This journal is
indexed in Scopus
Year 2018 Vol. 26 No 3
GENERAL & SPECIAL SURGERY
A.A. GLUKHOV 1, V.A. SERGEEV 2
ASSESSMENT OF EFFICIENCY OF THE PROGRAMMED ASPIRATION AND IRRIGATION REHABILITATION METHOD IN SUPPURATIVE NECROTIC COMPLICATIONS OF DIABETIC FOOT SYNDROME
Voronezh State Medical University named after N.N. Burdenko 1, Voronezh,
Orel Regional Clinical Hospital 2, Orel
The Russian Federation
Objective. To assess the efficiency of the programmed aspiration and irrigation rehabilitation (PAIR) method in the combined treatment of patients with suppurative necrotic complications of diabetic foot syndrome (DFS).
Methods. The treatment results of 84 patients with suppurative necrotic complications of DFS without critical ischemia of 52 to 63 years of age have been analyzed. The patients with DFS were divided into two groups depending on the way of postoperative rehabilitation of the suppurative focus. In the reference group, conventional therapy was carried out with the use of iodophors and polyethylene glycol ointments. In the study group, postoperative rehabilitation of the suppurative foci was performed using the programmed technique with the original equipment. The device was equipped with a pressure switch providing automatic setting and maintenance of a definite vacuum level in the cavity of a suppurative focus.
Results. In the study group, the reduction below the threshold levels in the bacterial load for suppurative necrotic foci proved to occur earlier than in the reference group (p<0.001). Alkalinization of the wound effluent and reduction in the protein amount in the wound discharge were faster in the study group (p<0.001). Hospital length of stay in the study group was significantly lower compared to the reference group (p<0.001). The number of suppurative complications was significantly smaller (p=0.014) than in the reference group. The frequency of high amputations performed in the study group was less than in the reference group.
Conclusions. The results of the conducted investigations confirmed the efficiency of programmed aspiration and irrigation rehabilitation method in the combined treatment of patients with suppurative necrotic tissue injury in diabetic foot syndrome, which significantly improves the rehabilitation of the suppurative focus, providing in turn the significant improvement of the treatment efficacy.
Keywords: diabetic foot syndrome, suppurative necrotic complications, active surgical approach, programmed aspiration and irrigation rehabilitation, surgical treatment of suppurative focus, plastic resection of the foot
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302000, The Russian Federation,
Orel, Pobedy Boul., 10,
Orel Regional Clinical Hospital,
Tel: +7 905 165 09 92,
Vladimir A. Sergeev
Glukhov Alexksandr A., MD, Professor, Head of the Department of General Surgery, Director of the Institute of Surgical Infection, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russian Federation.
Sergeev Vladimir A., PhD, Surgeon, the Coloproctological Unit, Orel Regional Clinical Hospital, Orel, Russian Federation.