OPTIMIZATION OF SURGICAL TREATMENT FOR PURULENT-INFLAMMATORY SOFT TISSUE DISEASES IN PATIENTS WITH TYPE 2 DIABETES MELLITUS USING SYNERGISTIC VASODILATION AND IMMUNOCORRECTION
DOI:
https://doi.org/10.11603/2414-4533.2026.1.16068Keywords:
type 2 diabetes mellitus, soft tissue infections, computer-assisted planimetry, regenerationAbstract
The aim of the work: to increase the effectiveness of treatment of patients with purulent-inflammatory soft tissue diseases with concomitant type 2 diabetes mellitus by developing and implementing tactics of synergistic use of systemic vasodilation and local immunocorrection.
Materials and Methods. Traditional surgical treatment methods often do not contribute to adequate wound healing in patients with diabetes mellitus due to "metabolic immunodepression" and microangiopathy. The paper presents the results of treatment of 148 patients with purulent-inflammatory soft tissue diseases (PISTD) on the background of type 2 diabetes mellitus (DM). It is proven that traditional treatment methods do not provide adequate regeneration due to immunometabolic paralysis and microangiopathy. The author proposed a treatment complex that includes systemic use of the vasodilator alprostadil and local immunocorrection with muramyl peptides.
Results. It was established that the combination of these components allows overcoming the "diabetic stopper" of healing. Cytologically confirmed acceleration of fibroblast appearance by 3–4 days. According to computer planimetry, the area of wounds in the main group on the 10th day decreased by 59.3 % ((26.42±1.8) cm²), while in the control group – only by 24.9 % (41.3±2.4 cm²). The average daily healing rate according in the main group was 7.6 %, which is 1.6 times higher than the results of standard therapy.
Conclusions. The synergistic effect of systemic vasodilation and immunocorrection effectively overcomes the "diabetic arrest of healing", which leads to significantly faster wound closure and objective improvement of regeneration parameters.
Received: 21.01.2026 | Revised: 04.02.2026 | Accepted: 23.02.2026
References
Zheliba MD, Khimich SD, Gerasymchuk PO, et al. Hniina khirurhiia: pidruchnyk [Pyogenic surgery: a textbook]. Kyiv. Medytsyna. 2016; 488. Ukrainian.
Gerasymchuk PO, Kit OM, Pavlovych OV, et al. Rol endotelialnoi dysfunktsii u patohenezi syndromu diabetychnoi stopy [The role of endothelial dysfunction in the pathogenesis of diabetic foot syndrome]. Shpytalna khirurhiia. Zhurnal imeni L Ya. Kovalchuka. 2017; (3):34-8. Ukrainian.
Dzyubanovskyi IYa, Mishchii MM, Haras MM. Suchasni pidkhody do likuvannia hniino-nekrotychnykh uskladnen syndromu diabetychnoi stopy [Modern approaches to the treatment of purulent-necrotic complications of diabetic foot syndrome]. Shpytalna khirurhiia. Zhurnal imeni L. Ya. Kovalchuka. 2018; (1):48-51. Ukrainian.
Lazzarini PA, Armstrong DG, Rogers LC, et al. Global burden of diabetic foot disease: a systematic review. Journal of Foot and Ankle Research. 2022; 15(1):1-12.
Holosh SV, Zheliba MD. Vplyv muramilpeptydiv na fahotsytarnu aktyvnist monotsytiv u khvorykh na diabetychnu stopu [Influence of muramyl peptides on phagocytic activity of monocytes in patients with diabetic foot]. Visnyk Vinnytskoho natsionalnoho medychnoho universytetu. 2020; 24(2):245-50. Ukrainian.
Shao M, Cheng L, Bin L, et al. The efficacy and safety of Alprostadil in the treatment of diabetic foot ulcers: A systematic review and meta-analysis. Frontiers in Endocrinology. 2023; 14:1122118.
Kovalchuk LYa, Polyatsko KH. Patohenetychni aspekty likuvannia hniino-nekrotychnykh uskladnen diabetychnoi stopy [Pathogenetic aspects of treatment of purulent-necrotic complications of diabetic foot]. Shpytalna khirurhiia. 2016;(2):5-9. Ukrainian.
Zheliba MD, Pokydko MI. Obhruntuvannia zastosuvannia systemnoi vazodylatatsii v kompleksnomu likuvanni hniinoi infektsii miakykh tkanyn [Substantiation of the use of systemic vasodilation in the complex treatment of purulent infection of soft tissues]. Vinnytskyi medychnyi zhurnal. 2019; (2):15-20. Ukrainian.
Chornopyshchuk RM, Zheliba MD, et al. Osoblyvosti khirurhichnoi taktyky likuvannia khvorykh na hniini zakhvoriuvannia miakykh tkanyn [Features of surgical tactics for the treatment of patients with purulent diseases of soft tissues]. Klinichna khirurhiia. 2021; (7-8):34-9. Ukrainian.
Wang C, Schwaitzberg S, Floyd E, et al. Robotic and digital tools in wound area measurement: a review of modern planimetric techniques. Journal of Surgical Research. 2023; 282:154-62.
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