Wound-directed revascularisation in the Diabetic Foot patients

The aim of the work was to study the reparative properties of the new combined cream on the model of stencil wounds in rats. Materials and methods. Reparative properties of a new combined preparation in the form of a cream for the treatment of inflammatory and microbial skin diseases conditionally named Dermalipoin, which included: α-lipoic acid, urea, olive oil, tea tree oil, PEG-400, was investigated on the model of extruded stencil wounds in rats. The effectiveness of treatment was assessed using planimetric indicators, which included determining: the area of wounds, the period of epithelialization, the number of animals with wounds that healed at different times and the coefficient of the rate of wound healing in comparison with the "Rescuer Forte" balm. The severity of the inflammatory reaction was drawn from changes in peripheral blood parameters: blood clotting time, hemoglobin content, the number of erythrocytes and leukocytes, leukocyte formula. To assess the effect of the cream on reparative processes, the activity of enzymes-markers of cytolysis ALAT and ASAT in the blood serum of experimental animals was determined. To assess the intensity of destruction of tissue proteins in the blood serum of experimental animals, the urea content was determined. Results. On the model of stencil wounds in rats, it was found that when applying the new cream Dermalipoin, rapid wound healing occurred: the coefficient of the rate of wound healing was 3,31 versus 2,79 and 1,45 in animals from the groups of the reference drug and control pathology, respectively (p≤0, 05).The study of the dynamics of biochemical parameters showed that the use of Dermalipoin cream was accompanied by a significant (compared to the control pathology) decrease in the activity of ALAT and ASAT, as well as a decrease in the content of urea in the blood serum of experimental animals on the ninth day of the experiment, which indicates a significant decrease in the severity of cytodestructive processes. Changes in hematological parameters indicate a decrease in the severity of the inflammatory process when using Dermalipoin cream and Rescuer Forte balm: at the end of the experiment, there was a significant decrease in the total number of leukocytes and an increase in hemoglobin levels. Conclusions. It was found that on the model of squeezed out stencil wounds in rats, Dermalipoin cream has a pronounced wound-healing effect and, in terms of the severity of the effect, is not inferior to the comparison drug, the Rescuer Forte balm. Therefore, further study of the new cream as a potential wound-healing and anti-burn drug is promising.Introduction: Peripheral arterial diseases in patients with diabetic foot have significant features in pathogenesis, manifestations and course compared with peripheral arterial disease. These features require different approaches to treatment and the the angiosome theory can help increase the effectiveness of revascularization in patients with diabetic foot. The aim: Analyse the results of revascularisation of lower extremity arteries in the patients with ischemic diabetic foot ulcers according to the angiosome theory. Materials and metods: We analysed 98 revascularisations of arteries of 77 lower limbs in 74 ischemic diabetic foot patients for the period from 2017 to 2021. Angioplasties were performed in 71 cases (72,5%), open operations – in 21 (21,4%), hybrid operations – 6 (6,1%). According to angiosome theory we divided the revascularizations into two groups. І group – direct revascularizations (DR) – 57 cases, ІІ group – indirect revascurizations (IR) – 21 cases. Results: Within 6 months foot lesions healing fixed in І group (DR) - 81.7%, in ІІ group (IR) – 78.6%. Major amputations were the consequences of 17,1% revascularizations: DR group – 12,4%, IR group – 33,3%. Functional capacity of the lower extremity within one year was saved in 79,3% in DR group and in 57,9% in IR group. Repeated revascularizations accounted for 21,4% of cases: in DR group – 20,5%, in IR group – 25%. The results of the statistical analysis revealed the dependence of the risk of amputation on adherence to angiosome theory during revascularization. Conclusions: Angiosome-targeted revascularization in the area of foot lesions increases efficiency of the revascularization and improves immediate and long-term treatment results