The nature of reparative and morphological changes in wounds was examined against the background of vacuum therapy in the comprehensive treatment of purulent and necrotic lesions of diabetic foot syndrome. We conducted comprehensive examination and treatment of 107 patients with DFS of grade II-IV according to Meggit-Wagner. The average age of patients was 53.2–4.3 years; there were 39 (36.4%) male and 68 (63.6%) female patients. Depending on the methods of topical treatment, patients were divided into two groups. The main group consisted of 55 (51.4%) subjects who underwent vacuum therapy during the topical treatment, and the comparison group comprised 52 (48.6%) patients who received standardized local treatment depending on the course of the wound process. In addition to the clinical studies, all patients underwent a comprehensive laboratory and instrumental examination, as well as measuring the area and pH of wounds on the 1st, 4th, 7th, 10th and 13th day after surgery. The analysis of the obtained results gives ground to establish that at a certain level of pH, there is a corresponding cytological pattern. The wide range of fluctuations in the pH of the wound medium in patients with purulent and necrotic lesions of diabetic foot syndrome leads to corresponding changes in cells, which is manifested by a long-lasting inflammatory process. In the main group, the rate of wound reduction was greatest on the 8th-10th days, and in the comparison group – on the 14th-15th days. Inpatient treatment was 14.2 bed-days in the main group and 23.5 ± 2.9 in the comparison group (p <0.05), respectively. Therefore, there is an acceleration of positive changes in clinical manifestations, cytological, morphological and pH-metric pattern against the background of conducting VT for an average of 5-7 days. The use of vacuum therapy makes it possible to accelerate the transition to the second phase of the wound process, which affects not only the time of treatment but also the outcome – preservation of the lower extremity in patients with diabetic foot syndrome.
This article describes the specifics of distance learning for students during the COVID-19 pandemic and martial law. Educational institutions are faced with new challenges, among with there is a task to get equipped and prepared to master and apply new methods of digital media technologies and implement digitalization at different levels of the doctor’s training process. Digitalisation of teaching and learning formats in education and training in medicine requires the creating of digitally supported didactic formats, the use of the relevant digital and communication tools as well as digital literacy from both parties. The implementation of the various digital resources will enable to significantly improve the results of distance learning among medical students in obtaining sound theoretical knowledge and mastering practical skills. The positive and negative aspects of distance learning in the institutions of higher medical education were also identified and outlined. The analysis points out that providing high quality distance education requires an investment of much time and considerable costs. The educational process must be equipped with special software, accessories, create and purchase appropriate computer programs and technical devices. It is important to stress a special role teaching staff, who must be ready to create various teaching and learning scenarios, master technical skills including uploading documents and videos, providing online instructions for self-directed learning and assessment, video conferencing as a part of classroom evens. Medical education, over time, would be increasingly supplemented by computers with combinations of multimedia elements and new strategies for using teaching and learning technologies. Providing the educational process with simulators and other smart technologies will help medical students to acquire the complex practical skills. In the near future, systems of artificial intelligence, augmented and virtual reality technologies will be introduced into the educational process of higher medical education institutions that will make a significant breakthrough in ensuring high-quality distance learning.
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