Treatment Of Diabetic Foot Syndrome Research Articles

Prostanoids in patients with diabetes and chronic limb-threatening ischemia: a meta-analysis of randomized clinical trials for the development of the Italian guidelines for the treatment of diabetic foot syndrome.

Prostanoids in patients with diabetes and chronic limb-threatening ischemia: a meta-analysis of randomized clinical trials for the development of the Italian guidelines for the treatment of diabetic foot syndrome.

Offloading systems for the treatment of neuropathic foot ulcers in patients with diabetes mellitus: a meta-analysis of randomized controlled trials for the development of the Italian guidelines for the treatment of diabetic foot syndrome.

To compare the effectiveness of commonly used offloading devices for the treatment of neuropathic foot ulcers in patients with diabetes mellitus. This meta-analysis (MA) has been performed for giving an answer to clinical questions on this topic of the Italian guideline on diabetic foot syndrome. The present MA includes randomized controlled studies (duration > 12weeks) comparing, in patients with diabetes mellitus and non-infected neuropathic foot ulcer: any offloading device vs either no offloading device or conventional footwear; removable versus non-removable offloading devices; surgical procedure vs other offloading approaches. The primary endpoint was ulcer healing. A total of 184 studies were identified, and 18 were considered eligible for the analysis. We found that: any plantar off-loading, when compared to the absence of plantar offloading device, is associated with a higher ulcer healing (MH-OR: 3.13 [1.08, 9.11], p = 0.04, I2 = 0%); total contact cast or nonremovable knee-high walker, compared to other offloading devices, had a higher ulcer healing rate (MH-OR: 2.64 [1.43, 4.89], p = 0.002, I2 = 51%); surgical offloading for active ulcers in combination with post-surgery offloading achieves higher ulcer healing rate when compared to offloading devices alone (MH-OR: 6.77 [1.64, 27.93], p = 0.008, I2 = 0%). Any plantar offloading, compared to the absence of plantar offloading device, is associated with a higher ulcer healing rate. Total contact cast or nonremovable knee-high walker, compared to other offloading devices, is preferable. Surgical offloading for active ulcers, in combination with post-surgery offloading devices, achieves a higher ulcer healing rate when compared to other offloading devices alone. Further studies with a larger cohort of patients with diabetic neuropathic foot ulcers and extended follow-up periods are necessary.

МУЛЬТИДИСЦИПЛИНАРНЫЙ ПОДХОД К ДИАГНОСТИКЕ И ЛЕЧЕНИЮ ИНФЕКЦИОННЫХ ОСЛОЖНЕНИЙ СИНДРОМА ДИАБЕТИЧЕСКОЙ СТОПЫ

Introduction. Diabetic foot syndrome is one of the severe complications of diabetes mellitus. This combination of pathological processes occurring in the foot is induced and aggravated by diabetes mellitus. Most often, diabetic foot syndrome is a consequence of angiopathy, neuropathy, osteopathy; it may be accompanied by infectious and ulcera-tive lesions, leading to amputation of the extremity. The aim of the study. To assess the results of diagnosis and treatment of diabetic foot syndrome, following the intro-duction of a multidisciplinary approach. Materials and methods. A retrospective analysis of 151 medical records of patients diagnosed with diabetic foot syndrome was carried out. There were 87 (57.6 %) men and 64 (42.4 %) women; the mean age was 63.6 ± 1.0 years. The most of patients (139 (92.1 %)) were diagnosed with type 2 diabetes mellitus. Results. A multidisciplinary approach to the diagnosis and treatment of diabetic foot syndrome was achieved through the efforts of a team of specialists consisting of a surgeon, general practitioner, endocrinologist and vascular surgeon. The average glycemic level in the examined patients was higher than normal and amounted to 10.6 ± 0.4 mmol/l. In 111 of patients, the correction of carbohydrate metabolism was carried out with insulin, in the remaining observations – with tableted hypoglycemic drugs. All patients received treatment aimed at eliminating the main links in the pathogenesis of diabetic foot syndrome. Local conservative treatment was carried out in 66 cases, surgical treatment – in 85 cases. The majority of surgical interventions (40–47 %) were minor surgeries (preserving the supporting function of the leg), in 20 (23.5 %) patients surgeries were performed on the arteries, in 19 (22.4%) – high amputations (above the ankle joint), in 6 (7.1 %) – opening of foot phlegmon. The average duration of treatment for diabetic patients with diabetic foot syndrome was 17.1 ± 0.6 days. Conclusion. Patients with diabetic foot syndrome were diagnosed with severe disorders of carbohydrate metabolism with the presence of angiopathy and neuropathy. A multidisciplinary approach to the diagnosis and treatment of diabetic foot syndrome makes it possible to identify the main links in pathogenesis and, based on existing protocols, to per-sonalize the treatment. This makes it possible to preserve the supporting function of the extremity in most patients and to reduce the number of high amputations.

