The use of collagen materials and growth factors in diabetic foot syndrome

Introduction. There is an increase in the number of patients with diabetic foot syndrome who have long-term non-healing wounds on the lower extremities. Serious complications of diabetes mellitus, such as diabetic polyneuropathy, angiopathy, and osteoarthropathy, aggravate the local process and contribute to the faster development of wound cachexia and disruption of repair and proliferation processes during wound healing.

Аim of the study was to evaluate the effectiveness of using synthetic collagen structures in combination with autologous growth factors to close wound defects as an alternative to autodermoplasty using a free split flap. To conduct a study of the effectiveness of the combined use of modern interactive dressings and bioplastic agents in the complex treatment of patients with diabetic foot syndrome, to improve the quality of local therapy for skin and tissue defects, to increase the effectiveness of surgical interventions at different stages of treatment.

Materials and methods. In an observational study involved 62 patients (average age 52.1 years) with trophic defects on the lower extremities with an area of 34.2 cm2 . A three-stage treatment method has been developed: necrectomy, organ-preserving surgery, plastic wound closure using bioplastic material (90% hyaluronic acid, 10% collagen) followed by the introduction of autologous growth factors.

Results. The study demonstrated the onset of marginal epithelialization of the wound defect on an average of 8.2 ± 1.9 days after the start of treatment. Granulation of wounds was observed without inflammatory reactions or signs of rejection of plastic material. Regenerative processes continued due to the formation of their own granulation tissues.

Conclusions. Bioplastic material has shown high efficacy in the treatment of diabetic foot syndrome. The patients showed a significant reduction in the size of wounds and pain. The inflammatory response decreased, and tissue repair intensified. In 64% of cases, the technique prevented complications and accelerated the regeneration of surrounding tissues.

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