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

Abstract

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. Inpatientswithischemiclesions(chronicarterial 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