scholarly journals COMPARATIVE CHARACTERISTICS OF TREATMENT RESULTS USING THE OFFLOADING MEANS IN PATIENTS WITH PURULENT-NECROTIC COMPLICATIONS OF DIABETIC FOOT SYNDROME

2021 ◽  
Vol 74 (8) ◽  
pp. 1891-1893
Author(s):  
Rostyslav S. Shevchenko ◽  
Stanislav I. Shevchenko ◽  
Dmytro S. Pryimenko ◽  
Oksana S. Tsyganenko ◽  
Vladimir M. Feskov
Keyword(s):  
Pain Intensity ◽  
Diabetic Foot ◽  
Inpatient Treatment ◽  
Healing Process ◽  
Laboratory Data ◽  
Diabetic Foot Syndrome ◽  
Clinical Indicators ◽  
Surgical Interventions ◽  
Accelerate Wound Healing ◽  
Minimal Contact

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.

Pro- and Anti-Angiogenic Factors: Their Relevance in Diabetic Foot Syndrome—A Review

Angiology ◽  
2021 ◽  
pp. 000331972110426
Author(s):  
Martyna Schönborn ◽  
Patrycja Łączak ◽  
Paweł Pasieka ◽  
Sebastian Borys ◽  
Anna Płotek ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Healing Process ◽  
Arterial Disease ◽  
Angiogenic Factors ◽  
Diabetic Foot Syndrome ◽  
Tissue Loss ◽  
Comprehensive Treatment ◽  
Diabetic Patients ◽  
Impaired Wound Healing ◽  
Peripheral Arterial

Peripheral arterial disease can involve tissue loss in up to 50% of patients with diabetic foot syndrome (DFS). Consequently, revascularization of narrowed or occluded arteries is one of the most common forms of comprehensive treatment. However, technically successful angioplasty does not always result in the healing of ulcers. The pathomechanism of this phenomenon is still not fully understood, but inadequate angiogenesis in tissue repair may play an essential role. Changes in pro- and anti-angiogenic factors among patients with DFS are not always clear and conclusive. In particular, some studies underline the role of decreased concentration of pro-angiogenic factors and higher levels of anti-angiogenic mediators. Nevertheless, there are still controversial issues, including the paradox of impaired wound healing despite high concentrations of some pro-angiogenic factors, dynamics of their expression during the healing process, and their mutual relationships. Exploring this process among diabetic patients may provide new insight into well-known methods of treatment and show their real benefits and chances for improving outcomes.

scholarly journals Surgical correction of foot deformities as a method for prevention and treatment of diabetic foot syndrome

2018 ◽  
Vol 25 (3-4) ◽  
pp. 47-57
Author(s):  
M. V Parshikov ◽  
P. S Bardyugov ◽  
G. R Galstyan ◽  
N. V Yarygin ◽  
V. M Golovchak ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Mechanical Effect ◽  
Diabetic Foot Syndrome ◽  
Foot Deformities ◽  
Surgical Interventions ◽  
Ulcer Relapse ◽  
Study Results ◽  
Prevention And Treatment ◽  
Grade 3

Purpose: to study the potentialities of orthopaedic surgery in foot deformities as a method for prevention and treatment of diabetic foot syndrome (DFS). Patients and methods. During the period from 2014 to 2017 thirty seven patients (13 men and 24 women aged 47 - 75 years) with DFS were operated on for feet deformity. According to Texas University classification 4 patients had grade 0, 7 - grade 3 and 26 patients - grade 4a pathology. Primary deformities were observed in 13 cases, secondary deformities resulting from DFS - in 24 cases. Forty seven different surgical interventions were performed. All interventions were grouped according to D.G. Armstrong classification for DFS surgical treatment. The surgical task was the correction of biomechanics, unloading of foot segments that were subjected to high mechanical effect caused by the deformity. Results. The follow up period was from 2 moths to 3 years. Primary healing of the ulcers was observed after 32 surgical interventions. In 2 cases revision (more radical) surgical intervention was performed. No deformity relapse was noted. Postoperative wound suppuration was recorded in 1 case. Ulcer relapse was observed in 1 case. Conclusion. The study results allow suggesting a significant role and wide-ranging potentialities of surgical orthopaedics for the effective and functional treatment of patients with DFS.

scholarly journals Modern approaches to local treatment of pyo-necrotic complications of the diabetic foot syndrome

2012 ◽  
Vol 93 (2) ◽  
pp. 301-303
Author(s):  
L E Slavin ◽  
B N Godzhaev ◽  
A Z Zamaleev
Keyword(s):  
Wound Healing ◽  
Diabetic Foot ◽  
Healing Process ◽  
Local Treatment ◽  
Water Soluble ◽  
Diabetic Foot Syndrome ◽  
Layered System ◽  
Second Phase ◽  
Bathing Solution ◽  
Optimal Conditions

