Endocrine Abstracts

Around 90–95% of all patients with DM have type 2, among whom 90% could likely suffer from ulcerative-necrotic manifestations of diabetic foot (DF). The latters may develop neuropathic form of DF in 80% of cases. To examine the effectiveness of treatment of ulcers in patients with the neurotic form of DF using ultrasonic cavitation.

57 patients with DM type 2 were treated who had the neurotic form of DF with 1–3 degrees of ulcers on the feet according to the Wagner classification. Compensation of diabetes was achieved by administering insulin regardless of previous hypoglycaemic therapy. Pending the results of bacteriological examination of the wound content the following groups of antibiotics were empirically prescribed: fluoroquinolones, penicillins, lincosamides, cephalosporins (first-generation). After receiving the results of the sensitivity of the wound microorganisms appropriate antibiotics were appointed according to this sensitivity. All patients had wound clearing according to treatment of wounds systemized by Qoustic model AR1000. The Qoustic is equipped with a domed device that allows dual supply of activated solution. The ultrasound energy was focused on the wound together with the application of sterile saline solution which resulted in tiny vibrating gas bubbles that separated dead and damaged cells from healthy tissue (cavitation). Ultrasonic vibration itself can also separate, destroy and remove non-viable tissue. This procedure was repeated once a day 3–6 times for each patient until achieving complete cleaning of the wounds. In order to compare, patients of the control group received the same medication with application of only necrotomy on the wound. Patients in both groups were superimposed by bandages with 10% povidone-iodine solution twice a day.

Epithelialization of ulcers in patients treated with the use of ultrasonic cavitation began after 2–3 days of the cavitation procedure with complete cleaning in 5–6 days, while the control group needed 4–6 and 9–12 days respectively.

The use of ultrasonic cavitation in treatment of ulcerative-necrotic lesions in patients with DF accelerates wound cleaning and healing and reduces the time of patients’ hospitalization, which leads to significant increase in effectiveness of the treatment both financially and socially.