Possibilities of rehabilitation in atherosclerosis of arteries of the lower limbs in combination with diabetes

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Abstract

BACKGROUND: According to the World Health Organization, more than 17 million people die from cardiovascular diseases every year in the world. Coronary heart disease is the leading cause of death in industrialized countries.

AIMS: To evaluate the immediate result of treatment by revascularization of the limb and organ-preserving surgical interventions for purulent-necrotic lesions of the feet, neuropathic form of diabetic foot with osteoarthropathy in chronic arterial insufficiency of the IV degree.

MATERIAL AND METHODS: In the paper, the authors investigated possible treatments with different limb lesions in patients diagnosed with diabetes mellitus. Since in this disease there are complications on the cardiovascular system, most people are diagnosed with obliterating atherosclerosis, which leads to slow necrosis of the limbs. This causes diabetes patients, not only severe pain and an aesthetically unsightly state of the body, but also noticeably worsens the quality of life.

RESULTS: With a consolidated approach to this problem, endocrinologists and cardiovascular surgeons developed and tested the method of endascular surgery. Patients diagnosed with obliterating lower extremity vascular atherosclerosis against the background of diabetes mellitus with trophic and necrotic lesions of the peripheral lower extremities underwent enduscular surgery to revascularize the limb, which showed not just positive immediate treatment results, but gave opportunities to preserve patients’ limbs.

CONCLUSION: Timely recognition and treatment of purulent-necrotic lesions of the feet, the neuropathic form of diabetic foot with osteoarthropathy requires an interdisciplinary approach and close cooperation of doctors of different specialties - endocrinologists, surgeons, podiatrists, orthopedists, general practitioners, etc. Only if these conditions are met, it is possible to achieve significant success and minimize the number of irreversible deformities and amputations of the feet, the weighting of disability groups.

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About the authors

Vera S. Spiridonova

St. Petersburg Institute of Advanced Training of Doctors-Experts

Author for correspondence.
Email: verushas@rambler.ru

MD, Cand. Sci. (Med.), Assistant Professor

Russian Federation, 11/12 Bolshoy Sampsoniyevsky ave., Saint Petersburg, 194044

Rimma T. Sklyarenko

St. Petersburg Institute of Advanced Training of Doctors-Experts

Email: solovei_rimma@bk.ru

MD, Dr. Sci. (Med.), Professor

Russian Federation, 11/12 Bolshoy Sampsoniyevsky ave., Saint Petersburg, 194044

Oleg A. Churzin

St. Petersburg Institute of Advanced Training of Doctors-Experts

Email: ochurzin@yandex.ru

MD, Cand. Sci. (Med.), Assistant Professor

Russian Federation, 11/12 Bolshoy Sampsoniyevsky ave., Saint Petersburg, 194044

Dmitry V. Antonov

Hospital for veterans of wars

Email: angiogvv@rambler.ru

MD

Russian Federation, Saint Petersburg

Magomed S. Omarov

Main Bureau of Medical and Social Expertise in the Moscow

Email: msomk@mail.ru

MD, Dr. Sci. (Med.)

Russian Federation, Moscow

References

  1. Kislyakov VA, Obolensky VN, Yusupov IA. Diabetic foot syndrome: a comprehensive approach to treatment. Russian Medical Journal. 2015;24(12):768–770. (In Russ).
  2. Bakker K, Apelqvist J, Lipsky BA, et al. Guidelines and documents of the International Working Group on Diabetic Foot in 2015 on the prevention and treatment of foot diseases in diabetes: achieving an evidence-based consensus (abbreviated Russian version). Ed. by I.V. Guryeva. Wounds and wound infections. Journal Named After B.M. Kostyuchenka. 2016;3(2):59–70. (In Russ). doi: 10.17650/2408-9613-2016-3-2-59-70
  3. Sklyarenko RT, Dovgalyuk AZ, Omarov MA, et al. Clinical and expert characteristics of persistent functional disorders in surgical diseases and the possibility of rehabilitation: a manual for doctors. Ed. by R.T. Sklyarenko. Saint Petersburg: Publishing house of the A.I. Herzen Russian State Pedagogical University; 2017. 718 p. (In Russ).

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Свидетельство о регистрации СМИ № 016140 от 23.05.1997 г. выдано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор). 
Свидетельство о регистрации СМИ ЭЛ № ФС 77 - 80654 от 15.03.2021 г. выдано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).


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