Use of Vacuum Therapy in the Treatment of Wounds in Patients with Diabetic Foot Syndrome

Background: According to the International Diabetes Federation (IDF), the number of patients on diabetes mellitus is now more than 415 million people on Earth, until 2030 it will increase to 439 million, and by 2035 ― will reach 592 million. Throughout life, 4.625% of patients with diabetes mellitus develops a diabetic foot syndrome with the formation of wounds, whose treatment, can not yet be considered satisfactory, since in 1525% of patients are the direct cause of high amputations of the lower limbs. This requires finding new effective methods for treating wound defects in patients with diabetic foot syndrome, one of which can be vacuum wound therapy. Aims: To study the effectiveness of vacuum therapy in the treatment of acute and chronic wound process in patients with diabetic foot syndrome, depending on the pathogenetic form of the lesion. Materials and methods: The effect of vacuum therapy on the course of acute and chronic wound process in 231 patients with neuropathic and ischemic form of diabetic foot syndrome was studied during 20142017. Evaluation of the dynamics of the wound process was carried out on the basis of clinical, planimetric, microbiological, morphological methods, as well as microcirculation indices in the area round the wound. Results: Vacuum therapy of acute and chronic wounds in patients with different pathogenetic forms of diabetic foot syndrome, allows to stabilize the course of wound process, stimulate regenerative processes in the wound, improve local microcirculation (p0.05). This, in turn, allows a shorter time to prepare a wound for closure by one of the methods of plastic surgery or create favorable conditions for its independent epithelization. In patients with ischemic lesions (chronic arterial insufficiency of the third degree), the carrying out of vacuum therapy by standard method leads to an intensification of the pain syndrome. This causes the need to apply an initial negative pressure in the system in the range of 7080 mm Hg, which makes it possible to stop pain during the day. At 23 days of the postoperative period, negative pressure is established at standard values. Conclusions: Vacuum therapy of wounds in patients with diabetic foot syndrome is an effective method of treatment that allows the doctor to reduces the duration of treatment of patients in hospital with a neuropathic form of diabetic foot syndrome on average (4.31.7) bed-days, and patients with ischemic form ― on average (4.11.9) bed-days, which has both medical and social significance.

Download Full-text

Diagnostic and treatment principles of wound process in patients with diabetic foot syndrome and risk groups. Draft recommendations

Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH) ◽

10.20340/vmi-rvz.2021.1.prot.1 ◽

2021 ◽

pp. 109-123

Author(s):

A. A. Supilnikov ◽

E. V. Kolesnikov ◽

A. A. Starostina ◽

L. A. Trusova ◽

M. S. Mikhailov ◽

...

Keyword(s):

Diabetic Foot ◽

Local Treatment ◽

Risk Groups ◽

Practical Experience ◽

Scientific Data ◽

Diabetic Foot Syndrome ◽

Original Research ◽

Scientific Group ◽

Treatment Of Wounds ◽

Medical University

The draft clinical guidelines were developed by the team of the scientific group for the treatment of wounds and wound process of the Reaviz Medical University, taking into account modern scientific data, practical experience and original research. The data on the formulation of the diagnosis in diabetic foot syndrome, the existing classification of ulcers and wounds, the survey plan, basic and additional therapy, local treatment of ulcers and wounds are presented.

Download Full-text

The wound process variants course in patients with diabetic foot syndrome in the vacuum therapy background

Modern medical technologies ◽

10.34287/mmt.2(41).2019.8 ◽

2019 ◽

Vol 41 part 1 (2) ◽

pp. 40-44 ◽

Cited By ~ 1

Author(s):

P. O. Gerasymchuk ◽

V. O. Shidlovskyi ◽

D. B. Fira

Keyword(s):

