Characteristic of microcirculation of the lower extremities in patients with complicated diabetic foot

Shapoval, S. D.; Savon, I.L.; Smirnova, D.A.; Sofilkanych, M. M.

doi:10.18484/2305-0047.2013.3.54

Cited by 4 publications

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“…та охоплювала хірургічне та медикаментозне лікування. Усі пацієнти були оперовані під загальним знеболенням, проте у хворих групи порівняння застосовувалася подовжена блокада сідничного нерва[7]. Їм були виконані різноманітні оперативні втручання: некректомії, некрсеквестректомії, розтин абсцесів і флегмон, ампутації пальців, ампутації на рівні гомілки та стегна.…”

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The state of cellular and humoral immunity in patients with purulent complications of the diabetic foot and the development of sepsis in them

Shapoval

2024

Rep. of Vinnytsia Nation. Med. Univ.

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Annotation. The purpose of the study was to find out the disorders of the specific immune system of the body in patients with DFS and in the case of complications of the disease with sepsis. Materials and methods. 1627 patients were examined for complicated DFS, in which in 4.1% of cases (67 patients) the disease was aggravated by sepsis. All patients had type II diabetes and were treated in the city purulent-septic center with beds for the diabetic foot of the CNPE “City Hospital № 3” in Zaporizhzhia for the period 2007-2022. The criteria for inclusion in the study were: purulent-necrotic processes of a diabetic's foot and cases when the disease was complicated by the development of sepsis. Exclusion criteria: type I diabetes and patients undergoing hemodialysis. Statistical analysis was performed using the “Statgraphics Plus for Windows 7.0” software package. The state of the T-cell system based on the derived formula of immune disorders was as follows: CD3+1- CD4+1- CD8+1+ CD25+1+, which is qualified as the 1st degree of immunological disorders of cellular immunity. On the 7th to 8th day of treatment of patients with DFS, the formula of immune disorders was as follows: CD3+2-CD4+2-CD8+1-CD25+1-, which indicated a disorder of the immune system of the II degree, and on the 12th to 16th day - CD3+1 - CD4+1- CD8+1- CD25+1+, which indicated the transition of the immune system disorder from II degree to I. In CDS patients whose disease was complicated by sepsis, the content of CD3+, CD4+, CD8+ at hospitalization was reliable (P < 0,05) was lower than in patients without sepsis. The results of the study of the cellular link in patients with sepsis can be represented by the formula: CD3+2- CD4+2- CD8+1- CD25+2-, which indicates an immune disorder of the II degree. The formula of immune disorders of the cellular link in patients with sepsis on the 7th - 8th and 12th - 16th day of the postoperative period indicated that the suppression of the cellular link corresponds to the II degree of immune disorders. The state of humoral immunity in patients with purulent-necrotic processes of the diabetic foot during hospitalization was as follows: Ig A1- Ig M1- Ig G1- CD221-, which indicated the first degree of immunological disorders, while in patients with sepsis - Ig A-1 Ig M3+ Ig G3+ CD22+1+. Similar changes in the latter corresponded to the II degree of immune disorders. On the 7th - 8th and 12th - 16th days, the formula of immune disorders was as follows: Ig A2- Ig M1- Ig G1- CD222-, which corresponded to the II degree of immune disorders. In patients with sepsis, during the same period of the study, an immune disorder of the II degree was observed, but the formula was as follows: Ig A1- Ig M1- Ig G1+ CD22+2-. Thus, the state of the cellular and humoral links of the immune system in patients with both purulent-necrotic processes of DFS and with the development of sepsis is qualified as general immune depression.

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The state of cellular and humoral immunity in patients with purulent complications of the diabetic foot and the development of sepsis in them

Shapoval

2024

Rep. of Vinnytsia Nation. Med. Univ.

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Unilateral Spinal Anesthesia as a Method of Anesthesia during Operations in Patients with Diabetic Foot Syndrome

Filimonov¹,

therapy²,

Filimonova³

et al. 2018

Ukr. ž. med. bìol. sportu

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Unilateral spinal anesthesia and the sciatic nerve block in foot surgery

Gritsenko

Shapoval

Filimonov

2021

Modern Medical Technology

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Purpose of the study. To evaluate the effectiveness of unilateral spinal anesthesia as a method of pain relief during foot surgery. Analyze the effectiveness of unilateral spinal anesthesia versus sciatic nerve block. To develop an algorithm for performing unilateral spinal anesthesia during foot surgery. Materials and methods. We examined 64 patients who were treated in the department of purulent surgery of the 3rd city hospital in Zaporozhye with a diagnosis of diabetic foot syndrome in the period from 2017 to 2019. Research methods. Assessment of the level of pain intensity using the standard visual analogue scale and the concentration of glucose in the blood serum. Monitoring of the parameters of the cardiovascular system, the temperature of the skin of the lower leg during anesthesia, Doppler scanning of the peripheral circulation in the foot. Results. 4 hours after performing anesthesia, the intensity of pain during movement of the lower limb, according to the visual analogue scale in the group with unilateral spinal anesthesia was 2,3 times less than in the group with sciatic nerve block (p < 0,05). After 10 hours – in the sciatic nerve block group there was a 9,4% increase in comparison with the unilateral spinal anesthesia group (p < 0,05). Compared with the unilateral spinal anesthesia group, in the sciatic nerve block group 20 minutes after anesthesia, the heart rate decreased by 7,2% (p < 0,05). After unilateral spinal anesthesia, the level of systolic blood pressure on 1 toe of the foot increased by 18,3% 20 minutes after anesthesia, and 20 minutes after sciatic nerve block – by 13,7% (p < 0,05). In patients with the unilateral spinal anesthesia group, the temperature on the operated lower limb after anesthesia increased by 3,8%, in the sciatic nerve block group – by 2,8% (p < 0,05). Conclusions. Regional anesthesia is the main method of choice for foot surgery compared to general anesthesia. sciatic nerve block does not in all cases lead to 100% surgical anesthesia and requires additional medical analgosedation. For foot surgery, unilateral spinal anesthesia is preferred.

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Characteristic of microcirculation of the lower extremities in patients with complicated diabetic foot

Cited by 4 publications

References 1 publication

The state of cellular and humoral immunity in patients with purulent complications of the diabetic foot and the development of sepsis in them

The state of cellular and humoral immunity in patients with purulent complications of the diabetic foot and the development of sepsis in them

Unilateral Spinal Anesthesia as a Method of Anesthesia during Operations in Patients with Diabetic Foot Syndrome

Unilateral spinal anesthesia and the sciatic nerve block in foot surgery

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