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Introduction. One of the complications of diabetes mellitus (DM) is diabetic foot syndrome (DFS), which develops in 6–11 % of patients and requires surgical treatment in 40–70 % of them. Various types of amputations and large necrectomies lead to a redistribution of the load on the foot with the development of violations of its support function and deformity. As a result, the soil arises for the development of purulent-necrotic processes, the quality of life of patients decreases. Rehabilitation is an important part of postoperative care. It should be carried out both in the hospital and at the outpatient stage of treatment and is an important measure in preventing complications and improving the quality of life of patients. Aim. To analyze the results of treatment of patients with purulent-necrotic complications (PNC) of DFS, for whom postoperative rehabilitation measures were included in the treatment complex. Materials and methods. The results of treatment of 128 patients operated on for PNC of DFS were studied. The examination and treatment were carried out according to the standards. At the outpatient stage, 45 patients underwent complex rehabilitation using a set of physical exercises in combination with physiotherapy methods of treatment. Determination of the degree of foot deformity was performed using plantography and X-ray of the foot bones. The dynamics of life quality indicators were studied using the Manchester-Oxford foot questionnaire (MOXFQ). Results and discussion. The obtained results showed that in conditions of rehabilitation treatment, after 6 months the number of complications in the main group was less than in the comparison group by 12.6 %, and after a year – by 25 %. The study of the quality of life using the MOXFQ questionnaire 6 months after rehabilitation showed a significant difference in indicators (p < 0.05) between the comparison and the main groups on pain and social interaction scales and the MOXFQ index in general, which indicates a positive effect of the used rehabilitation treatment on the quality life of patients. At the same time, after a year, the reliability of the difference in indicators on all scales and the MOXFQ-index of the main and comparison groups was not revealed, despite the best absolute figures. The result obtained indicates the need for repeated courses of rehabilitation measures in the complex of treatment. Conclusions. Treatment of patients with complications of DFS should be organ-preserving and complex. Treatment should include a set of rehabilitation measures aimed at restoring the motor function and support ability of the foot to prevent its deformation. The use of rehabilitation treatment can reduce the number of complications in the postoperative period and improve the quality of life of patients.

Purulent-necrotic complications in patients with diabetic foot syndrome is one of the main causes resulting in amputation and disability, or even lethal outcome. Our study was aimed at investigating a role played by MRSA and related molecular genetic features, as well as antibiotic resistance in developing purulent-necrotic forms of the diabetic foot syndrome in Krasnoyarsk, in the 2010–2016 period. A microbiota profile related to purulent-necrotic complications, antibiotic susceptibility, as well as the molecular genetic features of methicillin-resistant Staphylococcus aureus were examined in 240 patients with diabetic foot syndrome. A bacteriological method was used to investigate microbiota profile related to purulent complications. Antibiotic sensitivity was analyzed by disc-diffusion method; staphylococcal antibiotic sensitivity was evaluated by screening, PCR, solid medium serial dilution, in accordance with the CLSI and EUCAST international recommendations. Genotyping and examining molecular genetic features were performed by using PCR, M-PCR, and sequencing. The data were analyzed by using WHONET (WHO) software. Significance level was set at p

Diabetic foot or the syndrome of diabetic foot (SDF) is the problem due to a high frequency of ablations of the lower extremities followed with a significant social, psychological and economic consequences. The research objective is to estimate diagnostic opportunities of ultrasound doppler scanning (UDS) of arteries of lower extremities in the patients with diabetes mellitus (DM) in development of purulent-necrotic complications. The main group consisted of 141 patients with DM who were treated at purulent-septic center «City Hospital N 3» in Zaporizhzhya, during 2017-2018. Control group – 274 patients who were receiving treatment during 2009-2013. The average duration of DM was 12,8±2,9 years. Average age of patients was 56,3±5,3 years. 63 (44,7%) were men, women – 78 (53,3%). The groups were representative by key indicators and the accompanying pathology. During hospitalization patients had signs of purulent-necrotic lesion of the lower extremity. The complex of diagnostic actions included obligatory diagnostics of a vascular bed of the lower extremities by means of UDS. By comparison with retrospective data it was defined that the number of DM patients with vascular problems in development of purulent-necrotic complications has increased. If earlier the percentage of distribution to etiological forms made up: neuropathic - 36,9%, ischemic - 23,4%, mixed – 39,7%, currently, mixed form (p

