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Complex Treatment of Trophic Ulcers in Patient with Diabetic Foot Syndrome in a Multidisciplinary Hospital
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| Author:
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EDREES S. AL-KANANI, VLADIMIR F. KULIKOVSKIY, SERGEY V. ZHARKO, MAKSIM S. KAPRANOV, ADREY L. IAROSH, ALEKSANDR A. KARPACHEV, ALEKSANDR V. SOLOSHENKO, SERGEY P. FRANCEV, MARINA S. LINNIK
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| Abstract:
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Objectives: study the stages of treatment a patient with type 2 diabetes mellitus and diabetic foot syndrome with trophic complications of the lower extremities in a multidisciplinary surgical center.
Materials and Methods: In our work conducted the analysis of the results of complex treatment of patients with the diabetic foot syndrome, neuro-ischemic form who were treated in the hospital surgical clinic of Belgorod State University.
Results: Surgical and conservative methods of treatment of patients with complicated forms of type 2 diabetes mellitus are being improved every year, supplemented with new methods of operative and non-operative elimination of trophic ulcers of the lower extremities. The use of endovascular techniques and new sorbing materials allowed us to expand tactical approaches in the treatment of this complex group of patients. As our research has shown, the treatment of infected trophic ulcers still causes difficulties, a fragmentary approach to treatment, especially at the outpatient stage. In some cases, radical treatment with the preservation of the affected foot becomes impossible with advanced micro-macroangiopathy complicated by subtotal stenosis of the lower limb arteries. In our work we wanted to show that in addition to the classical treatment of trophic ulcers of the lower limbs different approaches drug treatment became widespread, such as multiple gels, ointments, sorbents of different origin. Treatment should begin with inspection of vessels of lower extremities starting from the thoracic aorta, arteries of the pelvis and lower extremities using Doppler ultrasound at the outpatient stage followed by x-ray angiography and CT angiography: various types of reconstructive operations on the vessels of the lower extremities (classic surgical interventions and endovascular in the form of balloon angioplasty or stenting), which at the present stage cannot be treated for this serious pathology.
Conclusions: Occurrence of arterial insufficiency can be detected in early stages of disease. This will help in high-risk groups to reduce the percentage of amputations and deaths.
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| Keyword:
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diabetes mellitus, diabetic foot syndrome, trophic foot ulcer, digital subtraction angiography, occlusion of popliteal artery, the modified silver form of montmorillonite.
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2020.SP1.164
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