Diabetic foot syndrome. Replacement for inpatient treatment technique based on the fast track surgery
https://doi.org/10.21518/1995-1477-2019-1-2-72-79
Abstract
One of the main problems of modern surgery is treatment of trophic skin and soft tissues defects due to the ambiguity of the pathogenesis, tendency to recurrence, deterioration in the patients’ quality of life, complexity and duration of treatment, large economic costs of treatment and rehabilitation. The article describes an algorithm for outpatient treatment of patients with trophic skin and soft tissues defects in diabetic foot syndrome. Debridement the wound from necrosis, purulent-fibrinous pellicles, wound biofilms is produced by a chemical necrectomy. A method of closing the wound defects by the means of high-tech biomaterials based on collagen type 1 is described.
About the Authors
K. A. Korejba
Kazan state medical University; The center «Diabetic foot», «Clinic of medical University»
Russian Federation
Russian Federation
Korejbа Konstаntin Аleksаndrovich – PhD, associate Professor of the surgical diseases chair of the Kazan state medical University, the honored doctor, head of the «Diabetic foot center».
420012, Kazan, Butlerova St., 49; 420012, Kazan, Sharifa Kamala St., 12.
A. R. Minabutdinov
The center «Diabetic foot», Clinic of medical University
Russian Federation
Russian Federation
Minаbutdinov Аjdаr Rаmilevich – the surgeon of the centre «Diabetic foot», Clinic of medical University.
420012, Kazan, Sharifa Kamala St., 12.
L. M. Tueshev
Almetyevsk CDH
Russian Federation
Russian Federation
Tueshev Lenаr Mаnsurovich – the surgeon, the radiologist, chief of x ray Department, Almetievsk CDH.
423461, Almetievsk, Stroitelei Prosp., 30/1.
A. R. Nuretdinov
City hospital № 5
Russian Federation
Russian Federation
Nuretdinov Аjdаr Rаfаkovich –the surgeon, Deputy chief physician on surgery of Municipal hospital No. 5.
423810, Naberezhnye Chelny, Vakhitova St., 13.
P. S. Lukin
Permsk region City clinical hospital № 5, City clinical diagnostic endocrinology center
Russian Federation
Russian Federation
Lukin Pаvel Sergeevich – PhD, the surgeon of City clinical diagnostic endocrinology center of the Perm region, City clinical hospital № 5.
614000, Perm, Karbysheva St., 111.
References
1. Wukich D.K., Ahn J., Raspovic K.M., Gottschalk F.A., La Fontaine J., Lavery L.A. Comparison of transtibial amputations in diabetic patients with and without end-stage renal disease. Foot Ankle Int. 2017;38 (4):388–96.
2. Mitish V.A., Makhkamova F.T., Paskhalova Yu.S., Gruzman V.A., Margolina I.I., Sokov S.L. The actual cost of complex surgical treatment of patients with neuroischemic form of diabetic foot syndrome. Khirurgiya. Zhurnal im. N.I. Pirogova. 2015;4:48–53. (In Russ).
3. Galstyan G.R., Sergeeva S.V., Ignatieva V.I., Aksentyeva M.V., Dedov I.I. Clinical and economic rationale for the quota cost for the treatment of patients with diabetic foot syndrome. Sakharny Diabet. 2013;3:71–83. doi: http://dx.doi.org/10.14341/2072–0351–820. (In Russ).
4. Zatevakhin I.I. Patient satisfaction with treatment outcome is the main criterion for our work. Doctor.Ru. 2015;15–16 (116-117):8. URL: https://rusmg.ru/images/15–1.pdf. (In Russ).
5. Tokmakova A.Yu., Zaitseva E.L., Voronkova I.A., Shestakova M.V. Clinical and morphological examination of tissue repair in diabetic foot syndrome. Sakharny Diabet. 2018;21 (6):490–496. doi: http://dx.doi.org/10.14341/DM9823 (In Russ).
