FEATURES OF THE INFLUENCE OF VACUUM THERAPY ON THE DYNAMICS OF THE CLINICAL PICTURE OF WOUND DEFECTS IN PATIENTS WITH DIABETIC FOOT SYNDROME
DOI:
https://doi.org/10.11603/1811-2471.2017.v1.i3.8174Keywords:
diabetes mellitus, diabetic foot syndrome, vacuum therapy.Abstract
Object. The purpose of the work was to study the dynamics of the clinical picture of wound defects in patients with diabetic foot syndrome.
Materials and methods. On the basis of examination and treatment 131 patients with diabetes mellitus were complicated by diabetic foot syndrome studied the effect of vacuum therapy on the dynamics of the clinical picture of wound defects. In order to control the clinical course of an acute wound process, the dynamics of the pain syndrome, local signs of the inflammatory process, the timing of granulation tissue development and the amount of wound, microcirculation, the rate of epithelization, and wound healing were studied. The severity of the pain was determined using the Numerical Rating Scale. Vacuum therapy was used with the vacuum apparatus "AGAT-DNIPRO" (80-125 mm. Hg). Patients conducted a general clinical-laboratory and instrumental examination.
Results.Starting from the 5th day, on the background of vacuum therapy, the pain syndrome had a pronounced tendency to decrease and was in the study group (3,13 ± 0,21) of the score (p <0,001), at the 8th day - (1,12 ± 0,08) of the ball (p <0,001) and on the 12th - (0,81 ± 0,02) ball (p <0,001). The edema of soft tissues significantly decreased on average (2,46 ± 0,84) days (p <0,01), tissue hyperemia on (2,16 ± 0,48) days (p <0,01), infiltration tissues around the wound on (3,25 ± 0,82) days (p <0,01). In patients with the main group, active regional epithelization began on (4,64 ± 1,12) days. Vacuum therapy of wound defects accelerates the appearance of granulation tissue; patients with the main group of NIF granulation were marked at 4,61 ± 0,96 days versus 7,84 ± 1,14 control groups. In patients with the main group, the granulation was marked at 6,53 ± 1,14 days versus 10,78 ± 1,31 days of the control group. The use of vacuum therapy for wound defects in patients with CCD stimulates the growth of granulation tissue, reduces tissue swelling, improves the general condition of patients, reduces pain syndrome and normalizes body temperature.
Object. The purpose of the work was to study the dynamics of the clinical picture of wound defects in patients with diabetic foot syndrome.
Materials and methods. On the basis of examination and treatment 131 patients with diabetes mellitus were complicated by diabetic foot syndrome studied the effect of vacuum therapy on the dynamics of the clinical picture of wound defects. In order to control the clinical course of an acute wound process, the dynamics of the pain syndrome, local signs of the inflammatory process, the timing of granulation tissue development and the amount of wound, microcirculation, the rate of epithelization, and wound healing were studied. The severity of the pain was determined using the Numerical Rating Scale. Vacuum therapy was used with the vacuum apparatus "AGAT-DNIPRO" (80-125 mm. Hg). Patients conducted a general clinical-laboratory and instrumental examination.
Results. Starting from the 5th day, on the background of vacuum therapy, the pain syndrome had a pronounced tendency to decrease and was in the study group (3,13 ± 0,21) of the score (p <0,001), at the 8th day - (1,12 ± 0,08) of the ball (p <0,001) and on the 12th - (0,81 ± 0,02) ball (p <0,001). The edema of soft tissues significantly decreased on average (2,46 ± 0,84) days (p <0,01), tissue hyperemia on (2,16 ± 0,48) days (p <0,01), infiltration tissues around the wound on (3,25 ± 0,82) days (p <0,01). In patients with the main group, active regional epithelization began on (4,64 ± 1,12) days. Vacuum therapy of wound defects accelerates the appearance of granulation tissue; patients with the main group of NIF granulation were marked at 4,61 ± 0,96 days versus 7,84 ± 1,14 control groups. In patients with the main group, the granulation was marked at 6,53 ± 1,14 days versus 10,78 ± 1,31 days of the control group. The use of vacuum therapy for wound defects in patients with CCD stimulates the growth of granulation tissue, reduces tissue swelling, improves the general condition of patients, reduces pain syndrome and normalizes body temperature.
References
Abaev, Yu. K. (2006). Rany i ranevaya infekciya. Spravochnik hirurga [Wounds and wound infection. Directory of surgeon]. Rostov on the Don: Phoenix [in Russian].
Beseedin, O.M., Malyuk,Yu.Yu., Karpenko, L.I. [and others] (2014). Vacuum-instilaciina terapiya u hvoryh sindromom diabetichnoi ctopy [Vacuum-instillation therapy for patients with diabetic foot syndrome]. Klinicheskaya hirurgia - Clinical Surgery, 11 (3), 8-10 [in Ukrainian].
Obolensky, V.N., Semenova,T.V., Leval, P.S., Plotnikov, A.A. (2010) Sindrom diabeticheskoi stopy v klinicheskoi praktike [Diabetic Foot Syndrome in Clinical Practice]. Russkiy medicinskiy zhurnal - Russian Med. Journal, 2, 45-58 [in Russian].
Udovychenko, O.V., Grekova, N.M. (2010) Diabeticheskaya stopa [Diabetic foot]. Moskva: Practical medicine [in Russian].
Khramilin, V.N., (2005) Sovremennie aspekty mestnogo lecheniya hronicheskih ran nizhnih konechnostei u bolnyh saharnym diabetom [Modern aspects of local treatment of chronic lower limb wounds in patients with diabetes mellitus] Saharnyi diabet - Diabetes mellitus,4,1-8. [in Russian].
