chewing gum and fluid intake. In 33 patients the standard complex of perioperative management (group II) is applied. The immediate results of surgical interventions have been studied. Results. There were no significant complications during the operation and in the early postoperative period. In the first group, seroma (after open alloplasty) was detected in 2 (5 %) cases, and in the second group, small wound complications were detected in 4 (12 %) cases (p > 0.05 according to the χ2 criterion). The duration of inpatient treatment in patients of group I is 4.4 ± 1.2 months, in group II – 7.0 ± 1.3 days (р < 0.001 by Student’s test). Conclusion. Application of the principles of Fast-track surgery and accelerated recovery at all stages of simultaneous laparoscopic hernioplasty and cholecystectomy (preparation for surgery, during the operation and in the postoperative period) does not increase the number of postoperative complications and decreased duration of inpatient treatment from 7,0 ± 1,3 in patients with traditional postoperative management to 4,4 ± 1,2 days.

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Bacteriological Profile of Wounds of Patients with Neuroischemic Form of Diabetic Foot

Health and Ecology Issues ◽

10.51523/2708-6011.2020-17-1-8 ◽

2020 ◽

pp. 45-50

Author(s):

V. I. Silvistrovich ◽

A. A. Lyzikov ◽

M. L. Kaplan ◽

J. I. Yarets

Keyword(s):

Antibacterial Therapy ◽

Diabetic Foot ◽

Antibiotic Susceptibility ◽

Inpatient Treatment ◽

Microbial Flora ◽

Diabetic Foot Syndrome ◽

Antibacterial Drugs ◽

Microbiological Study ◽

Microbiological Profile ◽

Bacteriological Profile

Objective: to assess the results of the microbiological study of wounds in patients with diabetic foot syndrome (DFS).Material and methods. The microbiological study of the wounds of 76 patients with the neuroischemic form of DFS having undergone inpatient treatment at Gomel Regional Diabetic Foot Center from 2016 to 2019 was performed.Results. The range of the microbial flora of the wounds of the patients with the neuroischemic form of DFS has been identified, the antibiotic susceptibility of the detected bacteria to antibacterial drugs has been analyzed.Conclusion. The microbiological profile of the wounds of the patients with the neuroischemic form of DFS was characterized by the variety of bacteria and included Enterococcusfaecalis (29%), Staphylococcusaureus (19%), as well as representatives of Enterobacteriaceae family (25%). The detected bacteria were most sensitive to glycopeptides, aminoglycosides, carbapenems, which makes it reasonable to prescribe these groups of antibiotics as the start antibacterial therapy.

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