Differentiated treatment of patients with diabetic foot syndrome at the stage of specialized surgical care

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Aim — to assess 1-year results of differentiated treatment of patients with diabetic foot syndrome (DFS) who were included into 3-year register of diabetic foot outpatient practice (DFOP). Material and methods. It was performed retrospective analysis of 570 patients with DFS (2015—2017): group I — neuropathic form (n=285), group II — neuroischemic form (n=285). Patients were classified according to Texas grade. Group I — 107 (37.5%) patients (BI—III); 91 (31.9%) patients (AII+BII—III). Diabetic osteoarthropathy was diagnosed in 97 (34.0%) cases. Group II included 113 (45.2%) patients with DI—III and 171 (60.0%) patients with CII—II+DII—III. 308 patients received combined outpatient treatment (including limb off-loading in 88%), 195 patients — in-hospital surgical treatment (including endovascular procedures — 52), 67 patients — treatment at the place of residence. Postoperative follow-up was in diabetic foot outpatient practice. Statistical analysis of data was performed by using of Biostat software package. Results. In group I 1-year results are unknown in 76 (26.7%) patients. Epitheliazation was noted in 101 (35.4%) cases, persistent diabetic ulcer — in 27 (12.9%), small amputations — 16 (7.7%), high amputations — 2 (0.95%). In group II results are unknown in 29 (10.2%) patients. Epitheliazation occurred in 121 (47.3%) cases, persistent diabetic ulcer — 53 (20.7%), small amputations — 47 (18.4%), high amputations — in 35 (13.7%) cases. Conclusion. DFOP is a key organizational unit of specialized medical care for patients with DFS. Regular follow-up of patients in DFOP and combined treatment at the stage of specialized surgical care allows to preserve limb in 99% of patients with neuropathic foot and in 86.3% of patients with neuroischemic foot.

Keywords:

diabetic foot syndrome

diabetic foot outpatient practice

specialized surgical treatment

1-year results

Authors:

Burleva E.P.

Kafedra obshcheĭ khirurgii GOU VPO "Ural'skaia gosudarstvennaia meditsinskaia akademiia", Ekaterinburg

Babushkina Yu.V.

Sverdlovsk regional clinical hospital, Ekaterinburg, Russia

Galimzyanov F.V.

Ural State Medical University, Ekaterinburg, Russia;
Sverdlovsk regional clinical hospital, Ekaterinburg, Russia

Fominykh A.N.

Sverdlovsk regional clinical hospital, Ekaterinburg, Russia

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