A clinical case of three-stage surgical treatment of a patient with a neuroischemic form of diabetic foot syndrome

Abstract

Diabetic foot syndrome remains one of the leading causes of non-traumatic amputations in the world, with the neuroischemic form being the most severe and having an unfavorable prognosis. Despite the development of revascularization methods, the frequency of high amputations reaches 40–60%, and postoperative mortality remains high. There is an urgent need to optimize the management of such patients to overcome the consequences of ischemia and post-reperfusion complications, making the search for effective comprehensive approaches critical for modern surgery. The article demonstrates the author's own clinical observation of a patient with a neuroischemic form of diabetic foot syndrome with critical ischemia, which led to the formation of a large, long-lasting wound on the right foot. The article presents the author's three-stage treatment method, in which local negative pressure therapy is considered an essential element included in the unified treatment strategy immediately after the restoration of магистрального blood flow and necrectomy. A clinical example shows that the simultaneous use of local negative pressure therapy and soft tissue plastic surgery in the post-revascularization period significantly improves treatment outcomes.