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S.V. Goryunov

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

A.I. Prividentsev

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

N.E. Manturova

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

V.A. Stupin

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:

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

More about the authors

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

DOI: 10.17116/plast.hirurgia202102148

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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

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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:

S.V. Goryunov

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

A.I. Prividentsev

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

N.E. Manturova

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

V.A. Stupin

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

Received:

03.03.2021

Accepted:

08.04.2021

List of references:

  1. Ayubova NL, Bondarenko ON, Galstyan GN. Clinical outcomes of lower limb peripheral vascular disease after endovascular intervention in patients with diabetes mellitus, critical limb ischemia and chronic kidney disease. Diabetes Mellitus. 2013;4:85-94. (In Russ.). https://doi.org/10.14341/dm2013485-94
  2. Belskaya GN, Sergienko DA, Pavlov YuI, Krochek IV. Multidisciplinary management of patients with diabetic foot syndrome. Medical Council. 2018;1:70-76. (In Russ.). https://doi.org/10.21518/2079-701x-2018-1-70-76
  3. Bobrov MI, Shatalin AE, Mitrofanov VN. Cutaneous plastics in diabetic foot syndrome. Klinicheskaya patofiziologiya. 2016;3-1(22):6. (In Russ.).
  4. Gerasimov GN. Results of modified method of autodermoplasty of sluggish-granulating wounds and trophic ulcers of lower extremities. Ekperimental’naya i klinicheskaya meditsina. 2015;3(68):135-138. (In Russ.).
  5. Gostishchev VK, Lipatov KV, Komarova EA, et al. Plastic surgery in patients with soft-tissue infektion. Khirurgiya. Zhurnal im. N.I. Pirogova. 2009;12: 20-23. (In Russ.).
  6. Grigoriev AA. Diabetic foot syndrome. Novaya apteka. 2015;6:36-38. (In Russ.).
  7. Davidenko OP, Girsh YaV, Gurieva IV. Diabetic foot syndrome: a comparative analysis of the treatment at the stage of specialized medical care. Endokrinologiya: novosti, mneniya, obuchenie. 2017;3(20):64-70. (In Russ.).
  8. Dedov II, Shestakova MV, Vikulova OK. Epidemiology of diabetes mellitus in Russian federation: clinical and statistical report according to the federal diabetes registry. Diabetes Mellitus. 2017;20;(1):13-41. (In Russ.). https://doi.org/10.14341/dm8664
  9. Dibirov MD, Gadzhimuradov RU, Koreiba KA. Analysis of the clinical application of epidermal growth factor (“Heberprot-P”) and bioplastic material (“Collost”) in treatment of skin and soft tissues defects in patients with diabetic foot syndrome. Khirurgiya. Zhurnal im. N.I. Pirogova. 2016;3:59-63. (In Russ.). https://doi.org/10.17116/hirurgia2016359-63
  10. Dibirov MD, Gadzhimuradov RU, Khalidov OKh, et al. Experience with actovegin in the treatment of the neuroischemic form of diabetic foot syndrome. Farmateka. 2014;20:50-54. (In Russ.).
  11. Dibirov MD, Gadzhimuradov RU, Khalidov OKh, et al. A modern approach to treating purulent-necrotic complications of diabetic foot syndrome. Moskovskaya meditsina. 2017;S2(21):51-52. (In Russ.).
  12. Zaitseva EL, Tokmakova AYu, Shestakova MV, et al. The study of influence of different methods of local treatment on wound healing in patients with diabetic foot ulcers. Vestnik Rossijskoj akademii meditsinskikh nauk. 2016;71(6): 466-471. (In Russ.).
