Differentiated treatment of patients with diabetic foot syndrome at the stage of specialized surgical care

Abstract

To assess 1-year results of differentiated treatment of patients with diabetic foot syndrome (DFS) who were included into 3-year register of diabetic foot outpatient practice (DFOP). It was performed retrospective analysis of 570 patients with DFS (2015-2017): group I - neuropathic form (n=285), group II - neuroischemic form (n=285). Patients were classified according to Texas grade. Group I - 107 (37.5%) patients (BI-III); 91 (31.9%) patients (AII+BII-III). Diabetic osteoarthropathy was diagnosed in 97 (34.0%) cases. Group II included 113 (45.2%) patients with DI-III and 171 (60.0%) patients with CII-II+DII-III. 308 patients received combined outpatient treatment (including limb off-loading in 88%), 195 patients - in-hospital surgical treatment (including endovascular procedures - 52), 67 patients - treatment at the place of residence. Postoperative follow-up was in diabetic foot outpatient practice. Statistical analysis of data was performed by using of Biostat software package. In group I 1-year results are unknown in 76 (26.7%) patients. Epitheliazation was noted in 101 (35.4%) cases, persistent diabetic ulcer - in 27 (12.9%), small amputations - 16 (7.7%), high amputations - 2 (0.95%). In group II results are unknown in 29 (10.2%) patients. Epitheliazation occurred in 121 (47.3%) cases, persistent diabetic ulcer - 53 (20.7%), small amputations - 47 (18.4%), high amputations - in 35 (13.7%) cases. DFOP is a key organizational unit of specialized medical care for patients with DFS. Regular follow-up of patients in DFOP and combined treatment at the stage of specialized surgical care allows to preserve limb in 99% of patients with neuropathic foot and in 86.3% of patients with neuroischemic foot.