Endovascular surgery for the treatment of purulent and necrotic complications in diabetic foot syndrome

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.

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Three-color spectroscopic terahertz images as an indicator for diabetic foot syndrome deterioration

2018 43rd International Conference on Infrared, Millimeter, and Terahertz Waves (IRMMW-THz) ◽

10.1109/irmmw-thz.2018.8510279 ◽

2018 ◽

Author(s):

G.G. Hernandez-Cardoso ◽

M. Alfaro-Gomez ◽

S.C. Rojas-Landeros ◽

I. Salas-Gutierrez ◽

E. Castro-Camus

Keyword(s):

Diabetic Foot ◽

Diabetic Foot Syndrome

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

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17116/vto201803-04147 ◽

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.

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