The wound process variants course in patients with diabetic foot syndrome in the vacuum therapy background

Purpose of the study. Study the effectivenessof vacuum therapy in the treatment of acute andchronic wound process in patients with diabetic footsyndrome, depending on the pathogenetic form ofthe lesion.Materials and methods. The effect of vacuumtherapy on the course of acute and chronic woundprocess in 231 patients with neuropathic andischemic form of diabetic foot syndrome was studiedduring 2014–2017. Evaluation of the dynamics ofthe wound process was carried out on the basis ofclinical, planimetric, microbiological, morphologicalmethods, as well as microcirculation indices in thearea around the wound.Results. Vacuum therapy of acute and chronicwounds in patients with different pathogeneticforms of diabetic foot syndrome, allows tostabilize the course of wound process, stimulateregenerative processes in the wound, improve localmicrocirculation (p < 0,05). This, in turn, allows ashorter time to prepare a wound for closure by oneof the methods of plastic surgery or create favorableconditions for its independent epithelization.In patients with ischemic lesions (chronic arterialinsufficiency of the third degree), the carrying outof vacuum therapy by standard method leads to anintensification of the pain syndrome. This causesthe need to apply an initial negative pressure in thesystem in the range of 70–80 mm Hg, which makesit possible to stop pain during the day. At 2–3 daysof the postoperative period, negative pressure isestablished at standard values.Conclusion. Vacuum therapy of wounds inpatients with diabetic foot syndrome is an effectivemethod of treatment that allows the doctor to reduce the duration of treatment of patients in hospitalwith a neuropathic form of diabetic foot syndromeon average 4,3 ± 1,7 bed-days, and patients withischemic form on average 4,1 ± 1,9 bed-days, whichhas both medical and social significance.Keywords: diabetes mellitus, diabetic foot,negative-pressure wound therapy.