scholarly journals Study of the influence of vacuum therapy on the wound process in patients with diabetic foot syndrome

2019 ◽  
Vol 74 (4) ◽  
pp. 283-288
Author(s):  
Petr A. Gerasimchuk ◽  
Alexander V. Shidlovskyi ◽  
Dmitriy B. Fira ◽  
Andrey V. Pavlyshyn
Keyword(s):  
Diabetes Mellitus ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Chronic Wound ◽  
Lower Limbs ◽  
Diabetic Foot Syndrome ◽  
Vacuum Therapy ◽  
Social Significance ◽  
Number Of Patients ◽  
Bed Days

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.

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

2019 ◽  
Vol 41 part 1 (2) ◽  
pp. 40-44 ◽  
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.

scholarly journals Peculiarities Of Treatment Of Purulent-Necrotic Complications In Patients With Diabetic Foot Syndrome

2021 ◽  
Vol 03 (06) ◽  
pp. 116-121
Author(s):  
Abdullaev R.N. ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Diabetic Foot Syndrome ◽  
Septic Complications ◽  
Complications Of Diabetes ◽  
Surgical Infection ◽  
Number Of Patients ◽  
Patients With Diabetes

The number of patients with diabetes mellitus in the Andijan region who were registered according to endocrinologists from 2000 to 2015 increased almost fourfold from 26,000 to more than 110,000 in 2016 (14). This also shows that the number of patients with various purulent-necrotic complications of diabetes mellitus also increases proportionally, in addition, there is an increase in patients with severe purulent-septic complications of these processes, with widespread, deep purulent-necrotic fasciitis [3]. Of patients in the department of surgical infection of the ASMI clinic, patients with purulent-necrotic complications of diabetes mellitus account for almost 78%, which indicates a significant increase in the number of these patients. This tendency continues and goes up every year. According to the WHO, by 2030 every 15 people will have diabetes, and by 2050 this figure will be equal to every 6 people.

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

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.

Experience of using atraumatic ointment bandages based on peruvian balsam in the complex treatment of patients with chronic wound defects of the lower limbs

2020 ◽  
pp. 43-57
Author(s):  
Anna Tabuika
Keyword(s):  
Diabetes Mellitus ◽  
Staphylococcus Aureus ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Local Treatment ◽  
Lower Limbs ◽  
Complex Treatment ◽  
Average Area ◽  
Arterial Insufficiency ◽  
Significant Activation

The article reflects the results of a retrospective non-comparative study, the objects of which were 34 outpatient comorbid patients (15 of which are over 60 years old) with chronic wounds of the lower limbs developed against the background of varicosity, post-thrombotic disease, chronic arterial insufficiency of the lower limbs, diabetes mellitus or their combination. Their local treatment was carried out using atraumatic ointment dressing «Branolind N» containing Peruvian balsam. There were 23 women (67.6 %) and 11 men (32.4 %). In microbiological study prior to the beginning of treatment in 31 patients the growth of a pathogen of wound infection was revealed; in 19 patients — Staphylococcus aureus in monoculture and in various associations, in 6 patients — Pseudomonas aeruginosa in monoculture, in other cases — other pathogens. In 3 patients the pathogen was not detected. The average wound size was 34 cm2 . The phase of the wound process was additionally confirmed by cytological studies. After treatment the average area of the wound defect decreased by 10 cm2 and made 24 cm2 on average. Full healing of the wound defect occurred in 11 patients, the others had granulation and active marginal epithelization. There was also a decrease in bacterial semination of wounds, a change in composition of infection agents to less aggressive monoflora, and cytologically — a decrease in signs of inflammation against the background of significant activation of reparative processes.

scholarly journals Negative pressure wound therapy use in diabetic foot syndrome-from mechanisms of action to clinical practice

2019 ◽  
Vol 49 (4) ◽  
pp. e13067 ◽  
Author(s):  
Sebastian Borys ◽  
Jerzy Hohendorff ◽  
Claudia Frankfurter ◽  
Beata Kiec-Wilk ◽  
Maciej T. Malecki
Keyword(s):  
Clinical Practice ◽  
Negative Pressure ◽  
Diabetic Foot ◽  
Negative Pressure Wound Therapy ◽  
Mechanisms Of Action ◽  
Diabetic Foot Syndrome ◽  
Wound Therapy

scholarly journals DIABETIC FOOT SYNDROME

2021 ◽  
pp. 139-143
Author(s):  
H.A. Bliznets ◽  
◽  
I.A. HadjiIsmail ◽  
A.C. Shuleiko ◽  
V.M. Shyshko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Foot ◽  
Premature Mortality ◽  
Cost Effective ◽  
Diabetic Foot Syndrome ◽  
Vascular Lesions ◽  
Modern World ◽  
Common Disease ◽  
Cost Effective Treatment ◽  
Working Age

In the modern world, diabetes mellitus is a common disease with multiple consequences, the main complications are vascular lesions (macroangiopathy) and nerves, which are the cause of many complications, such as chronic renal failure and blindness and amputations in patients of working age, which leads to early disability and premature mortality. In the treatment of diabetes mellitus, most of the costs are for the treatment of complications, and the most cost-effective treatment is still treatment for ulcers of the feet. The article defines the essence and classification of diabetic foot syndrome, highlights the stages of diagnosis, as well as the main approaches to its treatment, describes the basics of prevention.

scholarly journals Orthoses in diabetic foot treatment and prevention

2013 ◽  
Vol 94 (4) ◽  
pp. 536-541
Author(s):  
I V Klyushkin ◽  
K A Koreyba
Keyword(s):  
Diabetes Mellitus ◽  
Elastic Material ◽  
Diabetic Foot ◽  
Silver Ions ◽  
Cost Effective ◽  
Diabetic Foot Syndrome ◽  
Treatment And Prevention ◽  
Positive Treatment ◽  
Orthopedic Shoes

Aim. To define the role of orthoses in the treatment and rehabilitation of patients with diabetic foot syndrome. Methods. The review of the literature addressing the use of special orthopedic shoes in the treatment and rehabilitation of patients with complicated diabetes mellitus was performed. Results. The common requirements for orthopedic shoes for patients with complicated diabetes mellitus are the following: (1) rigid sole with an artificial curvature; (2) boot-tree elevated by 8 mm due to arch supporter, adequate volume, wide sole, removable insole; (3) insole without functional memory; (4) thermally variable elastic material, advisably with silver ions, for the lining; (5) minimal number of sutures at the lining; (6) no elastic material at the front of the shoe and at the lining at the toes; (7) increased volume and enough space for the toes; (8) front slant of 15°; (9) potential ability to adjust the inner volume of the shoe; (10) hard counter - stabilizing hard back with additional softening at the lining side; (11) heel with a front slant or a solid sole without a heel; (12) smooth non-traumatic surface suitable for scrubbing including cleansing with antiseptics. The indications for orthopedic relief in patients with diabetic foot syndrome are explained. Economic superiority of organ-preserving approaches in such patients is shown. There is an opposition for conservative methods of treatment of patients with diabetic foot syndrome, nevertheless, an amputation can not be estimated as a positive treatment outcome in such patients. Almost 70-90% of ulcers in this group of patients are healed without amputation. Limb-saving treatment and the use of specially selected shoes are cheaper and more cost-effective compared to the limb loss. Conclusion. The use of orthopedic shoes in patients with diabetic foot syndrome is used both for treatment and rehabilitation. This technique can reduce the risk of ulceration and prevent organ-sparing surgeries.

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

2018 ◽  
Vol 19 (4) ◽  
pp. 373-382 ◽  
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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