Multidisciplinary treatment of ischemic forms of diabetic foot

Purpose of the study. The phototherapy,platelet growth factor and coating materials in thetreatment complex using for improve the resultsof wound treatment in patients with the ischemicform of diabetic foot.Materials and methods. The analysis of theresults of treatment of 48 patients with ischemicforms of diabetic foot syndrome has been performedin the work. The patients were divided into thestudy and comparative groups. The patients weretreated at the clinic of the State institution «V.T. Zaitsev Institute of General and EmergencySurgery National Academy of Medical Sciencesof Ukraine» from 2012–2018, and all patientshad II stage diabetes mellitus and IV degree ofischemia by Fontaine. Patients in both groupsperformed open and hybrid reconstructions. Inthe patients of the study group, the developedtreatment technology was applied, containingphototherapy and photodynamic therapy with arange of: λ 470, 525 or 405 nm in the preoperativeperiod, closure with synthetic coating withapplication plasma enriched of transforminggrowth factor.The implementation of the developed tacticsallowed to achieve complete wound healing in91,7% of patients, partial healing – in 8,3% of patients.The terms treatment terms for these patients didnot exceed 2 months, high amputation was notrequired.Conclusions. Plastic closure of the wounds of the lower extremities after revascularization operationsin an ischemic diabetic foot syndrome is indicatedin cases where wounds do not tend to spontaneoushealing. The use of a treatment complex consistingof phototherapy and photodynamic therapy,the closure of wounds with a synthetic coatingof transforming growth factor is the effectivestimulator of development of granulation tissue inthe wound, suitable for further autodermoplasty.Keywords: foot ischemic diabetic syndrome,dermoplasty, synthetic coatings, photodynamictherapy, platelet growth factor.