APPLICATION OF VAC-THERAPY IN THE TREATMENT OF DIABETIC FOOT

Ivanna Sakhanda, Oleksii Orlov

Abstract


The aim. To substantiate the effectiveness of the use of VAC-therapy in the treatment of wounds in patients with diabetic foot syndrome.

Materials and methods. The patient with a complicated form of diabetic foot syndrome was examined. The monitoring of the course of the wound process is supplemented by clinical, cytological, microbiological and morphological criteria. In the treatment of patients we used vacuum therapy apparatus. Vacuum wound therapy was performed in negative pressure regimens in the range of 80–125 mm Hg.

Results. In the pattern of morbidity in economically developed countries, diabetes mellitus (DM) occupies one of the first places. Its prevalence is 1.5–6 %. The number of patients with diabetes in Ukraine is likely to reach 14 million by 2020. Lesions of the lower extremities of different genesis occur in 30–80 % of people with impaired carbohydrate metabolism. Most often, these lesions are complicated by the development of chronic peptic ulcer defects, which, when untimely diagnosed and inadequate treatment, leads to amputation of the affected limb. Even when radical surgery is avoided, the long and costly treatment of trophic disorders of the soft tissues of the feet and legs leads to huge costs of both material resources and time for medical staff. In 15 % of patients with DM, trophic ulcers of the lower extremities are diagnosed. Recent studies have focused on such important aspects of the study of this issue as the early diagnosis of soft tissue lesions in individuals with DM, the development of treatment aimed at preventing amputations, facilitating the further rehabilitation of patients. Vacuum therapy is one of the new methods of treating wound defects, including in patients with diabetic foot syndrome. Topical application of vacuum therapy has already become an integral therapeutic option for wound debridement in patients with diabetic foot syndrome. However, when applying the classic vacuum therapy technique, these patients have the problem of delaying the outflow of tissue exudate and lysis detritus to the vacuum system.

Conclusions. Optimization of the technique of the influence of negative pressure on the wound by applying forced drainage with irrigation of the wound with an antiseptic can maintain a constantly high concentration of antimicrobial agent in the wound, increase the speed of wound dialysis and prevent clogging of pores of the sponge and the bacterial colonies in it. The application of this technique avoids high amputation, accelerates the time of wound healing, and retains the supporting function of the lower extremity.


Keywords


diabetes mellitus; diabetic foot syndrome; vacuum-therapy; debridement; wound; amputation; lower limb

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DOI: http://dx.doi.org/10.21303/2585-663.2019.001096

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ISSN 2585-6634 (Online), ISSN 2585-6626 (Print)