AUTODERMOPLASTY IN PATIENTS WITH COMPLICATED FORMS OF THE DIABETIC FOOT SYNDROME
Abstract
Aim. To improve the results of surgical treatment of diabetic foot syndrome and evaluate the efficiency of the autodermoplasty.
Material and methods. 56 observed patients had complicated forms of diabetic foot syndrome after transmetatarsal amputation complicated by necrosis of the fasciocutaneous flap. The research was made on the basis of the Center for Endocrine and purulent-septic surgery at Dushanbe State clinical hospital №3. The research group consisted of 34 (60.7%) men and 22 (39.3%) women. The age of patients ranged from 30 to 54 years.
Results. After cleansing the necrotic masses of wounds and appearance of the granulations, plastic replacement of the defect with a free, perforated skin flap of 0.2 - 0.4 mm thickness that was taken from the anterior outer surface of a thigh, was performed. The TcpO2 was measured before the plastic surgery at the level of the thigh. TcpO2 was in the range of 31-42 mmHg (average 35.8 ± 2.4 mmHg). The flap was fixated to the stump by nodal catgut sutures. Good fixation of the autograft is necessary for its engraftment. The first bandage was made after three days. During this period bandage was irrigated by a solution of decasan. Full engraftment was observed in 36 (64,3%) cases. In 16 (28,6%) cases only partial engraftment and in 4 (7,1%) patients complete necrosis of the graft was observed.
Conclusion. Thus, the organ and functionality sparing surgery should be carried out after the elimination of the inflammatory process. It is achieved by complex conservative therapy where the free autodermoplasty surgery should remain a method of choice to prevent the faulty stump in complicated forms of diabetic foot syndrome.
About the Authors
N. S. Safarov
Head of Department of General Surgery № 2 TGMU named by Abuali ibni Sino
Tajikistan
Tajikistan
N. D. Mukhiddinov
State Education Establishment “Institute of Postgraduate Education in Health Sphere of the Republic of Tajikistan”
Tajikistan
Tajikistan
В. М. Hafizov
Head of Department of General Surgery № 2 TGMU named by Abuali ibni Sino
Tajikistan
Tajikistan
А. Р. Hudoydodov
Head of Department of General Surgery № 2 TGMU named by Abuali ibni Sino
Tajikistan
Tajikistan
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Review
For citations:
Safarov N.S., Mukhiddinov N.D., Hafizov В.М., Hudoydodov А.Р. AUTODERMOPLASTY IN PATIENTS WITH COMPLICATED FORMS OF THE DIABETIC FOOT SYNDROME. Health care of Tajikistan. 2018;(2):42-46. (In Russ.)
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