РЕДКИЙ СЛУЧАЙ ОБТУРАЦИОННОЙ КИШЕЧНОЙ НЕПРОХОДИМОСТИ: ТОНКО-ТОЛСТОКИШЕЧНАЯ ИНВАГИНАЦИЯ У ВЗРОСЛОГО

Introduction. Diabetic foot syndrome is one of the severe complications of diabetes mellitus. This combination of pathological processes occurring in the foot is induced and aggravated by diabetes mellitus. Most often, diabetic foot syndrome is a consequence of angiopathy, neuropathy, osteopathy; it may be accompanied by infectious and ulcera-tive lesions, leading to amputation of the extremity. The aim of the study. To assess the results of diagnosis and treatment of diabetic foot syndrome, following the intro-duction of a multidisciplinary approach. Materials and methods. A retrospective analysis of 151 medical records of patients diagnosed with diabetic foot syndrome was carried out. There were 87 (57.6 %) men and 64 (42.4 %) women; the mean age was 63.6 ± 1.0 years. The most of patients (139 (92.1 %)) were diagnosed with type 2 diabetes mellitus. Results. A multidisciplinary approach to the diagnosis and treatment of diabetic foot syndrome was achieved through the efforts of a team of specialists consisting of a surgeon, general practitioner, endocrinologist and vascular surgeon. The average glycemic level in the examined patients was higher than normal and amounted to 10.6 ± 0.4 mmol/l. In 111 of patients, the correction of carbohydrate metabolism was carried out with insulin, in the remaining observations – with tableted hypoglycemic drugs. All patients received treatment aimed at eliminating the main links in the pathogenesis of diabetic foot syndrome. Local conservative treatment was carried out in 66 cases, surgical treatment – in 85 cases. The majority of surgical interventions (40–47 %) were minor surgeries (preserving the supporting function of the leg), in 20 (23.5 %) patients surgeries were performed on the arteries, in 19 (22.4%) – high amputations (above the ankle joint), in 6 (7.1 %) – opening of foot phlegmon. The average duration of treatment for diabetic patients with diabetic foot syndrome was 17.1 ± 0.6 days. Conclusion. Patients with diabetic foot syndrome were diagnosed with severe disorders of carbohydrate metabolism with the presence of angiopathy and neuropathy. A multidisciplinary approach to the diagnosis and treatment of diabetic foot syndrome makes it possible to identify the main links in pathogenesis and, based on existing protocols, to per-sonalize the treatment. This makes it possible to preserve the supporting function of the extremity in most patients and to reduce the number of high amputations.

Effect of a multidisciplinary team approach in patients with diabetic foot ulcers on major adverse limb events (MALEs): systematic review and meta-analysis for the development of the Italian guidelines for the treatment of diabetic foot syndrome.

