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Goryunov S.V.

Pirogov Russian National Research Medical University;
Filatov Moscow City Clinical Hospital No 15

Prividentsev A.I.

Pirogov Russian National Research Medical University;
Filatov Moscow City Clinical Hospital No 15

Manturova N.E.

Pirogov Russian National Research Medical University;
Institute of Plastic Surgery and Cosmetology

Stupin V.A.

Pirogov Russian National Research Medical University;
Institute of Plastic Surgery and Cosmetology

Factors influencing the choice of organ-sparing reconstructive interventions in patients with diabetic foot syndrome

Authors:

Goryunov S.V., Prividentsev A.I., Manturova N.E., Stupin V.A.

More about the authors

Journal: Plastic Surgery and Aesthetic Medicine. 2021;(2): 48‑55

DOI: 10.17116/plast.hirurgia202102148

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Table of contents

FACTORS INFLUENCING THE CHOICE OF ORGAN-SPARING RECONSTRUCTIVE INTERVENTIONS IN PATIENTS WITH DIABETIC FOOT SYNDROME
FACTORS INFLUENCING THE CHOICE OF ORGAN-SPARING RECONSTRUCTIVE INTERVENTIONS IN PATIENTS WITH DIABETIC FOOT SYNDROME

To cite this article:

Goryunov SV, Prividentsev AI, Manturova NE, Stupin VA. Factors influencing the choice of organ-sparing reconstructive interventions in patients with diabetic foot syndrome. Plastic Surgery and Aesthetic Medicine. 2021;(2):48‑55. (In Russ., In Engl.)
https://doi.org/10.17116/plast.hirurgia202102148

Подписка 2026 Пластическая хирургия и эстетическая медицина (Plastic Surgery and Aesthetic Medicine)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

OBJECTIVE

To identify the factors influencing the choice of skin repair method for wound and ulcerative defects in patients with diabetic foot syndrome.

MATERIAL AND METHODS

We analyzed 135 patients with foot defects following treatment of diabetic foot syndrome with purulent-necrotic lesions. In 104 (77.1%) cases, non-healing wounds and ulcers were spontaneous, 31 (22.9%) patients had these lesions following injuries and burns. The following factors influencing the choice of reconstructive surgery were identified: defect area and shape, depth, tissues of the wound bed, localization, and severity of microcirculatory disorders. The optimal criteria for repair with local tissues were pulsatile blood flow with wound edge perfusion over 1 perfusion unit, PmeanO2≥30 mm Hg. Subcompensated circulation was determined by ankle-brachial index 0.3-0.8, perfusion units 0.3-1, PmeanO2 25-30 mm Hg. In some cases, skin repair method was determined intraoperatively in case of subcompensated blood flow. Repair with local tissues is preferred for defect closure and ensures more functional and aesthetic result. In case of skin perfusion decrease by 30%, partial tissue stretching or free transplantation of non-perforated cutaneous flap was used for defect closure.

RESULTS

Compensated type of microcirculation in 94 (69.6%) patients and subcompensated circulation in 41 (30.4%) patients (r=0.562; p=0.05) ensured choosing a more correct method of skin repair with favorable functional and aesthetic result.

CONCLUSION

Compliance with these indicators made it possible to close wound and ulcerative defects in patients with diabetic foot syndrome, reduce the number of complications, preserve support function of the foot and obtain favorable aesthetic result.

Keywords:

diabetic foot syndrome
wound and ulcerative defects
skin repair
microcirculation

Authors:

Goryunov S.V.

Pirogov Russian National Research Medical University;
Filatov Moscow City Clinical Hospital No 15

Prividentsev A.I.

Pirogov Russian National Research Medical University;
Filatov Moscow City Clinical Hospital No 15

Manturova N.E.

Pirogov Russian National Research Medical University;
Institute of Plastic Surgery and Cosmetology

Stupin V.A.

Pirogov Russian National Research Medical University;
Institute of Plastic Surgery and Cosmetology

Received:

03.03.2021

Accepted:

08.04.2021

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