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Diabetes is the most common endocrine disorder of carbohydrate metabolism. If left untreated, or improperly treated for many years, diabetes leads to multiple organ complications. One of the serious consequences of the disease is damage to the peripheral and autonomic nerves known as diabetic neuropathy. The most advanced form of neuropathy, leading to damage to the structures of the forefoot, midfoot...
The Negative Pressure Wound Therapy (NPWT) is an approved method of healing lower extremity ulcers of various origin, accelerating the wound closure process, thus decreasing the hospital-stay time and lowering the cost of the treatment. Although it is scarcely needed in developing countries such as Kenya, there is a lack of official supplier of the NPWT equipment. We present an improvised method of...
We present case report of 62-year-old man who underwent total laryngectomy, bilateral neck dissection and radiotherapy due to laryngeal cancer. After 11 months he was reoperated because of a local recurrence. The second procedure was complicated with postoperative wound dehiscence in tracheostomy site which was successfully treated with negative pressure wound therapy. We indicate the difficulties...
Surgical treatment of 178 patients with pressure sores in the rehabilitation period of traumatic illness was analyzed. A surgical approach of treatment with the use of the NPWT technique in the preoperative period was suggested. A positive effect of NPWT on local microcirculation, neoangiogenesis, bacterial decontamination and tissue repair was found. The indices of immunohistochemical markers CD34,...
In the modern world, local military conflicts are not uncommon. A feature of local wars is a dynamically changing tactical situation, which can lead to massive losses and more serious injuries. This creates new challenges related to the treatment of combat trauma victims. We analyzed our experience of application of NPWT in complex surgical treatment of combat wounds and injuries of various locations.
Diabetic foot ulceration (DFU) is a serious complication of diabetes mellitus, and one that is difficult to treat. In many cases of DFU, chronic osteomyelitis occurs in the foot. The present paper describes the course of treatment for chronic osteomyelitis of the great toe with metatarsophalangeal arthritis using selective resection of the bone preserving the soft tissues (the “empty toe technique”)...
Hard-to-heal wounds continue to be a challenge in the everyday surgical practice. Their treatment is time-consuming, expensive and in many cases requires interdisciplinary assessment. Therapy option include properly selected surgical procedures and dressings combined with systemic antibiotherapy. Application of vacuum assisted closure (VAC) facilitates the evacuation of pathological discharge, reduces...
NPWT is increasingly used in patients with diabetic foot. The protocol for performing NPWT is subject to debate. Main concerns regard the type of suction to use (continuous, intermittent, or variable), the wound-packing material, or the exact pressure to apply. Typically, an optimum pressure range of –80 to –125 mmHg is indicated. Following bone resection in diabetic foot patients, the surgical wound...
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