The treatment of patients with diabetic foot ulcers (DFUs) is extremely complex, requiring a comprehensive approach that involves a variety of different healthcare professionals. Several studies have shown that a multidisciplinary team (MDT) approach is useful to achieve good clinical outcomes, reducing major and minor amputation and increasing the chance of healing. Despite this, the multidisciplinary approach is not always a recognized treatment strategy. The aim of this meta-analysis was to assess the effects of an MDT approach on major adverse limb events, healing, time-to-heal, all-cause mortality, and other clinical outcomes in patients with active DFUs. The present meta-analysis was performed for the purpose of developing Italian guidelines for the treatment of diabetic foot with the support of the Italian Society of Diabetology (Società Italiana di Diabetologia, SID) and the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD). The study was performed using the Grading of Recommendations Assessment, Development, and Evaluation approach. All randomized clinical trials and observational studies, with a duration of at least 26weeks, which compared the MDT approach with any other organizational strategy in the management of patients with DFUs were considered. Animal studies were excluded. A search of Medline and Embase databases was performed up until the May 1st, 2023. Patients managed by an MDT were reported to have better outcomes in terms of healing, minor and major amputation, and survival in comparison with those managed using other approaches. No data were found on quality of life, returning-to-walking, and emergency admission. Authors concluded that the MDT may be effective in improving outcomes in patients with DFUs.

Effective combinations of glucose-lowering drugs in patients with obesity and type 2 diabetes mellitus during the treatment of diabetic foot syndrome

The article provides a brief analysis of the action mechanisms of modern combinations by glucose-lowering drugs for type 2 diabetes mellitus, diabetic foot syndrome and obesity. Using the example of clinical observations, the positive dynamics of reducing body weight and glycated hemoglobin was demonstrated. It also shows how good control of type 2 diabetes makes it possible to effectively treat such a formidable complication as diabetic foot syndrome.

The dos and don’ts in the treatment of diabetic foot syndrome from a surgical perspective

The dos and don’ts in the treatment of diabetic foot syndrome from a surgical perspective

The Role of Collagen in The Mechanisms of Chronic Wound Healing for Diabetic Foot Syndrome

The review of the world literature, is devoted to the role of collagen in the process of wound healing. The problems of epidemiology of chronic wounds and ulcers of various genesis, physiology and pathophysiology of wound healing phases are considered. The pathogenetic role of different types of collagen, as well as the mechanisms of collagen, macrophage, fibroblasts, matrix metalloproteinases and other cytokines in healing ulcers are discussed. The prospects of development and use of medical products and preparations based on collagen in the treatment of patients with chronic wounds and ulcers are shown. The results of clinical studies on the effectiveness of collagen with preserved (native) and unsaved (fractionated) structure are presented. The advantages of using native collagen in the treatment of diabetic foot syndrome are demonstrated

Bypass surgery versus endovascular revascularization for occlusive infrainguinal peripheral artery disease: a meta-analysis of randomized controlled trials for the development of the Italian Guidelines for the treatment of diabetic foot syndrome.

