Objective: to assess the results of the microbiological study of wounds in patients with diabetic foot syndrome (DFS).Material and methods. The microbiological study of the wounds of 76 patients with the neuroischemic form of DFS having undergone inpatient treatment at Gomel Regional Diabetic Foot Center from 2016 to 2019 was performed.Results. The range of the microbial flora of the wounds of the patients with the neuroischemic form of DFS has been identified, the antibiotic susceptibility of the detected bacteria to antibacterial drugs has been analyzed.Conclusion. The microbiological profile of the wounds of the patients with the neuroischemic form of DFS was characterized by the variety of bacteria and included Enterococcusfaecalis (29%), Staphylococcusaureus (19%), as well as representatives of Enterobacteriaceae family (25%). The detected bacteria were most sensitive to glycopeptides, aminoglycosides, carbapenems, which makes it reasonable to prescribe these groups of antibiotics as the start antibacterial therapy.

The results of the use in the experiment of composite hydrogel coatings of prolonged action based on polyvinyl alcohol are investigated.Objective. The aim of the study is a comparative clinical assessment of the effectiveness of the developed composite hydrogel coatings of prolonged action in an experiment in laboratory rats.Materials and research methods. After modeling alloxan diabetes mellitus and neuroischemic form of diabetic foot in laboratory white Wistar rats, the developed wound dressings were applied. A clinical analysis of their effectiveness was carried out and the optimal composition was determined. The animals were divided into three groups, 10 animals in each group, as follows: the first — control with self-healing of the wound, the second — with samples No. 1 (polyvinyl alcohol + chitosan + pectin + L-aspartic acid + gentamicin), the third — with samples No. 2 (polyvinyl alcohol + chitosan + pectin + L-aspartic acid + gentamicin + methyluracil). The first dressing change was carried out on the third day with the taking of histological material, then - every other day. When changing the dressing, such parameters as the nature and amount of wound discharge, the size of the ulcer, the presence of granulations and epithelialization were assessed. Dynamic assessment was performed on the 3rd, 7th, 14th and 21st days. The measurement of the area of the ulcer was carried out by transferring the contour of the ulcer to graph paper with manual counting.Research results. The healing rate of ulcers in the experimental groups was higher than in the control group. When comparing second and third groups, a significant increase in speed was noted by the seventh day in third group (p < 0.05), which reduced the overall healing time of ulcers by 7 days.Conclusion. The study showed that the healing time of ulcers in laboratory animals with the use of the developed wound dressings is significantly reduced in comparison with the control group. The proposed method of local treatment can be considered effective in the treatment of vascular etiology trophic ulcers against the background of diabetes mellitus.

Objective: to analyze the clinical characteristics of the course of the disease in patients with neuroischaemic diabetic foot depending on the presence of bacterial monocultures and associations in wounds.Material and methods. We have performed a comparative analysis of the parameters of the clinical course of the disease and the condition of patients’ wounds (n = 76) depending on the presence of monocultures (group 1, n = 32) and microbial associations (n = 42). The list of the compared parameters in the groups included the duration of diabetes, number of hospitalizations per year, achievement of target HbA1c levels (<7.5 %), condition of granulation tissue of wounds.Results. With increased duration of the course of diabetes (from 5 to 15 years), higher number of hospitalizations per year, deteriorated carbohydrate metabolism (HbA1c> 7.5%) in combination with clinical signs of the initial stages of wound infection, the frequency rate of the detection of mixed bacterial cultures increased.Conclusion. The work has found differences in the duration of the course of diabetes, the number of hospitalizations per year, local status of wounds in the patients, as well as the frequency of achieving the target levels of HbA1с <7.5 %, depending on the severity of microbial load.