  13. Ivanov DP, Serebryakova OV, Ivanov PA. Diabetic foot syndrome: classification and diagnosis of ischemic form, current state of the question. Zabajkal’skij meditsinskij vestnik. 2018;4:111-122. (In Russ.).
  14. Kolobova OI, Kozlov AV. Surgical and conservative treatment of the ischemic form of the diabetic foot syndrome. Khirurgiya. Zhurnal im. N.I. Pirogova. 2013;8:36-42. (In Russ.).
  15. Koreiba KA, Klyushkin IV, Minabutdinov AR, Koreiba EA. Managed tissue regeneration mathematical model in patients with diabetic foot syndrome. Vestnik sovremennoj klinicheskoj meditsiny. 2018;11(5):51-54. (In Russ.). https://doi.org/10.20969/vskm.2018.11(5).51-54
  16. Matyukov AA, Kabanov MYu, Zaitseva TE, et al. A multidisciplinary approach in the treatment of patients with diabetic foot syndrome. Tyumenskij meditsinskij zhurnal. 2014;2:44. (In Russ.).
  17. Minakov OE, Andreev AA, Ostroushko AP. The diabetic foot syndrome. Vestnik eksperimental’noj i klinicheskoj khirurgii. 2017;10(2):165-172. (In Russ.). https://doi.org/10.18499/2070-478x-2017-10-2-165-172
  18. Mitish VA, Paskhalova YuS, Eroshkin IA, et al. Pyo-necrotic injuries in case of the neuro-ischemic form of diabetic foot syndrome. Khirurgiya. Zhurnal im. N.I. Pirogova. 2014;1:48-53. (In Russ.).
  19. Nuzova OB, Studenikin AV, Stadnikov AA, Kolosova NI. Treatment of purulent wounds in patients with diabetes mellitus. Zdorov’e i obrazovanie v XXI veke. 2016;8(11):48-52. (In Russ.).
  20. Okroyan VP, Ibragimov TR, Galimov OV, Khanov VO. Current view on pathogenetic approach in surgical treatment of patients with diabetic foot syndrome. Permskij meditsinskij zhurnal. 2018;35(1):12-20. (In Russ.). https://doi.org/10.17816/pmj35112-20
  21. Pavlyshin AV, Shidlovsky VA, Gerasimchuk PA. Plastic closure of wounds and trophic ulcers in patients with diabetic foot syndrome by relief autoshred. Vestnik RAMN. 2013;1:72-75. (In Russ.). https://doi.org/10.15690/vramn.v68i1.541
  22. Rumyantseva SA, Stupin VA, Oganov RG, et al. Theory and practice of treating patients with vascular comorbidity: clinical guidance. M.: Mittel Press; 2016. (In Russ.).
  23. Sviridov MV, Golodnikov AE. Evalution of the effectiveness of VAC-therapy in the preparatory stage of plastic wound closure in patients with diabetic foot. Klinicheskaya endokrinologiya i endokrinnaya khirurgiya. 2016;2(54): 27-34. (In Russ.). https://doi.org/10.24026/1818-1384.2(54).2016.75862
  24. Stupin VA, Silina EV, Goryunov SV, et al. Assessment of changes in the lesions sizes and the incidence of complete epithelialization during the treatment of diabetic foot syndrome over a period of 4 weeks (multicenter study). Khirurgiya. Zhurnal im. N.I. Pirogova. 2017;3:55-60. (In Russ.). https://doi.org/10.17116/hirurgia2017355-60
  25. Stupin VA, Rumyantseva SA, Silina EV. Diabetes mellitus: problems and solutions. M. 2009. (In Russ.).
  26. Stupin VA, Silina EV, Koreiba KA, Goryunov SV. Diabetic foot syndrome (epidemiology, pathophysiological, diagnosis, and treatment). M.: LitTerra; 2019. (In Russ.).
  27. Stupin VA, Silina EV, Goryunov SV, Gorsky VA, et al. Assessment of changes in the lesions sizes and the incidence of complete epithelialization during the treatment of diabetic foot syndrome over a period of 4 weeks (multicenter study). Khirurgiya. Zhurnal im. N.I. Pirogova. 2017;3:55-60. (In Russ.). https://doi.org/10.17116/hirurgia2017355-60
  28. Sukovatykh BS, Pankrusheva TA, Abramova SA. Optimization of treatment of septic wounds in patients with diabetic foot ulcers. Grekov’s Bulletin of Surgery. 2014;3:28-32. (In Russ.).
  29. Sharobaro VI, Moroz VYu, Manturova NE, et al. Early plastic operations for the treatment of burn consequences. Khirurg. 2011;8:23. (In Russ.).
