Assessment of the outcomes of the treatment of patients with suppurative necrotic complications of diabetic foot syndrome with the use of programmed rehabilitation technologies
https://doi.org/10.24884/0042-4625-2018-177-6-63-68
Abstract
Objective. To assess the outcomes of the treatment of patients with suppurative necrotic complications of diabetic foot syndrome (DFS) without critical ischemia with the use of programmed rehabilitation technologies (PRT).
Material and methods. The study included 82 patients. 40 patients (reference group) underwent conventional rehabilitation, while 42 patients (study group) were treated with PRT with the use of the original equipment AMP-01.
Results. Use of PRT has been established to significantly improve the quality of rehabilitation, which helps to reduce the duration of inpatient treatment. The number of suppurative complications in the study group proved to be significantly less (p=0.014), and postoperative mortality was lower. The long-term outcomes of the treatment (number of late suppurative complications, ischemia progression, maintenance of foot support ability) in the study group was also found to be significantly better compared to the reference group.
Conclusion. The use of PST promotes the improvement of short-term and long-term outcomes of the treatment of the patients with DFS suppurative necrotic complications.
About the Authors
A. A. Glukhov
Voronezh N. N. Burdenko State Medical University.
Russian Federation
Russian Federation
V. V. Sergeev
Orel I. S. Turgenev State University; Orlovskaya Central Clinical Hospital of Orel Region.
Russian Federation
Russian Federation
G. A. Semyonova
Orel I. S. Turgenev State University.
Russian Federation
Russian Federation
References
1. Dedov I. I., Omel’yanovskij V. V., SHestakova M. V., Avksent’eva M. V., Ignat’eva V. I. Saharnyj diabet kak ehkonomicheskaya problema v rossijskoi federacii. Saharnyj diabet. 2016. Vol. 19, № 1. P. 30–43. (In Russ.)
2. Atanasov P., Chan J. C., Gagliardino J. J. et al. International Diabetes Management Practice Study (Idmps) : Resource Use Associated With Type 2 Diabetes In Africa, Middle East, South Asia, Eurasia and Turkey // Value Health. 2015. Vol. 18, № 7. Р. 619.
3. Gregg E., Li Y., Wang J. et al. Changes in Diabetes-Related Complications in the United States, 1990–2010 // New Engl. J. Med. 2014. Vol. 370, № 16. P. 1514–1523.
4. Cost-of-illness studies of diabetes mellitus : A systematic review / C. Ng, J. Lee, M. Toh, Y. Ko // Diabetes Res Clin Pract. 2014. Vol. 105. P. 151–163.
5. Seuring T., Archangelidi O., Suhrcke M. The Economic Costs of Type 2 Diabetes : A Global Systematic Review // PharmacoEconomics. 2015. Vol. 33, № 8. P. 811–831.
6. Krishnan S., Nash F., Baker N. et al. Reduction in diabetic amputations over 11 years in a defined UK population : benefits of multidisciplinary work and continuous prospective audit // Diabetes Care. 2008. Vol. 31, № 1. P. 99–101.
7. Diabetic peripheral neuropathic pain : clinical and quality-of-life issues / C. Argoff, B. Cole, D. Fishbain, G. Irving // Mayo Clin. Proc. 2006. Vol. 81, № 4. P. 3–11.
8. Brownrigg J., Hinchliffe R., Apelqvist J. et al. Performance of prognostic markers in the prediction of wound healing and/or amputation among patients with foot ulcers in diabetes : a systematic review // Diabetes Metab Res Rev. 2016. Vol. 32. P. 128–135.
9. Bus S., Van Deursen R., Armstrong D. Footwear and offloading interventions to prevent and heal foot ulcers and reduce plantar pressure in patients with diabetes : a systematic review // Diabetes Metab Res Rev. 2016. Vol. 32. P. 99–118.
10. Game F., Apelqvist J., Attinger C. et al. Effectiveness of interventions to enhance healing of chronic ulcers of the foot in diabetes : a systematic review // Diabetes Metab Res Rev. 2016. Vol. 32. P. 154–168.
11. Paisley A., Kalavalapalli S., Subudhi C. et al. Real time presence of a microbiologist in a multidisciplinary diabetes foot clinic // Diabetes Res. Clin. Pract. 2012. Vol. 96, № 1. P. e1–e3.
12. Peters E., Lipsky B., Aragón-Sánchez J. et al. Interventions in the management of infection in the foot in diabetes : a systematic review // Diabetes Metab. Res. Rev. 2016. Vol. 32. P. 145–53.
13. Mitish V. A., Doronina L. P., Galstyan G. R., Sergeeva S. V. Khirurgicheskoe lechenie stopy SHarko, oslozhnennoj flegmonoj. Rany i ranevye infekcii. 2015. Vol. 2, № 3. Р. 54–62. (In Russ.)
14. Braun L. R., Fisk W. A., Lev-Tov H. et al. Diabetic Foot Ulcer : An Evidence-Based Treatment Update // Am. Journ. of Clin. Dermatology. 2014. Vol. 15. P. 267–281.
15. Zajceva E. L., Doronina L. P., Molchkov R. V., Voronkova I. A., Mitish V. A., Tokmakova A. Yu. Osobennosti reparacii tkanei u pacientov s nejropaticheskoi i nejroishemicheskoi formami sindroma diabeticheskoi stopy na fone terapii otricatel’nym davleniem. Vestnik khirurgii. 2014. Vol. 173, № 5. Р. 64–72. (In Russ.)
16. Bassetto F., Lancerotto L., Salmaso R. et al. Histological evolution of chronic wounds under negative pressure therapy // J. Plast. Reconstr. Aesthet. Surg. 2012. Vol. 65, № 1. P. 91–99.
17. Ojalvo A., Acosta J., Marí Y. et al. Healing enhancement of diabetic wounds by locally infiltrated epidermal growth factor is associated with systemic oxidative stress reduction // Int. Wound J. 2017. Vol. 14. P. 214–225.
18. Chekmareva I. A., Mitish V. A., Paklina O. V., Blatun L. A., Paskhalova Yu. S., Ushakov A. A., Terekhova R. P., Gordienko E. N., Sokov S. L., Mun’os Sepeda P. A., Kachanzhi A. P. Morfologicheskaya otsenka ehffektivnosti primeneniya gidrohirurgicheskoj sistemy VersaJet® v sochetanii s kombinirovannoj antibakterial’noj terapiej pri lechenii gnojno-nekroticheskikh oslozhnenii sindroma diabeticheskoi stopy s bioplenochnymi formami bakterij. Rany i ranevye infekcii. 2015. Vol. 2, № 3. P. 8–20. (In Russ.)
19. Hong W., Hu M., Esquivel M. et al. The Role of Hypoxia-Inducible Factor in Wound Healing // Adv. Wound Care (New Rochelle). 2014. Vol. 3. P. 390–399.
20. Schintler M. V. Negative pressure therapy : theory and practice // Diabetes Metab. Res. Rev. 2012. Vol. 28. Р. 72–77.
21. Wukich D., Armstrong D., Attinger C. et al. Inpatient management of diabetic foot disorders : a clinical guide // Diabetes Care. 2013. Vol. 36. Р. 2862–2871.
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For citations:
Glukhov A.A., Sergeev V.V., Semyonova G.A. Assessment of the outcomes of the treatment of patients with suppurative necrotic complications of diabetic foot syndrome with the use of programmed rehabilitation technologies. Grekov's Bulletin of Surgery. 2018;177(6):63-68. (In Russ.) https://doi.org/10.24884/0042-4625-2018-177-6-63-68
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