Effect of negative pressure therapy on repair of soft tissues of the lower extremities in patients with neuropathic and neuroischaemic forms of diabetic foot syndrome

Abstract

Aim. To evaluate the efficiency of topical negative pressure wound therapy (NPWT) compared with standard therapy for the regeneration of the soft tissues of the lower extremities in patients with diabetic foot syndrome. Materials and Methods. The effects of negative pressure therapy on the clinical (size, tissue oxygenation), histological (light microscopy) and immunohistochemical (CD68, MMP-9, TIMP-1) aspects of repair of the soft tissue of the lower extremities in patients with diabetes mellitus were compared with those of standard treatment. Thirty-one patients with diabetic foot ulcers were included in the study from the moment of debridement until the plastic closure of the wound. During the perioperative period, 13 patients received NPWT (-90 to -120 mmHg) and 18 patients received standard therapy. Results. A reduction of the wound area (26.6%?17.2%) and the depth of the defects (40.5%?25.6%) were achieved with negative pressure therapy compared with baseline data. In the control group, the corresponding values were 25.3%?19.4% and 21.8%?21.6%, respectively. The results of transcutaneous oximetry showed a greater increase in the level of local hemodynamics in the study group (p

Clinical-functional and morphological parameters of purulonecrotic foci healing in diabetic foot syndrome using programmable sanitation technologies

“…The failures and insufficient effectiveness of the treatment of purulonecrotic foci in DFS are due to disturbed local tissue response to the introduction of an infectious agent, high bacterial contamination, and a deficiency of most growth factors involved in the repair process. Currently, experts consider the emergence of innovative methods of intraoperative and postoperative rehabilitation of purulent foci, overcoming antibiotic resistance and increasing the effectiveness of systemic antibacterial therapy, the use of targeted correction of immunotherapy to be promising areas in the treatment of purulent complications in DFS (Stupin et al, 2019;Zaytseva et al, 2014;Kayem & Karlov, 1977;Davydov et al, 1990;Sergeev & Glukhov,2020).…”

“…At the same time, there is a violation of the synthesis of growth factors due to a decrease in the activity of macrophages. The role of inflammatory cytokines and matrix metalloproteases in reducing the rate of remodeling of the extracellular matrix and the rate of collagen accumulation has been proven (Zaytseva et al, 2014;Baltzis et al, 2014;Liu et al, 2009;Li et al, 2013;Dinh et al, 2012;Brancato & Albina, 2011). These and several other pathophysiological mechanisms lead to a chronic prolonged course of wound defects in diabetes with a slowdown in their healing time.…”