To report a review and meta-analysis of all randomized controlled trials (RCTs) comparing bypass surgery (BS) and endovascular treatment (ET) in infrainguinal peripheral arterial disease (PAD) for several endpoints, such as major and minor amputation, major adverse limb events (MALEs), ulcer healing, time to healing, and all-cause mortality to support the development of the Italian Guidelines for the Treatment of Diabetic Foot Syndrome (DFS). A MEDLINE and EMBASE search was performed to identify RCTs, published since 1991 up to June 21, 2023, enrolling patients with lower limb ischemia due to atherosclerotic disease (Rutherford I-VI). Any surgical BS or ET was allowed, irrespective of the approach, route, or graft employed, from iliac to below-the-knee district. Primary endpoint was major amputation rate. Secondary endpoints were amputation-free survival major adverse limb events (MALEs), minor amputation rate, all-cause mortality, ulcer healing rate, time to healing, pain, transcutaneous oxygen pressure (TcPO2) or ankle-brachial index (ABI), quality of life, need for a new procedure, periprocedural serious adverse events (SAE; within 30days from the procedure), hospital lenght ofstay, and operative time. Twelve RCTs were included, one enrolled two separate cohorts of patients, and therefore, the studies included in the analyses were 13. Participants treated with ET had a similar rate of major amputations to participants treated with BS (MH-OR 0.85 [0.60, 1.20], p = 0.36); only one trial reported separately data on patients with diabetes (N = 1), showing no significant difference between ET and BS (MH-OR: 0.67 [0.09, 5.13], p = 0.70). For minor amputation, no between-group significant differences were reported: MH-OR for ET vs BS: 0.83 [0.21, 3.30], p = 0.80). No significant difference in amputation-free survival between the two treatment modalities was identified (MH-OR 0.94 [0.59, 1.49], p = 0.80); only one study reported subgroup analyses on diabetes, with a non-statistical trend toward reduction in favor of ET (MH-OR 0.62 [0.37, 1.04], p = 0.07). No significant difference between treatments was found for all-cause mortality (MH-OR for ET vs BS: 0.98 [0.80, 1.21], p = 0.88). A significantly higher rate of MALE was reported in participants treated with ET (MH-OR: 1.44 [1.05, 1.98], p = 0.03); in diabetes subgroup analysis showed no differences between-group for this outcome (MH-OR: 1.34 [0.76, 2.37], p = 0.30). Operative duration and length of hospital stay were significantly shorter for ET (WMD: - 101.53 [- 127.71, - 75.35] min, p < 0.001, and, - 4.15 [- 5.73, - 2.57] days, p < 0.001 =, respectively). ET was associated with a significantly lower risk of any SAE within 30days in comparison with BS (MH-OR: 0.60 [0.42, 0.86], p = 0.006). ET was associated with a significantly higher risk of reintervention (MH-OR: 1.57 [1.10, 2.24], p = 0.01). No significant between-group differences were reported for ulcer healing (MH-OR: 1.19 [0.53, 2.69], p = 0.67), although time to healing was shorter (- 1.00 [0.18, 1.82] months, p = 0.02) with BS. No differences were found in terms of quality of life and pain. ABI at the end of the study was reported by 7 studies showing a significant superiority of BS in comparison with ET (WMD: 0.09[0.02; 0.15] points, p = 0.01). The results of this meta-analysis showed no clear superiority of either ET or BS for the treatment of infrainguinal PAD also in diabetic patients. Further high-quality studies are needed, focusing on clinical outcomes, including pre-planned subgroup analyses on specific categories of patients, such as those with diabetes and detailing multidisciplinary team approach and structured follow-up.

RATIONALE FOR PRESCRIBING ANTICOAGULANT THERAPY IN THE COMPLEX TREATMENT OF PURULENT-NECROTIC COMPLICATIONS OF DIABETIC FOOT SYNDROME

