Introduction. Diabetic foot syndrome is associated with impaired reparative processes and the formation of chronic wounds, which substantiates the use of biologically active wound dressings.

Aim. Evaluate the effectiveness of application of collagen dressings in patients with diabetic foot syndrome.

Materials and methods. The study included 86 patients with diabetic foot syndrome presenting with postoperative granulating wounds. Depending on wound depth, patients were divided into two groups: superficial wounds (≤5 mm) and deep wounds (>5 mm). Within each group, patients were randomized into subgroups receiving collagen dressings of different thicknesses (2 mm and 8 mm). Treatment efficacy was assessed based on changes in wound area, wound depth, and the proportion of granulation tissue over a 20-day period.

Results. The use of collagen dressings was associated with significant improvement in all planimetric parameters of wound healing. In patients with superficial wounds, differences between treatment options were minimal, with wound area reduction of 55.6% and 53.6%, respectively. In patients with deep wounds, the use of 8 mm thick dressings resulted in a more pronounced reduction in wound depth (63.2% vs 47.3%) and a greater increase in granulation tissue (151.1% vs 102.7%) compared to 2 mm dressings (p < 0.001).

Conclusions. The differentiated use of collagen dressings depending on wound depth is an effective approach in the treatment of post-operative wounds in patients with diabetic foot syndrome. The use of thicker collagen dressings is advisable for deep wounds, whereas no significant differences in efficacy were observed in superficial defects.

Introduction. Morbid obesity is associated with a high risk of venous thromboembolic complications (VTE) after bariatric surgery; however, standard risk stratification scales do not always provide sufficient predictive accuracy for this patient population, and monitoring the efficacy of anticoagulant prophylaxis remains challenging.
Aim. To evaluate the use of thrombodynamics assay for assessing the risk of VTE in patients with morbid obesity undergoing bariatric surgery, stratified according to the modified Caprini-B score, and to analyze the dynamics of hemostasis parameters during anticoagulant prophylaxis.
Materials and methods. A prospective observational study included 113 patients with morbid obesity (BMI 44.5 ± 8.0 kg/m2) who underwent laparoscopic bariatric procedures. Patients were divided into two groups: moderate risk (7–11 points on the Caprini-B score, n = 63) and high risk (≥12 points, n = 50). VTE prophylaxis was performed with nadroparin calcium (38–57 anti-Xa IU/kg) for at least 21 days. Thrombodynamics assay was performed before surgery, immediately after surgery, and on postoperative day 4.
Results. No clinically significant VTE events were registered in either group. In high-risk patients, baseline hypercoagulation was detected (clot growth velocity V – 33.0 ± 2.5 μm/min vs. normal range 20–29 μm/min, p < 0.05), which increased after surgery. By day 4, nadroparin therapy achieved normocoagulation in the moderate-risk group; in the high-risk group, hypercoagulation decreased and stabilized at the upper limit of normal. No hemorrhagic complications were observed.
Conclusions. Thrombodynamics assay provides an objective assessment of hemostasis in bariatric patients and enables monitoring of anticoagulant prophylaxis efficacy. The most informative parameters are clot growth velocity and clot size (V, Vst, CS). In patients with ≥12 points on the Caprini-B score, hypercoagulation persists at the upper normal limit by day 4, which may require extended or intensified anticoagulant therapy