Endocrine Abstracts

Aim: To investigate the clinical efficacy of the treatment of patients with neuro-ishemic diabetic foot ulcers (DF) by using sorption-antimicrobial nanocomposition based on silica sorbents.

Methods: Hydrophobic-hydrophilic sorption-antibacterial nanocomposition, offered for the treatment of ulcers and wounds, contains sorbents (nano-disperse silicon dioxide, polymethylsiloxane) and antibacterial components (decamethoxin, metronidazole). In this study 78 patients with a neuroishemic form of DF and purulent complications on the foot were treated. The control group consisted (CG) of 34 patients, and study group (SG)-44 patients. Groups were comparable. Patients in both groups received standard treatment. The criteria for treatment effectiveness were the presence of epithelization and the dynamics of microbial contamination of the wound.

Results: At the 3rd day of treatment no signs of epithelization were detected in any patient of both groups. At the 7th day of treatment, signs of epithelization appeared in both groups, with the frequency of detecting signs of wound healing in SG with 57.83% higher than in CG (P<0.001). The number of patients with signs of marginal epithelization in CG significantly (by 58.90%) increased by the 10th day of treatment. But in EG at the 10th day of treatment, the relative number of patients with signs of marginal epithelization exaggerated such in CG at 31.32% Although healing of wounds depends not only on the degree of regional epithelization, but also on microbial contamination, compensation of diabetes and the course of its complications, the use of sorbent stimulates the development of wound epithelization, which eventually improves ultimate healing (P=0.0021) wounds compared with this process in patients with CG.

Conclusions: The analysis of the dependence of the rate of development of boundary epithelization on the level of microbial contamination has been carried out. The negative correlation between the rate of edge epithelization of the wound against the level of microbial contamination, in other words, the direct linear dependence of the development of boundary epithelization on the “purity” of the wound. The use of sorbents leads to a rapid wound cleansing, which is determined by the likely reduction in the number of microbial contamination. Such cleaning contributes to a significant acceleration of the appearance of epithelization, which is a guarantee of healing of ulcers against the background of diabetes.

Keywords: diabetes mellitus, wound, antimicrobial sorbents, diabetic foot syndrome.