Method of treatment of calcaneus osteomyelitis in patients with neuropathic form of diabetic foot syndrome
DOI:
https://doi.org/10.11603/2414-4533.2021.3.12333Keywords:
diabetic foot syndrome, osteomyelitis of the calcaneus, platelet-rich plasmaAbstract
The aim of the work: to improve results of treatment, to reduce quantity of postoperative complications, to reduce terms of inpatient treatment of patients with osteomyelitis of a heel bone with neuropathic form of diabetic foot syndrome due to application of the technique of the modified operative treatment offered by us.
Мaterials and Methods. The research was carried out in Septic Surgery of Odesa City Clinical Hospital No. 11. The patients with diabetes, type 2, with a neuropathic form of diabetic foot syndrome were included in research. In all the cases we saw a purulent-necrotic process in the area of calcaneus. Throughout 2014–2020, we observed patients with osteomyelitis of the calcaneus. Group 1 included 24 patients with osteomyelitis of the calcaneus, who were operated according to technique proposed by us. In order to stimulate reparative processes in the tissues, musculocutaneous flaps intraoperatively were infiltrated with platelets reached plasma. Another group was put on the submission of a retrospective analysis of the history of 32 patients, who were treated with the use of common methods.
Results and Discussion.
The use of the proposed method for the treatment of calcaneal osteomyelitis made it possible to reduce the number of postoperative complications from 25 % to 8.2 %, to reduce the average length of hospital stay from (29.4±6.2) to (17.14±5.2) days, as well as due to more effective treatment of osteomyelitis of the calcaneus to preserve the support ability of the limb, improve the quality of life of patients. We associate the absence of postoperative hematomas in the patients of group 1 with the use of the technique developed by us for “filling” the residual cavities, preventing the accumulation of exudate with its subsequent suppuration. Intraoperative tissue infiltration of platelet-rich plasma containing not only growth factors, but also adhesive molecules and cytokines that stimulate repair and anabolic processes in damaged tissues, stimulates neoangiogenesis, and reduces the likelihood of secondary necrosis in the wound.
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