Negative Pressure ◽

Diabetic Foot ◽

Chronic Wounds ◽

Chronic Wound ◽

Pain Syndrome ◽

Diabetic Foot Syndrome ◽

Vacuum Therapy ◽

Social Significance ◽

Duration Of Treatment ◽

Bed Days

Purpose of the study. Study the effectiveness of vacuum therapy in the treatment of acute and chronic wound process in patients with diabetic foot syndrome, depending on the pathogenetic form of the lesion. Materials and methods. The effect of vacuum therapy on the course of acute and chronic wound process in 231 patients with neuropathic and ischemic form of diabetic foot syndrome was studied during 2014–2017. Evaluation of the dynamics of the wound process was carried out on the basis of clinical, planimetric, microbiological, morphological methods, as well as microcirculation indices in the area around the wound. Results. Vacuum therapy of acute and chronic wounds in patients with different pathogenetic forms of diabetic foot syndrome, allows to stabilize the course of wound process, stimulate regenerative processes in the wound, improve local microcirculation (p < 0,05). This, in turn, allows a shorter time to prepare a wound for closure by one of the methods of plastic surgery or create favorable conditions for its independent epithelization. In patients with ischemic lesions (chronic arterial insufficiency of the third degree), the carrying out of vacuum therapy by standard method leads to an intensification of the pain syndrome. This causes the need to apply an initial negative pressure in the system in the range of 70–80 mm Hg, which makes it possible to stop pain during the day. At 2–3 days of the postoperative period, negative pressure is established at standard values. Conclusion. Vacuum therapy of wounds in patients with diabetic foot syndrome is an effective method of treatment that allows the doctor to reduce the duration of treatment of patients in hospital with a neuropathic form of diabetic foot syndrome on average 4,3 ± 1,7 bed-days, and patients with ischemic form on average 4,1 ± 1,9 bed-days, which has both medical and social significance. Keywords: diabetes mellitus, diabetic foot, negative-pressure wound therapy.

Download Full-text

Vacuum therapy in complex treatment of neuropathic form of diabetic foot syndrome in Ghana

Wounds and wound infections The prof B M Kostyuchenok journal ◽

10.25199/2408-9613-2018-5-3-16-24 ◽

2020 ◽

Vol 5 (3) ◽

pp. 16-24

Author(s):

W. M. Rdeini ◽

V. A. Mitish ◽

Yu. S. Paskhalova ◽

S. L. Sokov

Keyword(s):

West Africa ◽

Diabetic Foot ◽

Local Treatment ◽

Main Group ◽

Diabetic Foot Syndrome ◽

Comprehensive Treatment ◽

Vacuum Therapy ◽

City Hospital ◽

Study Results ◽

Antiseptic Solutions

Diabetic foot syndrome (DFS) is a serious public health problem in developing countries, where medical resources are limited, and the vast majority of patients turn to medical facilities too late with severe forms of the disease and often in advanced stages.Objective: to evaluate the effectiveness of negative pressure wound therapy (NPWT) in treating patients with a neuropathic form of DFS compared with traditional methods to reduce the number of high amputations and overall mortality in Ghana.Materials and research methods. A prospective, non-randomized, comparative clinical study of the results of examination and treatment of 59 patients with type 2 diabetes mellitus (DM) was performed at the Seventh-day Adventist City Hospital (Ghana, West Africa), Kumasi University Hospital and the Effiduase District Hospital (Ghana, West Africa) in the period from January 1, 2011 to December 31, 2013, there were 37 female patients (63.3 %), 22 male patients (36.7 %). The volume of foot tissue damage varied from II to IV degree according to Wagner classification (II degree was diagnosed in 55.6 % of cases). The average age of patients was 31.5 ± 7.3 (20–72) years. The average duration of DM was 7.3 ± 4.2 years. Bacteriological examination of wounds showed that Staphylococcus aureus was most often an isolated pathogen. All microorganisms identified from patients’ wounds had high resistance to commonly used antibiotics. Patients were randomly assigned to groups. NPWT is the only topical treatment in the main group; traditional dressings with antiseptic solutions (iodophors) were used in the comparison group.Study results. Comprehensive treatment of patients in both groups included surgical debridement of purulent foci, local treatment (NPWT or dressings with antiseptic solutions) and skin grafting or healing by secondary intention after the transition of the wound process to the reparative stage. None of the patients in both groups had a high amputation. Not a single fatal outcome has been recorded. In patients of the main group, the transition of the wound process to the reparative stage was carried out in a shorter time compared with those treated without NPWT.Conclusion. Treatment of the neuropathic form of DFS with the NPWT (for example, patients in Ghana) reduces the hospital stay and the number of high amputations of the lower extremities, and improves the quality of life of patients.

Download Full-text

INFLUENCE OF OZONOTHERAPY AND LOCAL VACUUM THERAPY ON ACTIVATION OF THE REPARATIVE PROCESS IN PATIENTS WITH ISCHEMIC-GANGRENOUS FORM OF DIABETIC FOOT SYNDROME

Clinical anatomy and operative surgery ◽

10.24061/1727-0847.16.4.2017.92 ◽

2017 ◽

Vol 16 (4) ◽

pp. 42-45

Author(s):

A. H. Iftodii ◽

V. D. Fundiur ◽

V. K. Hrodetskyi ◽

S. O. Yakobchuk ◽

Yu. V. Fundiur ◽

...

