Multidisciplinary treatment of ischemic forms of diabetic foot

Abstract

Purpose of the study. The phototherapy, platelet growth factor and coating materials in the treatment complex using for improve the results of wound treatment in patients with the ischemic form of diabetic foot. Materials and methods. The analysis of the results of treatment of 48 patients with ischemic forms of diabetic foot syndrome has been performed in the work. The patients were divided into the study and comparative groups. The patients were treated at the clinic of the State institution «V. T. Zaitsev Institute of General and Emergency Surgery National Academy of Medical Sciences of Ukraine» from 2012–2018, and all patients had II stage diabetes mellitus and IV degree of ischemia by Fontaine. Patients in both groups performed open and hybrid reconstructions. In the patients of the study group, the developed treatment technology was applied, containing phototherapy and photodynamic therapy with a range of: λ 470, 525 or 405 nm in the preoperative period, closure with synthetic coating with application plasma enriched of transforming growth factor. The implementation of the developed tactics allowed to achieve complete wound healing in 91,7% of patients, partial healing – in 8,3% of patients. The terms treatment terms for these patients did not exceed 2 months, high amputation was not required. Conclusions. Plastic closure of the wounds of the lower extremities after revascularization operations in an ischemic diabetic foot syndrome is indicated in cases where wounds do not tend to spontaneous healing. The use of a treatment complex consisting of phototherapy and photodynamic therapy, the closure of wounds with a synthetic coating of transforming growth factor is the effective stimulator of development of granulation tissue in the wound, suitable for further autodermoplasty. Keywords: foot ischemic diabetic syndrome, dermoplasty, synthetic coatings, photodynamic therapy, platelet growth factor.