Prysrupiuk M. Surgical treatment of patients with neuroischemic form of diabetic foot syndrome.

The thesis is devoted to theoretical generalization and new solution of scientific problem on improving the effectiveness of surgical treatment of patients with neuro-ischemic form of diabetic foot syndrome by improving the method of wound surface both ultrasonic and sorption technologies of debridement, using negative pressure wound therapy, development of minor amputations technologies and the method of plastic closure of the wound. It has been proved that the duration of treatment of neuro-ischemic form of DFS in hospital is directly related to the level of compensation of diabetes. It is established that sorbents lead to rapid wound cleansing, which is determined by significant reduction of microbial contamination of the wound. It was determined that ultrasound debridement method significantly reduces microbial contamination of wounds and speeds up the removal of necrotic tissue. Cleansing of patients' wound surface is seen on the 5.15±1.4 postoperative days, whereas full cleansing without ultrasound debridement is only observed on the 11.2±2.6 day. It was also established that the use of bacteriostatic draining bandage ensures engraftment of up to 89% of originally transplanted skin area. It was established as well that complex surgical treatment of foot purulent complications using vacuum therapy helps to accelerate wound cleansing 2 times fast and reduces the duration of surgery 52.3% (p<0,05) less. The improved autodermoplastic technique in combination with vacuum draining bandage reduces the risk of necrosis of transplanted skin and achieve its engraftment in 72% of cases.