  30. Yurova YuV, Krylov PK, Kozulin ID. Evaluation of information value of microcirculation indices of granulating wounds to optimize results of free autodermoplasty in victims with deep skin burns. Skoraya meditsinskaya pomoshch’. 2011;3:81-85. (In Russ.).
  31. Alavi A, Sibbald RG, Mayer D, et al. Diabetic foot ulcers: Part I. Pathophysiology and prevention. J Am Acad Dermatol. 2014;70(1):1.e1-18; quiz 19-20. 
  32. Armaghani SJ, Archer KR, Rolfe R, et al. Diabetes is related to worse patient-reported outcomes at two years following spine surgery. J Bone Joint Surg Am. 2016;98:15-22. 
  33. Bakker K, Apelqvist J, Lipsky BA, Van Netten J.J. International Working Group on the Diabetic Foot. The 2015 IWGDF guidance documents on prevention and management of foot problems in diabetes: development of an evidence-based global consensus. Diabetes Metab Res Rev. 2016;32:2-6. 
  34. Bamba R, Gupta V, Shack RB, et al. Evaluation of diabetes mellitus as a risk factor for major complications in patients undergoing aesthetic surgery. Aesthet Surg J. 2016;36:598-608. 
  35. Blume PA, Schmidt BM. The role of plastic surgery for soft tissue coverage of the diabetic foot and ankle. Clin Podiatr Med Surg. 2014;31(1):127-150. 
  36. Bobircã F, Georgescu D, Mihalache O, Pãtrascu T. The new prognostic — therapeutic index for diabetic foot surgery — extended analysis. Chirurgia (Bucur). 2016;111(2):151-155. 
  37. Bobircã F, Georgescu D, Mihalache O, Pãtrascu T. The new prognostic-therapeutic index — an easy method of establishing surgical indication in the pathology of the diabetic foot. J Med Life. 2014;7(Spec Iss 3):13-19. 
  38. Botezatu I, Laptoiu D. Minimally invasive surgery of diabetic foot — review of current techniques. J Med Life. 2016;9(3):249-254. 
  39. Brolmann FE, Eskes AM, Goslings JC, et al. Randomized clinical trial of donor-site wound dressings after split-skin grafting. British Journal of Surgery. 2013;100:619-627. 
  40. Cecchi R, Bartoli L, Brunetti L, Troiano G. Repair of a large lateral foot defect with a combination of keystone island flap and V-Y plasty. Eur J Dermatol. 2015;25(6):618-619. 
  41. Chittoria RK, Pratap H, Yekappa SH. Abductor hallucis: anatomical variation and its clinical implications in the reconstruction of chronic nonhealing ulcers and defects of foot. Adv Wound Care (New Rochelle). 2015;4(12): 719-723. 
  42. Dryden M, Baguneid M, Eckmann C, et al. Pathophysiology and burden of infection in patients with diabetes mellitus and peripheral vascular disease: focus on skin and soft-tissue infections. Clin Microbiol Infect. 2015;21:27-32. 
  43. Fischer JP, Tuggle CT, Au A, et al. A 30-day risk assessment of mastectomy alone compared to immediate breast reconstruction (IBR). J Plast Surg Hand Surg. 2014;48:209-215. 
  44. Goltsman D, Morrison KA, Ascherman JA. Defining the Association between Diabetes and Plastic Surgery Outcomes: An Analysis of Nearly 40,000 Patients. Plast Reconstr Surg Glob Open. 2017;5(8).
  45. Hart A, Funderburk CD, Chu CK, et al. The impact of diabetes mellitus on wound healing in breast reconstruction. Ann Plast Surg. 2017;78:260-263. 
  46. Ibrahim AM, Shuster M, Koolen PG, et al. Analysis of the National Surgical Quality Improvement Program database in 19,100 patients undergoing implant-based breast reconstruction: complication rates with acellular dermal matrix. Plast Reconstr Surg. 2013;132:1057-1066.
  47. Kong AP, Luk AO, Chan JC. Detecting people at high risk of type 2 diabetes — how do we find them and who should be treated? Best Pract Res Clin Endocrinol Metab. 2016;30:345-355. 
  48. Lee S, Kim MB, Lee YH, et al. Distally based abductor hallucisadipomuscular flap for forefoot plantar reconstruction. Ann Plast Surg. 2015;75(3):319-322. 