The analysis of publications devoted to modern methods of treatment of pyo-necrotic complications of diabetic foot syndrome has been presented. Identified were the most important principles of therapeutic tactics for this type of pathology. In order to create optimal conditions for wound healing after surgical sanitation local drug treatment is carried out - a thorough wound detersion with application of the isotonic sodium chloride solution or a neutral bathing solution, periodic (as needed) necrectomies, application of bandages, in accordance with the phase of wound healing process. The choice of medication for local treatment depends on the one hand on the type of lesion of the lower limbs, on the other - on the diabetes related morbidity and phase of wound healing. In the first phase of wound healing antiseptics are used: iodophors, polyhexanide (lavasept), hydroxymethyl quinoxaline dioxide (dioxidine), and in the absence of ischemia - compositions based on gelevine, water-soluble base ointments. In the second phase used were various wound covers based on collagen, as well as oil and hydrogel dressings. Ready-to-use bandages are also used, which are multi-layered system, comprised of a cellulose substrate, collagen, fibroblasts, growth factor, coated with plates of silicon to control humidity. The disadvantage of the ready-to-use dressings is the impossibility of controlling the wound on a daily basis. One of the trends in the treatment of chronic diabetic wounds is the use of living skin cells that serve as a source of growth factors, cytokines and other proteins that stimulate the healing process. The use of local immunomodulators is seen as promising. Treatment should be individualized and systemic antibiotic therapy is required. The main principle of local treatment is the creation of optimal conditions for accelerating the healing process.

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

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.

scholarly journals Growth factors in the treatment of diabetic foot syndrome

2019 ◽  
Vol 22 (4) ◽  
pp. 377-383
Author(s):  
Elena Y. Komelyagina ◽  
Michail B. Antsiferov
Keyword(s):  
Growth Factors ◽  
Growth Factor ◽  
Diabetic Foot ◽  
Chronic Wounds ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Diabetic Foot Syndrome ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Level Of Evidence

Growth factors play a key role in wound healing, deficiency of which leads to delayed healing. Various growth factors are used in the treatment of chronic wounds, including diabetic foot ulcers. The purpose of this review was to analyse the literature data on the effectiveness of epidermal growth factor, platelet-rich plasma and platelet growth factor in patients with diabetic foot syndrome. The effect of treatment with these growth factors on healing of diabetic foot ulcers and healing time were analysed. Published studies, mostly with low level of evidence, demonstrate a positive effect of various growth factors on the healing process of diabetic foot ulcers. Currently, there is no conclusion on the advantages of growth factor therapy. Further studies with a high level of evidence are needed to justify their use in routine clinical practice.

scholarly journals Predictors of unfavorable course of wound process in postoperative period in patients with purulent-necrotic complications of neuropathic and neuroischemic forms of diabetic foot syndrome

2020 ◽  
pp. 4-10
Author(s):  
Petr P. Kurlaev ◽  
Viktor A. Gritsenko ◽  
Yuliya P. Belozertseva
Keyword(s):  
Postoperative Period ◽  
Diabetic Foot ◽  
Clinical Laboratory ◽  
Main Group ◽  
Diabetic Foot Syndrome ◽  
Purulent Discharge ◽  
Surgical Interventions ◽  
Therapy Regimen ◽  
Microbiological Parameters ◽  
Surgical Tactics

Objective: to identify predictors of an unfavorable course of the wound process in the postoperative period in patients with purulent-necrotic complications (PNC) of neuropathic and neuroischemic forms of diabetic foot syndrome (DFS). Materials and methods. A comparative analysis of anamnestic, clinical, laboratory, and microbiological parameters of 40 patients with PNC of DFS, divided into 2 statistically homogeneous opposition groups of 20 patients each. Studies were conducted at the time of admission of patients to the hospital and 3-5 days after surgical treatment. In patients of the 1 (main) group with an unfavorable course of the wound process in the postoperative period, there was a need for repeated surgical interventions, and in patients of the 2 (compared) group, wound healing occurred after a single radical surgical aid. Results. Preoperative biomarkers of unfavorable course of wound process in patients with PNC of DFS were: age less than 60 years, treatment with insulin before admission, the lesion of the foot tissue of 4-5 degree (according to Wagner), the persistence of pulsation at a. dorsalis pedis, contamination of the wound by Pseudomonas aeruginosa or Staphylococcus aureus with gram-negative bacteria, resistance of the wound microflora to cephalosporins. In the postoperative period on the 3-5 days the patients of the main group significantly more often developed the following signs: hyperthermia >37.5°C, hypoalbuminemia <35 g/l, hyperglycemia >10 mmol/l and local signs of inflammation in the affected foot area, such as pain, edema, hyperemia, inconsistency of sutures, wet necrosis and purulent discharge from the wound, as well as detection of P. aeruginosa or enterobacteria. Conclusion. The identified biomarkers can be used to develop a model for predicting the unfavorable course of the wound process in the postoperative period in patients with PNC of neuropathic and neuroischemic forms of DFS which, in turn, will allow optimizing surgical tactics and timely adjusting the conservative therapy regimen.

Screening of Kazakhstan plants useful in the treatment of diabetic foot syndrome

Planta Medica ◽  
2013 ◽  
Vol 79 (13) ◽  
Author(s):  
TS Kustova ◽  
LK Mamonov ◽  
CL Cantrell ◽  
SA Ross
Keyword(s):  
Diabetic Foot ◽  
Diabetic Foot Syndrome
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