Abstract. This article is based on the study of hemostasis indicators in 25 patients with diabetic foot syndrome. Diabetic foot syndrome (DFS) develops against the background of diabetic neuropathy, micro- and macroaniopathy, osteoarthropathy, which lead to frequent traumatization of the soft tissues of the foot, infection with the subsequent development of purulent-necrotic processes on the foot, and in the course of progression leads to high limb amputations. According to the international federation, which deals with the problem of diabetes mellitus (DM), the 21st century is considered a pandemic of DM. It should be noted that the number of patients with diabetes is increasing every year. Patients with diabetes are characterized by an atherothrombotic state caused by multiple disorders in the hemostasis system. Hemostatic disorders in patients with diabetes are complex and include activation of natural mechanisms of the coagulation system, inhibition of fibrinolytic activity, and various platelet dysfunctions.&#x0D; The purpose of the study is to substantiate the appointment of anticoagulation therapy in patients with SDS.&#x0D; Materials and methods. On the basis of KNP KMKL No. 6 in Kyiv in 2023, for a period of 6 months, 69 patients with SDS were treated. The state of indicators of the coagulation link of the hemostasis system in 49 people was studied. At the same time, 26 patients had purulent-necrotic complications of the neuroischemic form of SDS, 23 people were healthy (comparison group). The patients were divided according to the article and age, according to the duration of diabetes mellitus, and according to the stages according to Wagner. The following indicators were determined for patients: prothrombin index (PTI), plasma recalcification time, fibrinogen, B-naphthol test, ethanol test, Willebrand factor, endothelin-1, coagulation factor (VIII), fibronectin.&#x0D; The results of the study and their discussion: Based on the study, 61.5 % of patients with SDS are of working age. Of them, 57.7 % are men, 42.3 % are women. The largest number of patients with SDS is observed in the group of patients who have had diabetes for more than 10 years - 57.7 %, and the largest number of patients with stage III-IV according to Wagner - 88.5 %. In patients with diabetes with neuroischemic form of SDS, the PTI level is increased by 28.8 % and the prothrombin time is shortened by 21 %, which indicates an increase in the activity of external blood clotting mechanisms. An increase in fibrinogen by 29.7 % indicates an increase in the activity of coagulation hemostasis. Willebrand factor increased by 34.5 %, coagulation factor (VIII) increased by 20.3 %, fibronectin increased by 83.01 %, which indicates an increase in aggregation and procoagulant processes, which in turn increases thrombus formation.&#x0D; Conclusion. Thus, with diabetic foot syndrome, hypercoagulation is observed, which leads to an increase in the level of thrombus formation, which justifies the appointment of anticoagulant therapy in the complex treatment of diabetic foot syndrome.

Development of the Italian clinical practice guidelines for the treatment of diabetic foot syndrome: design and methodological aspects.

Diabetic foot syndrome (DFS) and its complications are a growing public health concern. The Italian Society of Diabetology (SID) and the Italian Association of Clinical Diabetologists (AMD), in collaboration with other scientific societies, will develop the first Italian guidelines for the treatment of DFS. The creation of SID/AMD Guidelines is based on an extended work made by 19 panelists and 12 members of the Evidence Review Team. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology has been used to decide aims, reference population, and target health professionals. Clinical questions have been created using PICO (Patient, Intervention, Comparison, Outcome) conceptual framework. The definition of questions has been performed using a two-step web-based Delphi methodology, a structured technique aimed at obtaining by repeated rounds of questionnaires a consensus opinion from a panel of experts in areas wherein evidence is scarce or conflicting, and opinion is important. The mean age of panelists (26.3% women) was 53.7 ± 10.6years. The panel proposed 34 questions. A consensus was immediately reached for all the proposed questions, 32 were approved and 2 were rejected. The areas covered by clinical questions included diagnosis of ischemia and infection, treatment of ischemic, neuropathic, and infected ulcers, prevention of foot ulceration, organization and education issues, and surgical management. The PICO presented in this paper are designed to provide indications for healthcare professionals in charge of diabetic foot treatment and prevention, primarily based on clinical needs of people with diabetic foot syndrome and considering the existing organization of health care.

A Modern Approach to the Study and Analysis of Biochemical Parameters in Diabetic Foot Syndrome

Diabetic foot syndrome, which is one of the complications of diabetes mellitus, is characterized by a change in biochemical parameters from negative to positive, and thanks to a new method in Uzbekistan for the treatment of diabetic foot syndrome, patients recover their working capacity and resume their quality of life. Study of the effect of the new drug "Rheomannisol" on vital organs, taking into account of diagnostics and prevention of pathophysiological aspects in the complex treatment of experimental diabetic foot syndrome.

