SYNDROME OF DIABETIC FOOT: MODERN APPROACHES OF COMPLEX TREATMENT

The article presents the results of treatment of 201 patients with neuroischemic form of diabetic foot syndrome. The research included 158 women and 43 men of the middle age of 62,5±11,2 years. The complex approach was applied in treatment includ ing medicamentous treatment, revasculization of extremity, an application of modern combined collagenous coating and foot relieving using silicone insoles and orthopedic footwear. The endovascular and open reconstructive operations were performed in order to obtain the revasculization of extremity. Given complex approach allowed reducing the terms of hospital stay, the rate of ulcerous defects recurrences and relapses of ischemia of lower extremities during one year after endovascular interventions.

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Mini-invasive revascularization operations in the complex treatment of neuroischemic and ischemic forms of diabetic foot syndrome

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v20i4.54140 ◽

2021 ◽

Vol 20 (4) ◽

pp. 817-825

Author(s):

Bazylbek Zhakiyev ◽

Murat Jakanov ◽

Bernat Zhanabaev ◽

Anuar Koyshibaev ◽

Samat Mukanov ◽

...

Keyword(s):

Diabetic Foot ◽

Treatment Success ◽

Medical Science ◽

Blood Flow Rate ◽

Main Group ◽

Lower Limbs ◽

Diabetic Foot Syndrome ◽

Control Group ◽

Complex Treatment ◽

Endovascular Interventions

Objective: Diabetic foot syndrome is the most dramatic complication of diabetes mellitus. The treatment success is impossible without improving blood circulation and the elimination of hemodynamic disorders in the affected limb.The study aim was to evaluate mini-invasive revascularization operations effectiveness on the lower limbs peripheral arteries in neuro-ischemic and ischemic diabetic foot syndrome forms. Materials and methods: The study enrolled 104 patients with purulent-necrotic complications of diabetic foot syndrome. 54 (51.9%) patients underwent stenting and balloon angioplasty (the main group). The comparison group included 50 (48.1%) patients, undergoing indirect revascularization surgeries in complex treatment. Results and discussion:After endovascular interventions, the API index increased by 47.6% (p<0.01) after 20 days compared to the admission index, the average blood flow rate increased by 1.8 times (p<0.01), and the tPo2 value improved by 67.8% (p<0.01). In the control group, the tPo2 value increased by 40.3% after 20 days, and API – by 34.4%. In the main group, the swelling disappearance in the foot wounds area was by 3.7±0.5 days faster (p<0.001), wounds purification by 4.1 days (p<0.001), granulation appearance by 3.5±0.4 days (p<0.001), wound margins infiltration disappearance happened 3.3±0.9 days earlier (p<0.001), and the wound epithelization was 2.9 days earlier (p<0.01) than in the control group patients. Conclusion: Foot support function at discharge from hospital was preserved in 94.4% of the main group and in 84% of the control group. Bangladesh Journal of Medical Science Vol.20(4) 2021 p.817-825

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CURRENT VIEW ON PATHOGENETIC APPROACH IN SURGICAL TREATMENT OF PATIENTS WITH DIABETIC FOOT SYNDROME

Perm Medical Journal ◽

10.17816/pmj35112-20 ◽

2018 ◽

Vol 35 (1) ◽

pp. 12-20

Author(s):

V P Okroyan ◽

T R Ibragimov ◽

O V Galimov ◽

V O Khanov

Keyword(s):

Diabetes Mellitus ◽

Diabetic Foot ◽

Surgical Techniques ◽

Diabetic Foot Syndrome ◽

Long Term Results ◽

Current View ◽

Results Of Treatment ◽

Complex Approach

Aim. To improve the immediate and long-term results of diabetic foot syndrome treatment, using modern surgical techniques. Materials and methods. The results of treatment of 264 patients were analyzed. For these patients with purulo-necrotic affection of extremities against the background of diabetes mellitus, complex treatment, including the techniques of extremity revascularization as well as modern hydrocolloid bandage materials, depending on the stage of wound process, was used; different variants of foot unloading at the clinical and ambulatory stages were offered. The method of treatment of purulo-necrotic wounds against the background of diabetes mellitus, based on differentiated use of ozonotherapy combined with application of biomaterials for closing ulcerous defects, was developed and introduced by the authors. Results. The systemic approach and criteria for choosing surgical strategy of diabetic foot syndrome treatment were worked out and presented. The immediate and long-term results of using the introduced scheme of the management of patients were studied. Conclusions. The developed complex approach is aimed at preservation of the foot and supporting function of the lower extremity; its clinical use permits to decrease the percent of amputations and lethality, improving patients’ quality of life indices.

