Modern approaches in the surgical treatment of infectious complications of diabetic foot syndrome

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Abstract

The study analyzed modern Russian and foreign scientific publications devoted to infectious complications in patients with diabetes mellitus and diabetic foot syndrome. The data of the International Diabetes Federation, the state register of patients with diabetes mellitus, demonstrate that the actual prevalence of diabetes mellitus is much higher than the registered data, which predisposes to large annual economic costs for the prevention, diagnosis, and treatment of diabetes mellitus, taking into account the treatment of complications and monitoring the morbidity of the global population. In the treatment of infectious complications in these patients, classical purulent surgeries are widely used, including opening abscesses and phlegmon and drainage of anatomical spaces of the foot. The classifications of infectious complications of diabetic foot syndrome has evolved. Modern surgical methods of treatment of infectious complications in these patients are highlighted. The classical approach to surgical opening and drainage of purulent foci is highly traumatic owing to impaired blood supply and innervation, prolonged postoperative period, and impaired supporting function of the limb, which is irreversible, at least during inpatient stay. The paper also described the use of minimally invasive approaches, including the use of endovide support, for the drainage of deep plantar phlegmon and the performance of staged rehabilitation, including additional treatment methods such as ultrasound cavitation, local application of negative pressure, and ozone therapy.

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About the authors

Sergey Yа. Ivanusa

Military Medical Academy of S.M. Kirov

Email: bobdoc@inbox.ru
ORCID iD: 0000-0003-3948-6928
SPIN-code: 8752-1600

doctor of medical sciences, professor

Russian Federation, Saint Petersburg

Boris V. Risman

Military Medical Academy of S.M. Kirov

Email: bobdoc@inbox.ru
ORCID iD: 0000-0002-6634-4450
SPIN-code: 8022-6313

doctor of medical sciences

Russian Federation, Saint Petersburg

Rauan E. Shaiakhmetov

Military Medical Academy of S.M. Kirov

Author for correspondence.
Email: rauan198944@gmail.com
ORCID iD: 0000-0002-4459-4790
SPIN-code: 9334-1613

adjunct

Russian Federation, Saint Petersburg

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2. Fig. Surgical approaches during drainage of the phlegmon of the foot: a ― “club-shaped” incision; b ― projection lines of the T-shaped incision; c ― oblique plantar access (according to Konstantini)

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