Multidisciplinary Approach to the Management of Diabetic Foot Complications
https://doi.org/10.35401/2541-9897-2023-26-3-99-104
Abstract
Background: According to the International Working Group on the Diabetic Foot (2015), 28 % of diabetic foot ulcers result in major amputations. Over 30 % of patients with diabetic foot undergo major amputations that result in death in 13.0 %-14.0 % of the cases.
Clinical case: In our experience of treating a female patient with diabetic foot complications, we observed that such cases require a multidisciplinary approach to determine management strategies, as well as strict surgery staging. Early plastic and reconstructive surgery demonstrated its positive impact on postoperative wound closure.
Conclusions: We managed the infection and achieved the complete closure of the major wound and primary intention healing through the multidisciplinary approach and strict adherence to surgical staging (debridement, revascularization, reconstruction). Thus, patient quality of life and rehabilitation potential significantly improved.
About the Authors
V. V. FedyushkinRussian Federation
Vladimir V. Fedyushkin, Surgeon
Vascular Surgery Unit No. 2
350086
ulitsa 1 Maya 167
Krasnodar
P. V. Sukhoruchkin
Russian Federation
Pavel V. Sukhoruchkin, Cardiovascular Surgeon, Head of Unit
Vascular Surgery Unit No. 2
Krasnodar
A. G. Baryshev
Russian Federation
Aleksandr G. Baryshev, Dr. Sci. (Med.), Deputy Chief Physician (Surgery)
Krasnodar
S. K. Chibirov
Russian Federation
Soslan K. Chibirov, Endovascular Surgeon
Vascular Surgery Unit No. 2
Krasnodar
R. K. Amirova
Russian Federation
Regina K. Amirova, 4th Year Student
Faculty of Pediatrics
Krasnodar
D. D. Shevchuk
Russian Federation
Daniil D. Shevchuk, sixth-year Student
Faculty of Medicine
Krasnodar
References
1. Bensman VM. Surgical Treatment of Purulent Necrotic Complication of the Diabetic Foot: A Guide for Physicians. 2<sup>nd</sup> ed., revised and amended. Medpraktika-M; 2015. (In Russ.).
2. Baytinger VF, Selayninov KV, Kurochkina OS, Kamolov FF, Baytinger AV, Sukhinin TYu. Evolution of technologies for closure of vast and deep soft-tissue defects of human body. Issues of Reconstructive and Plastic Surgery. 2018;21(1):5–14. (In Russ.).
3. Gurieva IV, ed. International Agreement on Diabetic Foot. Bereg; 2000. (In Russ.).
4. Pyatakov SN. Tissue Distraction in the Treatment of Extensive Skin and Soft Tissue Defects of Various Etiologies. Dissertation. Kuban State Medical University; 2019. (In Russ.).
5. Obolenskiy VN. Modern treatment methods of the chronic wounds. Medical Council. 2016;(10):148–154. (In Russ.). doi: 10.21518/2079-701x-2016-10-148-154
6. Gaibov AD, Kalmykov EL, Kamolov AN. Low extremity amputation in treatment of chronic critical limb ischemia (data review). Russian Journal of Cardiology and Cardiovascular Surgery. 2009;2(2):40–46. (In Russ.).
7. Lokhvitskii SV, Afanasev AN, Malamud MYa. Diabetic Purulent Osteoarthropathy: Pathogenesis, Clinical Presentation, Treatment. Karaganda; 1995. (In Russ.).
8. Akashev RV, Piksin IN, Pigachev AV. “LANOTPAD” classification of diabetic foot. Medical Almanac. 2013;(5):165–168. (In Russ.).
9. Belozertseva YP, Kurlayev PP, Gritsenko VA. Diabetic foot syndrome: etiology, pathogenesis, classifications and treatment. Kursk Scientific and Practical Bulletin Man and His Health. 2016;(1):69–78. (In Russ.).
10. International Diabetes Federation. IDF Diabetes Atlas. 5<sup>th</sup> ed. International Diabetes Federation; 2011.
11. Solun MN. M.I. Akhunbaev, A.P. Kalinin, D.S. Rafibekov. Diabetic angiopathy of the lower extremities and diabetic foot. - Bishkek, 1997 .-- 143 p. Problems of Endocrinology. 1999;45(1):56. (In Russ.). doi: 10.14341/probl11710
12. 2017 ESC guidelines on the diagnosis and treatment of peripheral arterial diseases, in collaboration with the European Society for Vascular Surgery (ESVS). Russian Journal of Cardiology. 2018;(8):164–221. (In Russ.). doi: 10.15829/1560-4071-2018-8-164-221
13. Demirtaş H, Değirmenci B, Çelik AO, et al. Anatomic variations of popliteal artery: evaluation with 128-section CT-angiography in 1261 lower limbs. Diagn Interv Imaging. 2016;97(6):635–642. PMID: 27033461. doi: 10.1016/j.diii.2016.02.014
Review
For citations:
Fedyushkin V.V., Sukhoruchkin P.V., Baryshev A.G., Chibirov S.K., Amirova R.K., Shevchuk D.D. Multidisciplinary Approach to the Management of Diabetic Foot Complications. Innovative Medicine of Kuban. 2023;(3):99-104. (In Russ.) https://doi.org/10.35401/2541-9897-2023-26-3-99-104