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Treatment of the diabetic foot infections in septic surgery unit of the municipal versatile hospital

Regional blood circulation and microcirculation ◽

10.24884/1682-6655-2015-14-1-60-66 ◽

2015 ◽

Vol 14 (1) ◽

pp. 60-66

Author(s):

A. A. Protasov ◽

N. A. Bubnova ◽

M. A. Shatil ◽

A. S. Soloveichik ◽

K. S. Suprun ◽

...

Keyword(s):

Diabetic Foot ◽

Volume Flow ◽

Diabetic Foot Syndrome ◽

Complex Treatment ◽

Peripheral Speed ◽

Diabetic Foot Infections ◽

Complex Therapy ◽

Popliteal Block ◽

Surgical Unit

Experience of surgical and complex treatment more than 2500 patients with the purulent and necrotic complications of various forms of a diabetic foot syndrome was generalized. The number of such patients in our unit for the last fifth anniversary in comparison with previous years was doubled. At an ischemic form vasodilating complex therapy was carried out. At the femoral and popliteal block with a limited distal necrosis autovenous shunting with the subsequent economical necretomy was carried out, without sending of the patient from the septic surgical unit. In a case of the neuropathic form of a diabetic foot syndrome drainage of suppurative focuses, economical and sometimes repeated necretomies at various levels of the foot was made. It allowed us to keep foot of the patient for an extremity support in 80 % of the all cases. Frequency of high amputations in recent years was reduced, at the level of a femur from 13 to 1.4 %, at the level of a shin - from 11.5 to 5.8 %. In diagnostics, operation scoping and an assessment of effectiveness of treatment, researches of microcirculation by means of the device «Minimax-Doppler-К» were used. When the indexes of the peripheral speed of a linear bloodflow more than 1.6 mm/sec and rate of volume flow more than 0.0128 ml/min reamputation was not required.

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Result of using a minimally invasive method of surgical treatment of purulent-necrotic complications in a patient with diabetic foot syndrome

Russian Military Medical Academy Reports ◽

10.17816/rmmar64986 ◽

2020 ◽

Vol 39 (3) ◽

pp. 60-64

Author(s):

Sergey Y. Ivanusa ◽

Boris V. Risman ◽

Andrey V. Yanishevskiy

Keyword(s):

Surgical Treatment ◽

Minimally Invasive ◽

Diabetic Foot ◽

Pain Syndrome ◽

Diabetic Foot Syndrome ◽

Military Medical Academy ◽

Results Of Treatment ◽

Medical Academy ◽

Invasive Method ◽

Short Time

The article presents an analysis of the results of treatment of a patient with purulent-necrotic complications of diabetic foot syndrome, who, in the framework of surgical treatment, used a minimally invasive method of treatment of purulent-necrotic complications of diabetic foot syndrome, developed at the departments of general surgery and normal anatomy of the S.M. Kirov Military Medical Academy. The effectiveness of the developed method has been demonstrated, which makes it possible to sanitize the purulent cavity in a short time, stop pain syndrome and restore the support ability of the foot (4 figs, 1 table, bibliography: 7 refs).

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Complex treatment of patients with pyo-necrotic complications of the neuropathic form of diabetic foot syndrome

Khirurgiya Zhurnal im N I Pirogova ◽

10.17116/hirurgia202004181 ◽

2020 ◽

pp. 81

Author(s):

B.M. Belik ◽

I.P. Chumburidze ◽

M.Yu. Shtilman ◽

O.A. Yavruyan ◽

Yu.P. Savchenko

Keyword(s):

Diabetic Foot ◽

Diabetic Foot Syndrome ◽

Complex Treatment

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Bubbling Treatment Option in the Complex Therapy of Diabetic Foot Syndrome

Vestnik of Experimental and Clinical Surgery ◽

10.18499/2070-478x-2021-14-3-210-215 ◽

2021 ◽

Vol 14 (3) ◽

pp. 210-215

Author(s):

Anton Petrovich Ostroushko ◽

Alexander Alekseevich Andreev ◽

Alexander Alexandrovich Shmarin ◽

Vladislav Valeryevich Novomlinsky ◽

Anastasia Yurievna Laptiyova ◽

...