Treatment of Diabetic Foot Syndrome By Means of Hyaluronidase Infusion Therapy – Single Patient Case Report

Background: Diabetic foot syndrome (DFS) is one of the most severe secondary complications of diabetes mellitus. It is currently treated with improvement and maintenance of good glycemic control, pain drugs, antibiotics, and drugs and surgical measures to improve the vascular blood flow into the legs. In late stages, foot amputation (in part or total) is the only means to safe the patient’s life. Case Report: A 56-year-old woman with type 1 diabetes for more than 40 years, suffered from diabetic foot syndrome with complete closure of the arteria fibularis and a non-healing foot ulcer at the left leg. The need for lower ankle amputation was already determined. We tried to improve the vascular situation by means of a series of intravenous hyaluronidase infusions over a period of three weeks. An immediate improvement of the general condition was observed. The ulcer healed completely within 8 weeks, and a re-opening of the previously closed vessel as well as further additional collateral blood-flow into the left foot could be determined by means of an angiogram six months later. Discussion: The observed beneficial impact of intravenous hyaluronidase treatment on atherosclerotic lesions can be explained by the molecular action of the enzyme on the glycocalix, the extracellular hyaluronan layer that separates the endothelial cells from the blood stream. Successful treatment of DFS with hyaluronidase infusions has been reported already 50 years ago but research on this topic ceased, when stents and other apparently more compelling vascular treatment methods were detected. Conclusions: In a severe case of DFS, we were able to re-open a critical arterial vessel and improve the entire vascular blood flow by means of intravenous hyaluronidase infusions. Clinical studies are required to confirm the value of hyaluronidase infusions as treatment alternative to amputation for DFS.

Experimental Treatment of Purulent-Necrotic Lesions of The Lower Extremities with New Generation Drugs

Diabetes mellitus and its complications remain an urgent problem of modern surgery. Therefore, it is important for surgeons to create new stages in the treatment of diabetic foot syndrome and restore their ability to work and improve the quality of life in relation to patients. An assessment of the effectiveness of a new biological preparation is shown

Assessment of the Process of Epithelialization After Complex Treatment of Diabetic Foot Syndrome

Currently, the treatment of diabetes mellitus and its complications remains an urgent problem. Patients with diabetic foot syndrome, a complication of diabetes mellitus, are increasingly losing their quality of life and ability to work. The treatment of diabetes mellitus and its complications affects the economic and financial efficiency of our country. Therefore, the new drug Reomannisol, produced in our country, helps to stop the purulent-necrotic process of the foot, which is a complication of diabetes mellitus

ORNIDAZOL-BASED APPLICATION SORBENT WITH NANO SILICA AND ITS ANTIMICROBIAL ACTIVITY.

The aim: To investigate the effect of application sorbent based on ornidazole with nanosilicon in experiment and clinic. Materials and methods: In order to study the effectiveness of the Ornidasil application sorbent for the treatment of purulent wounds, we conducted an experimental study in rats. Also, we studied the effectiveness of the Ornidasil in the clinic for the treatment of patients with diabetic foot syndrome and to prevent the suppuration of postoperative wounds in patients with purulent peritonitis in toxic and terminal stages. Results: The formation of active substance complexes with hydroxylated matrices is due to hydrogen bonds between the oxygen atom of the silanol group of the silica surface and the hydrogen atom of the alcohol group of the ornidazole molecule. This promotes the gradual release of ornidazole from the surface of such a matrix into the wound exudate. Thus, on day 13, 9 experimental rats of group I healed completely, 11 rats had a small wound surface, complete healing occurred on day 15. We also investigated the effectiveness Ornidasil in the clinic. In the comparison group, postoperative wound suppuration occurred in 6 patients (31.6%), and in the main group - in 3 patients (12.5%). Conclusions: A study of the effectiveness Ornidasil in the complex treatment of Diabetic foot syndrome showed that in the experimental groups, wound healing occurred 1.6 -1.9 times faster. The use of polyurethane wound protector in combination with Ornidasil reduced the suppuration of postoperative wounds in patients of the main group by 2.5 times relative to patients in the comparison group.

