[The use of negative pressure wound therapy in patients with infectious surgical complications of diabetic foot].

Abstract

In the Russian Federation diabetes affects about 11 million people. The frequency of amputation in patients with diabetes in Russia varies from 0.76 to 18.2 per 1.000 patients. From 48.9% to 60% are large amputation in which postoperative mortality reaches 50% and more. Up to half of all patients with diabetes have the defeat of major vessels of lower extremities with the formation of ischemic and neuroischemic forms of the diabetic foot syndrome. These patients are the most difficult and to save limbs need for revascularization. However, the existing algorithms of treatment of such patients do not take into account possible combination of such important pathogenetic factors, as ischemia, the prevalence of purulent-necrotic lesion of the tissues of the foot and the severity of clinical course of surgical infection. Also still not finally defined the sequence of execution of revascularization and rehabilitation of necrotic tissue, there are no indications for the use of new effective methods of treatment and rehabilitation of wounds in patients with diabetic foot. From the above, pathogenetic factors, the authors have developed a personalized Protocol of treatment of patients with ischemic and neuroischemic forms of the diabetic foot, the indications and conditions for holding therapy negative pressure. Efficiency of the proposed Protocol is accompanied by clinical examples.

• Authors: V V Zavatskiĭ, A S Novitskiĭ
• Journal: Khirurgiia (Khirurgiia (Mosk)) Issue 10 Pg. 88-101 ( 2014) ISSN: 0023-1207 [Print] Russia (Federation)
• PMID: 25484158 (Publication Type: Case Reports, English Abstract, Journal Article)

Topics

• Aged
• Algorithms
• Amputation, Surgical (adverse effects, methods)
• Angiography
• Clinical Protocols
• Debridement (adverse effects, methods)
• Diabetic Foot (diagnosis, physiopathology, surgery)
• Female
• Humans
• Ischemia (diagnosis, physiopathology, surgery)
• Lower Extremity (blood supply, pathology, surgery)
• Male
• Middle Aged
• Negative-Pressure Wound Therapy (methods)
• Severity of Illness Index
• Surgical Wound Infection (etiology, physiopathology, therapy)
• Treatment Outcome