Keyword(s):

Treatment Option ◽

Diabetic Foot ◽

Soft Tissues ◽

Treatment Method ◽

Late Complications ◽

Diabetic Foot Syndrome ◽

Control Group ◽

Results Of Treatment ◽

Patients With Diabetes ◽

After Cancer

Diabetes mellitus (DM) is the most common and socially significant endocrine disease that leads to early disability and is the most common cause of mortality in patients after cancer and cardiovascular pathology. The cost of managing patients with diabetes can reach 30% of the country's health budget, 90% of which is spent on the treatment of its complications. Diabetic foot syndrome (DFS) is developed in 20-80% of patients and is one of the most dangerous late complications. In clinical practice, various approaches to its treatment are used, but the number of high amputation and mortality rate in this group of patients remains significant. The aim of the study was to improve the results of treatment of patients with diabetic foot syndrome (DFS) by including the bubbling treatment method in the program of therapeutic measures. Forty-eight patients with neuropathic and neuroischemic forms of DFS were treated. The control group consisted of 23 patients receiving conventional treatment, the main group included 26 patients, who were applied bubbling treatment option locally. The analysis of groups of patients showed no significant differences by gender, age, stages of diabetic foot syndrome, depth of necrotic defect, complications and concomitant diseases. The use of the bubbling treatment method in the complex treatment of patients with DFS allowed more effectively arresting symptoms of local (edema, hyperemia, wound exudate, necrolysis) and general inflammation, anemia and intoxication syndromes, contributed to the activation of regeneration processes in soft tissues, which, combined with complex FDS treatment, together, reduced the number of amputations by 18.7%.

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The results of complex treatment of patients after metatarsal resection concerning complications of diabetic foot syndrome

10.18411/spc-31-05-2017-15 ◽

2017 ◽

Author(s):

E. Krivoshchekov ◽

E. Elshin ◽

V. Romanov

Keyword(s):

Diabetic Foot ◽

Diabetic Foot Syndrome ◽

Complex Treatment

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Biological Mechanisms of Chronic Wound and Diabetic Foot Healing: The Role of Collagen

Serbian Journal of Experimental and Clinical Research ◽

10.2478/sjecr-2018-0077 ◽

2018 ◽

Vol 19 (4) ◽

pp. 373-382 ◽

Cited By ~ 5

Author(s):

Victor Alexandrovich Stupin ◽

Ruslan Borisovich Gabitov ◽

Tatiana Georgievna Sinelnikova ◽

Ekaterina Vladimirovna Silina

Keyword(s):

Wound Healing ◽

Diabetic Foot ◽

World Literature ◽

Chronic Wounds ◽

Chronic Wound ◽

Treatment Algorithm ◽

Diabetic Foot Syndrome ◽

Results Of Treatment ◽

Native Collagen ◽

Chronic Ulcers

Abstract The treatment of chronic wounds is a continuously developing research focus. The problems of excessive mechanical forces, infection, inflammation, reduced production of growth factors, and lack of collagen will affect the results of treatment. The purpose of this study was to analysse the elements that lead to long-term non-healing of chronic wounds and trophic ulcers, including diabetic foot syndrome, by determining the optimal treatment algorithm. The paper presents an analysis of the world literature on the etiopathogenesis and principles of chronic wound treatment in diabetic foot syndrome. The epidemiology of chronic wounds of different genesis is presented. The issues of physiological and metabolic disorders in chronic ulcers affecting the process of wound healing are discussed. Particular attention is paid to collagen, which is a protein that forms the basis of connective tissue; collagen ensures the strength and elasticity of the skin, which confirms the importance of its role not only in aesthetics but also in the process of wound healing. Different types of collagen and their roles in the mechanisms of chronic wound healing in diabetic foot syndrome are described. The results of clinical studies evaluating the effectiveness of medical products and preparations, consisting of collagen with preserved (native collagen) and fractionated structures, in treating chronic wounds of diabetic foot syndrome are analysed. It has been shown that the use of native collagen preparations is a promising treatment for chronic ulcers and wounds, including diabetic foot syndrome, which makes it possible to increase the effectiveness of treatment and reduce the economic costs of managing these patients.

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Prostaglandin E1 in vascular reconstructive operations in patients with diabetic foot syndrome

Kazan medical journal ◽

10.17816/kmj2340 ◽

2012 ◽

Vol 93 (2) ◽

pp. 370-371

Author(s):

K A Koreyba ◽

A V Maksimov

Keyword(s):

Blood Vessels ◽

Diabetic Foot ◽

Prostaglandin E1 ◽

Lower Extremities ◽

Perioperative Period ◽

Diabetic Foot Syndrome ◽

Reconstructive Operations

The article presents the results of using prostaglandin E1 in the perioperative period in patients with diabetic foot syndrome who underwent reconstructive operations on the blood vessels of the lower extremities. This method made it possible to optimize the treatment of this group of patient.

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