CYTOLOGICAL STUDY OF WOUND PROCESS DYNAMICS IN DIABETIC FOOT SYNDROME

Aim. To study the results of cytological investigation of trophic ulcers in complex treatment of patients with diabetic foot syndrome (DFS) at surgical units of polyclinics and hospitals to optimize therapeutic tactics. Materials and methods. The results of dynamic analysis of trophic ulcers cytograms of 256 patients with diabetic foot syndrome, treated at the 24-hour hospital and 60 patients - at the polyclinics, are presented in the paper. Complex treatment of patients, belonging to the main groups, was supplemented by intravenous injection of thioctic acid by means of modified infusion system; local therapy included the combination of adhesive bandages Permafoam and Atrauman Ag. Results. The cytological study of trophic ulcers in patients of the main groups, treated at the 24-hour hospital and polyclinic, indicated that in patients with statistically similar initial indices in these groups, already within the day 5, there was observed a positive dynamics in the form of decreased bacillary and coccal flora, leucocytes number, appearance of fibroblasts and epithelial cells as well as reduced number of macrophages. During this period, the cytogram changes in the groups of comparison were insignificant and statistically did not differ from the initial ones. Within the day 10th of treatment, active processes of healing, confirmed by the growth of epithelial cells in impression smears, disappearance of bacillary microflora, decrease in the number of leucocytes and macrophages were noted in the main groups. Conclusions. The offered complex for DFS treatment hastens the processes of trophic ulcer healing. The study of impression smears detected the increased number of epithelial cells in the ulcer and the reduced number of macrophages, coccal and bacillary flora already within the day 5th of treatment.

Cytogram, impression smears, diabetic foot syndrome