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

  • V.I. Liakhovskyi Ukrainian Medical Stomatological Academy (Poltava)
  • O.O. Kyzymenko Ukrainian Medical Stomatological Academy (Poltava)
  • O.H. Krasnov Ukrainian Medical Stomatological Academy (Poltava)
  • O.I. Krasnov Ukrainian Medical Stomatological Academy (Poltava)
  • T.V. Horodova-Andrieieva Ukrainian Medical Stomatological Academy (Poltava)
Keywords: purulent and necrotic lesions, diabetic foot syndrome, vacuum therapy

Abstract

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.

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References

1. Besedіn OM, Zigankov KV, Grischenko PO Morfologіchna charakteristika ran u chvorich zukrovim dіabetom na fonі vakuumterapіi. Charkіvs'ka chіrurgіchna shkola. 2016; 1(76):51-57.
2. Vasilyuk SM, Krilez' SA Chіrurgіchne lіkuvannya іnfіkovanich virazok u chvorich іz sindromom dіabetichnoi stopi. Ukrayins'kiy zhurnal chіrurgіi. 2013; 1(20):S. 20-24.
3. Dedov II, Tokmakova AYu, Egorova DN, Galstyan GR Klinicheskie rekomendazii po diagnostike i lecheniyu sindroma diabeticheskoy stopy (2015). Mіzhnarodniy endokrinologіchniy zhurnal. 2015; 7:105-112.
4. Lyapіs MO, Gerasimchuk PO Sindrom stopi dіabetika. Ternopіl'. – Ukrmedkniga. 2001: 275s.
5. Kutovoy AB, Kosul'nikov SO, Tarnapol'skiy SA Lechenie gnoynoy rany s ispol'zovaniem vakuuma. Klіnіchna chіrurgіya. 2011; 6: 59-61.
6. Obolenskiy VN, Semenistyy AYu, Mikitin VG, Sychev DV.Vakuum-terapiya v lechenii ran i ranevoy infekzii. RMZh. 2010; 18,17(381): 1064-1072.
7. Svetuchin AM, Zemlyanoy AB, Koltunov VA Otdalennye rezul'taty lecheniya bol'nych s gnoyno–nekroticheskimi formami sindroma diabeticheskoy stopy. Chirurgiya. 2008; 7:8–10.
8. Kizimenko OO, Lyachovs'kiy VІ, Gorodova-Andreeva TV, Krasnov OG, vinachіdniki; Ukrayins'ka medichna stomatologіchna akademіya, patentovlasnik. Sposіb lіkuvannya-gnіyno-nekrotichnich urazhen' sindro-mu dіabetichnoї stopi. Patent Ukraїni № 126213 2018 serp 11.
9. Udovichenko OV, Grekova NM Diabeticheskaya stopa. M.: Prakticheskaya medizina, 2010: 272 s.
10. Armstrong DG, Boulton AJM, Bus SA Diabetic Foot Ulcers and Their Recurrence. New England Journal of Medicine. 2017;376 (24): 2367-2375.
11. Cavanagh P, Attinger С, Abbas Z et all. Cost of treating diabetic foot ulcers in five different countries. Diabetes Metab Res Rev. 2012; 28(suppl 1): 107-111.
12. Dinh T, Tecilazich F, Kafanas A et all. Mechanisms involved in the development and heal¬ing of diabetic foot ulceration. Diabetes. 2012; 61(11):2937-2947.
13. Kvitkina T, Narres M, Claessen H et all. Incidence of lower extremity amputation in the diabetic compared to the non-diabetic population: a systematic review protocol. Syst Rev. 2015; 4:74.
14. Lipsky BA, Berendt AR, Cornia PB et all. Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections. Clin Infect Dis. 2012; 54:132-173.
15. Vela-Orús MP, Osma-Chacharro S, Ortiz-García-Diego N Use of negative pressure wound therapy in the treatment of diabetic foot ulcers. Angiología. 2015; 67:427-430.
16. Willy C, Agarwal A, Andersen C Closed incision negative pressure therapy: international multidisciplinary consensus recommendations. International Wound Journal. 2016; 1-14.
Published
2019-12-16
How to Cite
Liakhovskyi, V., Kyzymenko, O., Krasnov, O., Krasnov, O., & Horodova-Andrieieva, T. (2019). OPTIMIZATION OF THE VACUUM-ASSISTED TREATMENT FOR COMPLICATIONS OF DIABETIC FOOT SYNDROME. The Medical and Ecological Problems, 23(5-6), 15-19. https://doi.org/10.31718/mep.2019.23.5-6.02