Anaplerosis in Complex Treatment of Patients with Diabetic Foot Syndrome
The article describes the improvement of anaplerosis in patients with diabetic foot syndrome using skin flaps on vascular pedicle of the perforating vessels. The study involved patients with type 2 diabetes mellitus complicated with diabetic foot syndrome of neuroischemic form and chronic wounds of the lower extremities that do not heal for more than 21 days from the date of occurrence. The wounds were cleaned with ultrasonic cavitation. There was applied bandage with sorption antibacterial remedy base on nanodispersed silicon dioxide. There was applied a drainage vacuum bandage on a wound on the third day (VAC therapy). The flap is forming fitting to the size and configuration of a wound on a foot. Fourteen patients (93 %) in the basic group were found to have survived flaps. Long-term follow up in 6 months demonstrated full maintenance of supporting function and good survived skin graft, absence of foot ulcers. In a control group 7 patients had recurrent foot ulcer. Improved techniques of autodermoplasty in patients with diabetic foot syndrome include glycemia control, preparation of a wound using vacuum apparatus bandage. Usage of split-skin graft combined with vacuum apparatus bandage allows close acute and chronic wounds effectively, maintain supporting function of an extremity, decrease in-hospital staying, and improve quality of patient’s life. Adequate foot wound closure prevents high-level amputation of low extremities in diabetic patients.
Anikin A.I., Gorjunov S.V., Zhidkih S.Ju. at al. Kozhno-plasticheskie vmeshatel'stva pri sindrome diabeticheskoj stopy // International Journal of Endocrinology. – 2009. – 5 (23) http://www.mif-ua.com/archive/article/10059
Belousov A.E., Plasticheskaja, rekonstruktivnaja i jesteticheskaja hirurgija. - SPb.: «Gippokrat». – 1998. – 744 s.
Ministry of Health Ukraine. Nakaz # 1118 vіd 21.12.2012. Unіfіkovanij klіnіchnij protokol pervinnoї ta vtorinnoї (specіalіzovanoї) medichnoї dopomogi «Cukrovij dіabet 2 tipu», rozroblenij na osnovі adaptovanoї klіnіchnoї nastanovi "Cukrovij dіabet 2 tipu".
Slesarenko S.V., Badjul P.A. Primenenie lokal'nyh loskutov i tehniki propellera pri plasticheskom vosstanovlenii defektov pokrovnyh tkanej// Hіrurgіja Ukraїni. – 2012 – № 1 (41) – 103-112/
Shkvarkovs'kij І.V., Antonjuk T.V, Fіlіpec' O.І. Zastosuvannja vakuum-kavіtacіjnih metodіv sanacії v lіkuvannі sindromu dіabetichnoї stopi // Shpital'na hіrurgіja. – 2014. – № 1. – 45-48.
Bakker K, Schaper N.C. International Working Group on Diabetic Foot. Editorial Board. The development of global consensus guidelines on the management and prevention of the diabetic foot 2011// Diabetes Metab Res Rev. – 2012 . – Suppl . –V.116. –P.8. doi: 10.1002/dmrr.2254.
Chawla A., Bhasin G., Chawla R. Validation of neuropathy symptoms score (NSS) and neuropathy disability score (NDS ) in the clinical diagnosis of peripheral neuropathy in middle aged people with diabetes. Internet scientific publications. http://ispub.com/IJFP/12/1/1517
Fette Andreas M. A clinimetric analysis of wound measurementtools http://www.worldwidewounds.com/2006/january/Fette/Clinimetric-Analysis-Wound-Measurement-Tools.htm
J?rgensen M.E., Almdal T.P., Faerch K. Reduced incidence of lower-extremity amputations in a Danish diabetes population from 2000 to 2011//Diabet Med. – 2014/– V.31(4):443-447. doi: 10.1111/dme.12320.
Mart?nez-G?mez D.A., Moreno-Carrillo M.A., Campillo-Soto A. et al. Reduction in diabetic amputations over 15 years in a defined Spain population. Benefits of a critical pathway approach and multidisciplinary team work.// JL Rev Esp Quimioter. – 2014. – V.27(3):170-179.
Tzeng Y.S., Deng S.C., Wang C.H. et al. Treatment of Nonhealing Diabetic Lower Extremity Ulcers with Skin Graft and Autologous Platelet Gel: A Case Series//BioMed Research International. – 2013, Article ID 837620/http://dx.doi.org/10.1155/2013/837620
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution 4.0 International License.
© "Publishing House "Zaslavsky", 1997-2018