Abstract
Objective: Diabetic foot syndrome is the most dramatic complication of diabetes mellitus. The treatment success is impossible without improving blood circulation and the elimination of hemodynamic disorders in the affected limb.The study aim was to evaluate mini-invasive revascularization operations effectiveness on the lower limbs peripheral arteries in neuro-ischemic and ischemic diabetic foot syndrome forms.
 Materials and methods: The study enrolled 104 patients with purulent-necrotic complications of diabetic foot syndrome. 54 (51.9%) patients underwent stenting and balloon angioplasty (the main group). The comparison group included 50 (48.1%) patients, undergoing indirect revascularization surgeries in complex treatment.
 Results and discussion:After endovascular interventions, the API index increased by 47.6% (p<0.01) after 20 days compared to the admission index, the average blood flow rate increased by 1.8 times (p<0.01), and the tPo2 value improved by 67.8% (p<0.01). In the control group, the tPo2 value increased by 40.3% after 20 days, and API – by 34.4%. In the main group, the swelling disappearance in the foot wounds area was by 3.7±0.5 days faster (p<0.001), wounds purification by 4.1 days (p<0.001), granulation appearance by 3.5±0.4 days (p<0.001), wound margins infiltration disappearance happened 3.3±0.9 days earlier (p<0.001), and the wound epithelization was 2.9 days earlier (p<0.01) than in the control group patients.
 Conclusion: Foot support function at discharge from hospital was preserved in 94.4% of the main group and in 84% of the control group.
 Bangladesh Journal of Medical Science Vol.20(4) 2021 p.817-825
Highlights
In the period from 2015 to 2019, 104 patients with purulent necrotic Diabetic foot syndrome (DFS) lesions were treated at the Department of Purulent Surgery of Aktobe Medical Center
Conservative Diabetic foot (DF) therapy was an obligatory component of complex treatment for all patients that included insulin therapy, the antiaggregant, anticoagulant, antibacterial, and immunostimulant therapy, as well as prescription of drugs that improve the rheological properties of blood
After application of minimally invasive endovascular interventions, namely, the stenting and cylinder dilatation of peripheral arteries of the lower limbs in the complex treatment of ischemic and neuro-ischemic forms of DFS, a significant positive and statistically significant dynamics of rheogemodynamic indices, as well as improvement of the wound process course was observed in comparison with combined indirect revascularization operations
Summary
In the period from 2015 to 2019, 104 patients with purulent necrotic DFS lesions were treated at the Department of Purulent Surgery of Aktobe Medical Center. Comprehensive treatment began with small operations, namely, the sanitation of purulent focus on the foot, which included autopsy phlegmon, exarticulation, and necrotomy. Subsequent tactics of patient management depended on the course of the wounding process. Conservative DF therapy was an obligatory component of complex treatment for all patients that included insulin therapy, the antiaggregant, anticoagulant, antibacterial, and immunostimulant therapy, as well as prescription of drugs that improve the rheological properties of blood. Out of 54 (51.9%) patients who comprised the main group, endovascular surgeries were used in the complex treatment. 31 patients underwent stenting and 23 – balloon dilatation of peripheral arteries of the lower limbs
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