[Endothelial dysfunction indicators in patients with diabetic foot syndrome].

BACKGROUND: In recent years, scientists have become increasingly interested in the role of the endothelium in the pathogenesis of vascular lesions of various origins, including diabetic patients. Therefore, the aim of the study was to investigate the expression of endothelial dysfunction in patients with diabetic foot syndrome (DFS), by examining the levels of nitric oxide, endothelin-1 levels in the serum, as well as lower limb microcirculation by laser doppler flowmetry. PATIENTS AND METHODS: It was examined 72 patients with diabetic foot syndrome with I-IV degree of lesion (by Meggit- Wagner classification). Neuropathic form was diagnosed in 32 people, ischemic--40 patients. The function of endothelium was studied on the basis of the determination of enzyme-linked immunosorbent NO and endothelin-1 in peripheral blood serum, as well as to assess the state of the microcirculation of the lower limbs by laser doppler flowmetry, using apparatus LACK-02 (Russia). RESULTS: Patients with DFS are marked with endothelial dysfunction, the severity of which depends on the type of diabetes, glycemic level and pathogenic forms of destruction. This is manifested by secretion reducing of vasodilators (NO) and increased synthesis of vasoconstrictors (endothelin-1), which leads to disruption of peripheral hemodynamic. Characteristic changes in the microcirculation are a dramatic violation of endothelium-dependent regulation mechanism, the redistribution of blood towards the nutritional circulation. Also it is showed a significant reduction in reserve capacity of the capillary bed in response to the sample and the occlusal restoration of blood flow during reactive hyperemia. CONCLUSION: Development of endothelial dysfunction and changes in peripheral hemodynamic in patients with DFS contributes to the emergence and prolongation of necrotic lesions, as well as violation of reparative processes.

[Plastic closure of wounds and trophic ulcers in patients with diabetic foot syndrome by relief autoshred].

This article describes the features of the surgical treatment of patients with diabetes mellitus complicated with diabetic foot syndrome. Results of autodermoplasty of acute and chronic skin damages with ripped and flat skin graft in 185 patients who were treated in the clinic of general surgery of I.Ya. Horbachevsky Ternopil State Medical University, Ukraine, in the period from 2007 to 2012 Using of this method leads to improved cosmetic and functional results in 81.7% of patients with reducing of treatment duration up to 12 days.