New Methods of Treatment for Trophic Lesions of the Lower Extremities in Patients with Diabetes Mellitus
Introduction. Complications in the form of trophic ulcers of the lower extremities are one of the serious consequences of diabetes mellitus (DM), as they often lead to severe health and social problems, up to high amputations. The aim of the study was the development and clinical testing of diagnostic and therapeutic algorithm for the comprehensive treatment of trophic ulcers of the lower extremities in patients with DM. Materials and methods. Here are presented the results of treatment of 63 patients (42 women and 21 men) with neuropathic type of trophic lesions of the lower limbs or postoperative defects at the stage of granulation. Of them, 32 patients (study group) received local intradermal injections of hyaluronic acid preparations and sodium succinate (Lacerta) into the extracellular matrix. Patients of the comparison group were treated with hydrocolloid materials (hydrocoll, granuflex). The level of glycated hemoglobin, the degree of circulatory disorders (using ankle brachial index, before and after the test with a load) and neuropathic disorders (on a scale for the evaluation of neurologic dysfunctions — NDS) were assessed in patients. Results. The results of treatment were assessed by the rate of defect healing during 2 or more months. In the study group, 24 patients showed complete healing of the defect (75 %), while in the control group the healing was observed in 16 patients (51.6 %). During the year, relapses occurred in 22.2 % of cases in the study group, and in 46.9 % — in the control one (p < 0.05). Conclusion. The developed method of treatment using Lacerta allowed to increase the effectiveness of therapy, to speed recovery, to decrease a number of complications in patients with DM and trophic ulcers of the lower extremities.
Full Text:PDF (Українська)
Bregovskiy VB, Zayzev AA, Zalevskaya AG et al. Defeat of lower limbs in diabetes. StPet: DILA, 2004. – 263 p. (Russian)
Pat. 65158 Ukraine, МПК А61К 31/00. A method of treatment of trophic ulcers of the lower extremities / Ponomarenko OV, Virskyj MV. (Ukraine). - № 201106271; 25.11.2011. Bul. № 22. Ukrainian.
Sviridov NV, Mykhajlychenko VY, Bondarenko NN. Integrated surgical treatment of purulent-necrotic lesions in patient with diabetes mellitus. – Doneczk: Yugo-Vostok, 2014. 280 p. (Russian)
Udovychenko OV, Grekova NM. Diabetic foot. Мoskow: Praktycheskaya medycyna, 2010. – 271 s. (Russian)
Al-Rubeaan K, Al Derwish M, Ouizi S., Youssef AM, Subhani SN, Ibrahim HM, Alamri BN. Diabetic foot complications and their risk factors from a large retrospective cohort study // PLoS One; 2015. 10(5): e0124446. doi: 10.1371/journal.pone.0124446.
Andersen CA Diabetic limb preservation: defining terms and goals. J Vasc Surg. 2010;1:106-7. doi: 10.1016/j.jvs.2010.06.007.
Cavanagh PR, Bus SA. Off-loading the diabetic foot for ulcer prevention and healing. J Vasc Surg. 2010;52(3):37S-43S. doi: 10.1016/j.jvs.2010.06.007
Healy A, Naemi R, Chockalingam N. The effectiveness of footwear and other removable off-loading devices in the treatment of diabetic foot ulcers: a systematic review . Curr Diabetes Rev. 2014;10(4):215-220. PMID: 25245020
Noor S, Zubair M, Ahmad J. Diabetic foot ulcer – A review on pathophysiology, classification and microbial etiology. Diabetes Metab Syndr. 2015;9(3):192-9. doi: 10.1016/j.dsx.2015.04.007.
This work is licensed under a Creative Commons Attribution 4.0 International License.
© "Publishing House "Zaslavsky", 1997-2018