Diabetes and predetermined him heavy purulent-necrotic complications is actual problem medicine today’s. It is proved that patients with diabetes have big risk to development of heart-vessel disease due to the development of atherosclerosis. Standard of diagnosis peripheral arterial disease of lower limb is finding ankle-brachia index (ABI). This method is good at definition of degree of arterial occlusion. Purpose of the study. Purpose of the work: to analyse the diagnostic capability of ABI in patients who have purulent-necrotic complications of diabetic foot. Material and methods. The prospective studies covered 218 patients. The average patients age 54,2 ± 10,3years, 45,5% of them – men. The mild form of disease was in 33,2%, moderate severity – in 45,2%, severe – in 21,6%. The duration of purulent-necrotic complications was 11,5 ± 1,2 days. Results. We have seen that 128 patients have different degrees of macroangiopathy. in patients who performed amputation at the level of the thigh of ABI was 0,41 ± 0,13; at the level of the leg – 0,59 ± 0,12. Conclusion. 1. Timely diagnosis is the basis of effective treatment of purulent necrotic complications of diabetic foot. 2. In treatment, it is necessary to take into account the indicators of ABI as the main diagnostic marker of peripheral artery disease of lower limb. 3. Definition of ABI is an objective and valuable predictive marker.

Background: Purulent lesions of the feet in diabetes mellitus bring excruciating suffering to the patient, reduce the quality of life and often lead to limb amputation and possible death. The disappointing results of the treatment of purulent complications of diabetes encourage the search for both new approaches to treatment and methods for assessing the reparative potential of wound defects. Aim: This study aimed to improve the treatment of purulent-necrotic complications of the diabetic foot by studying the morphological assessment of healing processes when using promising treatment methods such as then programmed debridement. Methods: Over the past 10 years, the results of treatment of 106 patients with purulent-necrotic complications of diabetic foot syndrome (DFS) without critical ischemia have been analyzed. The patients were randomized into two groups. In the experimental group (n = 55), after surgical treatment, the wound was sutured tightly, and in the postoperative period, programmed debridement was carried out using the original AMP-01 device. In the control group of patients (n = 51), the purulent wound was not sutured after the operation, and local treatment was carried out with solutions of iodophors, ointments based on polyethylene glycol. To assess the dynamics of reparative processes in purulent wounds, a cytological method was used, which makes it possible to quickly and reliably assess the stage of the wound process and the effectiveness of the treatment. The simplicity and availability of the method allows it to be recommended to all practicing specialists. Results and Discussion: In the experimental group, by day 9 after surgery, the number of degenerative forms of neutrophils in cytological smears was 2.9 times lower than in the control group - 12.3 ± 0.3% versus 36.4 ± 0.4% (p <0.001) - and the RDI indicator in experimental group was 3.4 times higher compared with the control group - 2.6 ± 0.1 and 0.9 ± 0.1, respectively (p <0.001). This indicated more active phagocytosis, more rapid cleansing of the purulent cavity. An earlier appearance of cells of young connective tissue was observed in the experimental group. The number of fibroblasts by day 9 after surgery was 4.6 times higher (6.4 ± 0.4%) than in the control group - 1.4 ± 0.1% (p <0.001), which confirmed the presence of active regenerative processes in the wound. Conclusions: The use of programmable sanitation technologies in treating purulent complications of a diabetic foot leads to a more significant reduction in the duration of the inflammation phase and acceleration of reparative processes. [ABSTRACT FROM AUTHOR]

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Objective: The aim: To conduct a comparative analysis of clinical data, laboratory results, and pain intensity in patients using developed by us device for offloading the foot and plaster splint during inpatient treatment of purulent-necrotic complications of diabetic foot syndrome., Patients and Methods: Materials and methods: We examined 76 patients with purulent-necrotic complications of diabetic foot syndrome, who used a plaster splint and a device for offloading the foot. We evaluated the clinical indicators of the healing process, laboratory data and pain intensity., Results: Results: Comparing the results of using the device for offloading the foot and the plaster splint showed that the developed by us device had a positive effect on the dynamics of the healing process: the edema disappeared on average 1.5 days earlier; the redness vanished on average 2.5 days earlier. We observed granulation and epithelialization significantly earlier (p <0.05) than in the group where the plaster splint was used. The number of recorded surgical interventions was statistically significant and less (p <0.05) in the group where our device was used. Low pain rates were in patients using a device for offloading the foot due to minimal contact of the wound surface with the floor., Conclusion: Conclusions: According to the results of comparative using the device for offloading the foot and plaster splint, we found out that using the device for offloading the foot allows creating statistically significant better conditions to accelerate wound healing in patients and reduce the duration of inpatient treatment.