Individualized surgical tactics for diabetic foot syndrome
DOI:
https://doi.org/10.11603/2414-4533.2020.4.11782Keywords:
diabetic foot syndrome, treatment, surgery, algorithmAbstract
The aim of the work: to develop an individualized algorithm for surgical treatment of patients with diabetic foot syndrome (DFS).
Materials and Methods. The comprehensive clinical study covers 123 cases of surgical treatment of DFS (patients of various degrees according to the PEDIS classification, I–V stages according to F. Wagner, with mild, moderate, severe infection according to IDSA). The development of the algorithm of surgical activity in DFS was carried out according to the recommendations of the Institute for Algorithmic Medicine (Houston, USA), using software (HTML/XML/GMT) package Document Exploration and Linking Tool/ ddons (DELTA) developed by Vienna University of Technology, Institute of Software Technology and Interactive Systems, Information Angineering Group, Vienna, Austria.
Results and Discussion. Angiographic or technical success of endovascular interventions, which leads to a significant increase in the lumen of the vessel in the area of stenosis or occlusion, was obtained in 94.3 % of cases. The technical success of balloon angioplasty was observed in almost all cases; the slightly worse angiographic results were obtained with interventions on several arteries of the shin – 55.0–94.1 % of successful angioplasties. In ischemic and mixed neuroischemic forms, most patients were able to compensate for critical ischemia by performing vascular interventions. The proposed algorithm of surgical interventions for DFS requires further study under conditions of greater randomization and expansion of the cohort of patients.
References
Schaper, N.C., van Netten, J., & Apelqvist, J. On behalf of the International Working Group on the Diabetic Foot (IWGDF). IWGDF Guidelines on the Prevention and Management of Diabetic Foot Disease. Retrieved from: https://iwgdfguidelines.org/wp-content/uploads/2019/05/01-IWGDF-practical-guidelines-2019.pdf.
Nelson, A., Wright-Hughes, A., & Backhouse, M.R. (2018). CODIFI (Concordance in Diabetic Foot Ulcer Infection): a cross-sectional study of wound swab versus tissue sampling in infected diabetic foot ulcers in England. BMJ Open., 8 (1), e019437.
Chen, S.Y., Giurini, J.M., & Karchmer, A.W. (2017). Invasive systemic infection after hospital treatment for diabetic foot ulcer: Risk of occurrence and effect on survival. Clin. Infect. Dis., 64 (3), 326-334.
Sartelli, M., Abu-Zidan, F.M., & Labricciosa, F.M. (2019). Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study. World J. Emerg. Surg., 14 (34). Retrieved from; https://doi.org/10.1186/s13017-019-0253-2.
Khomko, O.Y., Sydorchuk, R.I., Volyanyuk, P.M., Karliychuk, O.A., Petryuk, B.V., Bilyk, I.I., & Knut, R.P. (2017). Status of immunity cellular link in diabetic foot syndrome. Klinicheskaya khirurgiya – Clinical Surgery, 8, 48-49.
Pavlovich, K.V., & Sydorchuk, R.I. (2015). Vykorystannia iniektsiinoho materialu dlia reheneratsii shkiry latserta® dlia likuvannia trofichnykh vyrazok u khvorykh pry syndromi diabetychnoi stopy [The use of injectable material lacerta® for the regeneration of skin in the treatment of trophic ulcers in patients with diabetic foot syndrome]. Klin. Khirurhiia – Clinical Surgery, 7, 44-46 [in Ukrainian].
Sydorchuk, R.I., Sydorchuk, L.P., Khorshani Bilel, Hrushko, O.I., Plehutsa, O.M., Sydorchuk, I., Plehutsa, I.M., Vakarchuk, A.V., Sydorchuk, A.R., Ilaschuk, I.I., & Plehutsa, N. (2019). Microbiota alleviates host resistance and causes septic complications in diabetic foot syndrome. Infection., 47 (Suppl. 1), S57-S58.
Netten van J.J., Lazzarini, P.A., & Armstrong, D.G. (2018). Diabetic Foot Australia guideline on footwear for people with diabetes. J. Foot Ankle Res., 11, 2.
Khomko, O.Y., Sydorchuk, R.I., Karateieva, S.Y., Makarova, E.V., Bilyk, I.I., & Khomko, B.O. (2014). Ozone application in multimodal treatment of pyoinflammatory complications in patients with diabetes mellitus. European Applied Sciences, 1, 41-42.
Causey, M.W., Ahmed, A., & Wu, B. (2016). Society for Vascular Surgery limb stage and patient risk correlate with outcomes in an amputation prevention program. J. Vasc. Surg., 63, 1563-1573.
Votruba, P., Miksch, S., Kosara. R. (2004). Tracing the formalization steps of textual guidelines. Kaiser, K., Miksch, S., Tu, S. (Eds.). Computer-based Support for Clinical Guidelines and Protocols. Proceedings of the Symposium on Computerized Guidelines and Protocols, volume 101 Studies in Health Technology and Informatics. IOS Press.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Hospital Surgery. Journal named by L.Ya. Kovalchuk
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).