6. Izzo V., Meloni M., Vainieri E. et al. Department of Internal Medicine. Tor Vergata University, Rome, Italy. Matrix Metalloproteinaseslevels influence the integration of dermal grafts in diabetic foot ulcers. XII. Meeting of the Diabetic Foot Study Group of the EASD. Bratislava, Slovakia, 2014. P. 50.
7. Demyanenko I.A., Kalmykova N.V., Melnikova S.V., Tretyakova A.V., Marchenko A.I., Mikhina L.V. The study of the allergenic and genotoxic effects of the medical device «Collost absorbable collagen membrane, gel» on in vivo preclinical models. Razrabotka i Registratsiya Lekarstvennykh Sredstv. 2017;21 (4):256–261. (In Russ).
8. Kamilov F.Kh., Selskaya B.N., Danilova O.V., Kapuler O.M. Metabolism of collagen in the skin of experimental animals at interdermal injection of unmodified bovine collagen type I. Vestnik Udmurtskogo Universiteta. Seriya «Biologiya. Nauki o Zemle». 2017;27 (3):356–361. (In Russ).
9. Silina E.V., Stupin V.A., Gabitov R.B. The role of collagen in the mechanisms of healing of chronic wounds in diabetic foot syndrome. Klinicheskaya Meditsina. 2018;96 (2):106–115. doi: http://dx.doi.org/10.18821/0023–2149–2018–96-2-106–115. (In Russ).
10. Stupin V.A., Silina E.V., Goryunov S.V., et al. Assessing the dynamics of the wound area and the incidence of complete epithelialization in the treatment of diabetic foot syndrome (results of a multicenter study). Khirurgiya. Zhurnal im. N.I. Pirogova. 2017;3:55–60. doi:10.17116/hirurgia2017355–60. (In Russ).
11. Stupin V.A., Silina E.V., Gorsky V.A., Goryunov S.V., Liquid S.Yu., Komarov A.N., et al. Efficacy and safety of topical application of collagen biomaterial in the complex treatment of diabetic foot syndrome (results of a multicenter randomized clinical study). Khirurgiya. Zhurnal im. N.I. Pirogova. 2018;6:91–100. doi:https://doi.org/10.17116/hirurgia2018691–100. (In Russ).
12. Dibirov M.D., Gadzhimuradov R.U., Khamitov, F. F., Polyansky M.V., Tereshchenko S.A., Kakubava M.R. The use of modern technologies in the treatment of purulent-necrotic complications of diabetic foot syndrome. Klinicheskaya i Eksperimental’naya Khirurgiya. Zhurnal im. Akademika B.V. Petrovskogo. 2016;2:60–70. (In Russ).
13. Kalmykova N.V., Demyanenko I.A., Shevlyagina N.V., Andreevskaya S.G., Suslov A.P. Comparative analysis of the effectiveness of simple and multicomponent methods of alkaline decellularization on the example of purification of the fibrous extracellular matrix of the dermis. Morfologicheskie Vedomosti. 2016;24 (4):36–45. (In Russ).
14. Shekhter A.B., Guller A.E., Istranov L.P., Istranova E.V., Butnaru D.V., Vinarov A.Z., et al. Morphology of collagen matrices for tissue engineering (biocompatibility, biodegradation, tissue reaction). Arkhiv Patologii. 2015;77 (6):29–38. doi: https://doi.org/10.17116/patol201577629–38. (In Russ).
15. Kotelnikov G.P., Shpigel A.S. Evidence-based medicine. Scientific-based medical practice: Monograph. Samara; Samara State Medical University, 2000: 19–24. (In Russ).
Review
For citations:
Korejba K.A., Minabutdinov A.R., Tueshev L.M., Nuretdinov A.R., Lukin P.S. Diabetic foot syndrome. Replacement for inpatient treatment technique based on the fast track surgery. Ambulatornaya khirurgiya = Ambulatory Surgery (Russia). 2019;(1-2):72-79. (In Russ.) https://doi.org/10.21518/1995-1477-2019-1-2-72-79
Views:
1227
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International.
Email this article 