  49. Lind M, Svensson AM, Kosiborod M, et al. Glycemic control and excess mortality in type 1 diabetes. N Engl J Med. 2014;371:1972-1982.
  50. Mahmoodi BK, ten Kate MK, Waanders F. High absolute risks and predictors of venous and arterial thrombembolic events in patients with neprotic syndrome: Results from a large retrospective cohort study. Circulation. 2008; 117(2):224-230. 
  51. Miller JD, Salloum M, Button A, et al. How Can I Maintain My Patient with Diabetes and History of Foot Ulcer in Remission? Int J Low Extrem Wounds. 2014;13(4):371-377. 
  52. Miller RJ. Neuropathic Minimally Invasive Surgeries (NEMESIS): Percutaneous Diabetic Foot Surgery and Reconstruction. Foot Ankle Clin. 2016; 21(3):595-627. 
  53. Nehring P. Mrozikiewicz-Rakowska B, Krzyżewska M, et al. Diabetic foot risk factors in type 2 diabetes patients: a cross-sectional case control study. J Diabetes Metab Disord. 2014;4(13):79. 
  54. Nickerson DS. Improving outcomes in recurrent and other new foot ulcers after healed plantar forefoot diabetic ulcer. Wound Repair and Regeneration. 2018;26(1):108-109. 
  55. Nykiel M, Sayid Z, Wong R, et al. Management of mastectomy skin flap necrosis in autologous breast reconstruction. Ann Plast Surg. 2014;72:31-34. 
  56. Orneholm H, Apelqvist J, Larsson J, Eneroth M. Recurrent and other new foot ulcers after healed plantar forefoot diabetic ulcer. Wound Repair Regen. 2017;25(2):309-315. 
  57. Pögl D, Stadler N, Kempny T. Plastic surgery options for the treatment of chronic foot ulcers. Orthopade. 2015;44(1):25-32. 
  58. Ramanujam CL, Stuto AC, Zgonis T. Use of local intrinsic muscle flaps for diabetic foot and ankle reconstruction: a systematic review. J Wound Care. 2018;1(27):22-28. 
  59. Raspovic KM, Wukich DK. Self-Reported Quality of Life and Diabetic Foot Infections. J Foot Ankle Surg. 2014;53(6):716-719. 
  60. Ricco J.B. Thanh Phong L, Schneider F, et al. The diabetic foot: a review. J Cardiovasc Surg. 2013;54:755-762. 
  61. Rodriguez-Collazo ER, Pereira RJ, Craig GC. Reverse distally based abductor hallucis muscle flap for soft tissue coverage of the first metatarsophalangeal joint wounds. Int J Low Extrem Wounds. 2017;16(3):208-211. 
  62. Salvo NL, Walsh MD, Brewster LP Promoting Limb Salvage through Multi-Disciplinary Care of the Diabetic Patient. Curr Treat Options Cardiovasc Med. 2017;19(7):55. 
  63. Sanniec K, Nguyen T, van Asten S, et al. Split Thickness Skin Grafts to the Foot and Ankle of Diabetic Patients. J Am Podiatr Med Assoc. 2017; 107(5):365-368. 
  64. Shah BR, Hux JE. Quantifying the risk of infectious diseases for people with diabetes. Diabetes Care. 2003;26:510-513. 
  65. Shirol SS, Nimbaragi G, Prabhu M, Ratkal J. Abductor digitiminimi muscle flap in reconstruction of diabetic foot ulcers: a case series. Eur J Plast Surg. 2014;37(4):227-232. 
  66. Short DJ. Local intrinsic muscle flap reconstruction for soft tissue coverage of the diabetic foot. In: Short DJ, Zgonis T. Surgical reconstruction of the diabetic foot and ankle. 2nd edn. Wolters Kluwer; 2018.
  67. Suh HS, Hong JP. Diabetic foot ulcer. J Korean Med Assoc. 2015;58(9): 795-800. 
  68. Tang ZQ, Chen HL, Zhao FF. Gender differences of lower extremity amputation risk in patients with diabetic foot: a meta-analysis. Int J Low Extrem Wounds. 2014;13(3):197-204. 
  69. Walker RJ, Strom WJ, Egede LE. Influence of race, ethnicity and social determinants of health on diabetes outcomes. Am J Med Sci. 2016;351: 366-373. 
  70. Wang J, Gao L. New progress in the treatment of chronic wounds of diabetic foot. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018;32(7):832-837. 

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