Modern aspects of diagnosis and treatment of diabetic foot syndrome

Modern aspects of diagnosis and treatment of diabetic foot syndrome

ULTRASTRUCTURAL CHANGES OF MONONUCLEAR MACROPHAGES UNDER THE ACTION OF OZONE THERAPY AND LOCAL APPLICATION OF AUTOLOGOUS PLATELET-RICH PLASMA IN THE TREATMENT OF DIABETIC FOOT SYNDROME

Objective – to study the character of ultra- structural changes in the tissue macrophages under the eff ect to complex of accessory factors promoting reparative process activation in the wound: ozone therapy, local application of autologous platelet-rich-plasma.Materials and methods. The patients were divided into three groups. The 1st group included 23 (32,85%) individuals who were treated by means of ozone therapy. The 2nd group included 23 (32,85%) patients treated by means of local platelet-rich plasma (PRP) therapy. The control group included 24 (34,28%) individuals who received a complex of therapeutic measures according to the generally accepted method. Surgery or all the patients was performed with maximum saving of the vessels in the plantar region, and the local treatment included topical vacuum therapy in the amount of 5-6 procedures. Electronic- microscopic examination used the fragments of tissue from the wound surface preserved in 2,5% glutaraldehyde solution on phosphate buff erі (рН – 7,2-7,4), followed by further processing in 1% anhydride solution. The material was dehydrated in increasing concentration alcohols and placed into araldite. The morphological structures were contrasted with a concentrated solution of uranyl acetate in the process of dehydration, and on the sections – with lead citrate. The sections 40-60 nm thick obtained by means of ultratome УМТП-3 were examined under the electron microscope TESLA БС-500. The specimens for examination were taken in the patients during dressings on the 7, 14 and 21-23 days of treatment. The dynamics of changes in the tissue macrophages was conducted by means of Astaldi principle generalizing percentage evaluation. It is a semi-quantitative method considering distinctive cytological changes determined in the similar amount of the cells examined (tissue macrophages).Results. Stimulation of the macrophage functional activity under the eff ect of ozone with destructive changes found in the cells without necrotizing damage was found to be explained by apoptosis mechanism involved as a positive factor in the regulation of local homeostasis at the completion of infl ammatory (exudative) phase of the wound process. Activation of phagocytic possibilities of the tissue macrophages with local application of autologous platelet-rich plasma occurs without any signs of apoptosis prevailing, and it is indicative of stimulation of their functional activity by antigenic or enzymatic mechanisms stimulating their functional activity.Conclusions. Stimulation of macrophage functional activity under ozone eff ect and availability of destructive changes in the cells without necrotizing damage can be explained by the involving of apoptosis mechanism as a positive factor in the regulation of local homeostasis at the completion of infl ammatory (exudative) phase of the wound process. Activation of phagocytic possibilities of the tissue macrophages with local application of autologous platelet-rich-plasma occurs without any signs of apoptosis prevailing, and it is indicative of stimulation of their functional activity by antigenic or enzymatic mechanisms stimulating their functional activity.Prospects of further studies. The results obtained confi rm and determine further necessity to conduct search innovations in the treatment of diabetic foot syndrome using the factors of physical and biological eff ect directed to the activation of a reparative process in the wound.

Recombinant interleukine-2 in treatment of diabetic foot syndrome

The experience of using Roncoleukin® – recombinant interleukin-2 (rIL-2) in the complex treatment of diabetic patients with various forms of diabetic foot syndrome is summarized. The use of rIL-2 contributed to the positive dynamics of laboratory and immunological parameters and improved the results of surgical treatment, this was manifested in a decrease in the frequency of purulent-septic complications, the frequency of amputations, a decrease in the mortality rate, reducing the time of hospitalization and an improvement in long-term treatment results.

Substantiation of the use of antioxidant therapy in the complex conservative treatment of diabetic foot syndrome

Substantiation of the use of antioxidant therapy in the complex conservative treatment of diabetic foot syndrome