Vіsnik Naukovih Doslіdžen' (Nov 2017)
CHANGES IN THE SPECIFIC STRUCTURE OF MICROFLORA AFTER THE VACUUM THERAPY OF ACUTE WOUND DEFECTS IN PATIENTS WITH DIABETIC FOOT SYNDROME
Abstract
According to experts from the World Health Organization, the number of people with diabetes mellitus (DM ) in the world currently exceeds 120 million and continues to grow exponentially. It is predicted that by 2030 there will be about 360 million patients on the planet. The aim of the study – to learn the change in the quantitative and qualitative composition of the microflora in the application of vacuum therapy for acute wounds in patients with diabetic foot syndrome. Materials and Methods. On the basis of examination and treatment of 76 patients with diabetes mellitus, complications of diabetic foot syndrome have been studied the effect of vacuum therapy on the species composition of the microflora of acute wounds. Among the examined patients, there were were 49 (64.5 %) men, and 27 (35.5 %) women, aged from 48 to 72. The average age of patients – (64.7 ± 4.5) years. The patients with diabetes mild degree were 12, the average severity – 47, and the severe one – 17. All underwent general clinical and laboratory and instrumental examination: objective examination, collection of complaints and anamnesis of the disease, cytological, microbiological and morphological studies, therapeutic influence of the vacuum provided by vacuum – apparatus "AGAT -DNЕPR ", with negative pressure in the range of 80–125 mm. Hg. The quantitative and qualitative composition of the acute wound microflora was determined by bacteriological examination of the wound exudate on the day of admission, 3, 6, 9 and 14 days of treatment. Results and Discussion. The study of the presence of microbial associations in acute wounds showed that 55.8 % of patients had a combination of 2–3 types of microorganisms, 34.8% – 4–5, and 9.4 % had monoinfection. Since 6 days, the total density of microorganisms in the group of patients receiving vacuum therapy was (4.19 ± 0.45) lg CFU / g, lower than in the control group (5.88±0.66) lg CFU / g ( P <0.05). It has been proved that the use of vacuum for the treatment of acute wounds reduces the quantitative and specific composition of microorganisms in wound defects, which in turn reduces the hospitalization of patients on average (4.1±1.6) bed-days.
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