Keyword(s):

Diabetic Foot ◽

Diabetic Foot Syndrome ◽

Vacuum Therapy ◽

Reparative Process

Download Full-text

OPTIMIZATION OF THE VACUUM-ASSISTED TREATMENT FOR COMPLICATIONS OF DIABETIC FOOT SYNDROME

The Medical and Ecological Problems ◽

10.31718/mep.2019.23.5-6.02 ◽

2019 ◽

Vol 23 (5-6) ◽

pp. 15-19

Author(s):

V.I. Liakhovskyi ◽

O.O. Kyzymenko ◽

O.H. Krasnov ◽

O.I. Krasnov ◽

T.V. Horodova-Andrieieva

Keyword(s):

Diabetic Foot ◽

Topical Treatment ◽

Comparison Group ◽

Local Treatment ◽

Main Group ◽

Diabetic Foot Syndrome ◽

Comprehensive Treatment ◽

Vacuum Therapy ◽

Second Phase ◽

Wide Range

The nature of reparative and morphological changes in wounds was examined against the background of vacuum therapy in the comprehensive treatment of purulent and necrotic lesions of diabetic foot syndrome. We conducted comprehensive examination and treatment of 107 patients with DFS of grade II-IV according to Meggit-Wagner. The average age of patients was 53.2–4.3 years; there were 39 (36.4%) male and 68 (63.6%) female patients. Depending on the methods of topical treatment, patients were divided into two groups. The main group consisted of 55 (51.4%) subjects who underwent vacuum therapy during the topical treatment, and the comparison group comprised 52 (48.6%) patients who received standardized local treatment depending on the course of the wound process. In addition to the clinical studies, all patients underwent a comprehensive laboratory and instrumental examination, as well as measuring the area and pH of wounds on the 1st, 4th, 7th, 10th and 13th day after surgery. The analysis of the obtained results gives ground to establish that at a certain level of pH, there is a corresponding cytological pattern. The wide range of fluctuations in the pH of the wound medium in patients with purulent and necrotic lesions of diabetic foot syndrome leads to corresponding changes in cells, which is manifested by a long-lasting inflammatory process. In the main group, the rate of wound reduction was greatest on the 8th-10th days, and in the comparison group – on the 14th-15th days. Inpatient treatment was 14.2 bed-days in the main group and 23.5 ± 2.9 in the comparison group (p <0.05), respectively. Therefore, there is an acceleration of positive changes in clinical manifestations, cytological, morphological and pH-metric pattern against the background of conducting VT for an average of 5-7 days. The use of vacuum therapy makes it possible to accelerate the transition to the second phase of the wound process, which affects not only the time of treatment but also the outcome – preservation of the lower extremity in patients with diabetic foot syndrome.

Download Full-text

EFFECT OF SUBATMOSPHERIC NEGATIVE PRESSURE ON BIASED pH CHANGES IN PURULENT NECROTIC DEFECTS IN DIABETIC FOOT SYNDROME

Актуальні проблеми сучасної медицини Вісник Української медичної стоматологічної академії ◽

10.31718/2077-1096.19.2.26 ◽

2019 ◽

Vol 19 (2) ◽

pp. 26-30

Author(s):

O.O. Kizimenko

Keyword(s):

Wound Healing ◽

Negative Pressure ◽

Diabetic Foot ◽

Negative Pressure Wound Therapy ◽

Diabetic Foot Syndrome ◽

Vacuum Therapy ◽

Second Phase ◽

Wound Therapy ◽

Ph Changes ◽

Therapy Efficacy

The number of patients with diabetes mellitus worldwide is increasing with geometric progression, and thus there is an increase in the percentage of related complications. Diabetic foot syndrome is one of the most serious chronic complications that often results in early disability, long stretches of hospitalization, mounting expenses, and an amputated limb. At present, vacuum therapy in the treatment of purulent necrotic lesions of diabetic foot syndrome is being successfully used in medical practice. The aim of our study was to search and verify for indirect methods of express control of the vacuum therapy efficacy. Based on applying our patented local treatment technique, which includes the negative pressure wound therapy, we determined the pH dynamic changes and the monitored the microbiological climate of wounds. According to the results obtained, the high efficacy of the proposed technique has been found out and statistically confirmed. Starting from the 4th day of applying this technique, the main group demonstrated induced, significantly accelerated pH changes in the wounds that create the conditions for early growth of granulation tissue; the reduction of microbial load in the wound indirectly enhances these processes that were found out twice as slow in the comparison group. Therefore, the contact pH monitoring of wound is quite helpful for checking the therapy efficacy as well as for predicting the course of wound healing. Our study has confirmed its effectiveness in pH changing that positively affects the course of wound healing. Applying negative pressure wound therapy as an integral component of combined treatment of purulent necrotic lesions of diabetic foot syndrome allows medical practitioners to accelerate pH changes to reach their optimum values and considerably promotes the beginning of the second phase of wound healing. The study has also proven the enhanced elimination of bacterial agents from the wound by using this technique that also promotes the early activation of the phase 2 and significantly reduces the percentage of suppurative complications in the future.

Download Full-text