Ways of limbs salvage in postoperative period of treatment of complications of diabetic foot syndrome

Кривощеков, Е. П.; Elshin, E. B.; Romanov, V. E.; Aliapyshev, G S; Rodnianskiĭ, D V

doi:10.33529/angio2020401

Cited by 4 publications

(1 citation statement)

References 6 publications

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“…At the same time, PRP can regulate the balance of matrix metalloproteinases and their inhibitors and can promote the restoration of senescent cells. Previous studies have shown 17,18 that, compared with antibiotic treatment, PRP did not induce antibiotic resistance and had a synergistic effect in preventing infection. Moreover, PRP can effectively promote wound repair in patients with refractory diabetic foot ulcers without causing severe adverse reactions.…”

Section: Discussionmentioning

confidence: 96%

Clinical Study on the treatment of chronic infectious ulcers using Platelet-Rich technology combined with moist dressings

Zhang,

Lang

2024

Pak J Med Sci

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Objective: To explore the clinical efficacy of platelet-rich technology combined with moist dressings in the treatment of chronic infectious ulcers. Methods: This was a retrospective study. The subjects of the study were 48 patients with chronic infectious ulcers in Sichuan Provincial Orthopedics Hospital from January 2019 to June 2022. Enrolled patients were randomly divided into four groups(n=12), and received different treatment methods respectively. Further analysis and comparison were performed on the changes in wound volume, wound healing status, wound bacterial culture results, and the incidence of adverse reactions among the four groups. Results: Three months after debridement, the wound volume of all four groups of patients was significantly reduced compared with that before debridement, with a statistically significant difference in intra-Group-Comparison(P<0.05). The inter-Group-Comparison revealed a statistically significant difference in wound volume in Group-A, Group-B, and Group-C than that in Group-D(P<0.05). After treatment, the wound healing status of patients in groups A, B, and C was significantly better than that of patients in Group-D, with a statistically significant difference(P<0.05). During treatment, patients in all four groups had decreased count of would bacteria, and showed negative results of wound bacterial culture by the three-month follow-up. No serious adverse reactions were observed in the four groups during treatment, and all improved after management, with no statistically significant difference in the incidence of adverse reactions(P>0.05). Conclusion: Platelet-rich technology combined with moist dressings may effectively promote the repair of chronic infectious ulcer wounds, with good clinical safety. doi: https://doi.org/10.12669/pjms.40.7.8468 How to cite this: Zhang X, Lang Z. Clinical Study on the treatment of chronic infectious ulcers using Platelet-Rich technology combined with moist dressings. Pak J Med Sci. 2024;40(7):---------. doi: https://doi.org/10.12669/pjms.40.7.8468 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 96%

Clinical Study on the treatment of chronic infectious ulcers using Platelet-Rich technology combined with moist dressings

Zhang,

Lang

2024

Pak J Med Sci

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Modern possibilities and prospects of conservative treatment of patients with peripheral arterial diseases

Katorkin

Krivoshchekov

Elshin

et al. 2022

Ambulatornaya khirurgiya

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The most common clinical manifestation of peripheral arterial disease is intermittent claudication due to insufficient blood supply to the affected limb. The article summarizes and systematizes the latest achievements in the field of conservative treatment of patients with intermittent claudication. In accordance with the requirements of evidence-based medicine, an overview of modern promising trends in conservative therapy presented in the latest Russian and foreign consensus documents, is given. The basis of the complex treatment of patients with peripheral arterial diseases is: non-drug and drug treatment to relieve the symptoms of chronic ischemia, pharmacotherapy for the secondary prevention of cardiovascular complications, open or endovascular revascularization to increase the distance of painfree walking. With the development of atherosclerosis, disturbances in the peptide composition of the endothelium occur, which reduce the ability of the vascular wall to resist inflammation and the associated triggering of pathological processes. It has been experimentally proven that the use of a complex of peptides obtained from the vessels of healthy and young animals in this situation restores the endothelial function of the arteries, affecting the main links of pathogenesis. Decrease in oxidative stress, decrease in atherogenic and lipidemic action, normalization of vascular tone and blood coagulation parameters, increase in the microvascular bed – these are the mechanisms that justify the indication of peptides to patients with atherosclerosis obliterans. Angioprotector based on a complex of polypeptides isolated from blood vessels can become an important part of the treatment of patients with obliterating diseases of the arteries of the lower extremities, providing a complex pathogenetic effect. It is necessary to further study in multicenter clinical trials the duration of the therapeutic effect of a drug in a longer period after a course of treatment, its effect on long-term outcomes of the disease, the possibility of using repeated courses, in chronic obliterating diseases of the arteries of the lower extremities III-IV stages according to the Fontaine classification, as well as the use drug for the treatment of systemic atherosclerosis of various arterial basins.

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The use of cilostazol in the treatment of patients with obliterating atherosclerosis on the background of diabetes mellitus

et al. 2022

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Introduction. Symptomatic peripheral arterial disease (intermittent claudication) is the main cause of disability and loss of mobility in patients and thus has a significant negative impact on their quality of life. Conservative treatment of these patients should be aimed at improving local blood flow, tissue metabolism and blood rheology. Cilostazol is the only drug with a Class I (Evidence A) recommendation for the treatment of intermittent claudication.Objective. Тo evaluate the clinical efficacy and safety of the use of cilostazol in patients with a combination of obliterating atherosclerosis of the arteries of the lower extremities and diabetes mellitus.Materials and methods. In 2021–2022, 102 patients were treated. Men – 78, women – 24, the average age was 62 ± 2.8 years. All patients were prescribed basic treatment of atherosclerosis of the arteries against the background of diabetes mellitus. In the first group (n = 52), cilostazol was additionally prescribed 100 mg 2 times a day. In the second group (n = 50), pentoxifylline was additionally prescribed 600 mg 2 times a day. The severity of the pain syndrome, the pain-free walking distance, the maximum walkable distance, the change in the ankle-shoulder index and partial oxygen pressure in the capillary blood of the foot tissues, the presence of negative outcomes were assessed after 1, 3, 6 months of treatment.Results and discussions. In group 1 patients, a more pronounced decrease in pain syndrome was noted compared to group 2, both in patients with IIA degree and in patients with IIB degree of lower limb ischemia according to Fontaine. The increase in pain-free walking distance and the maximum walking distance in group 1 were more significant than in group 2, starting from the 3rd month of treatment. The ankle-brachial index practically did not change, both in group 1 and in group 2. Negative outcomes of treatment after 6 months in the 1st group – 1.9%, and in the 2nd group – 8%.Conclusions. If it is impossible to revascularize the limb in patients with obliterating atherosclerosis of the arteries on the background of diabetes mellitus, the inclusion of cilostazol in the treatment regimen shows better final results than the appointment of pentoxifylline. The use of cilostazol significantly improved the quality of life and functional ability of the lower extremities in patients with intermittent claudication.

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Ways of limbs salvage in postoperative period of treatment of complications of diabetic foot syndrome

Cited by 4 publications

References 6 publications

Clinical Study on the treatment of chronic infectious ulcers using Platelet-Rich technology combined with moist dressings

Clinical Study on the treatment of chronic infectious ulcers using Platelet-Rich technology combined with moist dressings

Modern possibilities and prospects of conservative treatment of patients with peripheral arterial diseases

The use of cilostazol in the treatment of patients with obliterating atherosclerosis on the background of diabetes mellitus

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