Terapevticheskii arkhivTerapevticheskii arkhiv0040-36602309-5342LLC Obyedinennaya Redaktsiya3227710.17116/terarkh2017891012-16Research ArticleImpact of various wound dressings on wound bed neoangiogenesis in patients with different forms of diabetic foot syndromeZaitsevaE L-TokmakovaA Yu-DoroninaL P-VoronkovaI A-GalstyanG R-ShestakovaM V-151020178910121610042020Copyright © 2017, Consilium Medicum2017Aim. To investigate the impact of various wound dressings on wound bed neoangiogenesis in patients with different forms of diabetic foot syndrome (DFS). Subjects and methods. The clinical (local tissue oxygenation) and immunohistochemical (CD31) markers of foot soft tissue neoangiogenesis were evaluated in patients with DFS receiving negative pressure (NP) therapy and collagen-containing dressings (CCDs) versus standard treatment. 63 patients with neuropathic and neuroischemic (without critical ischemia) forms of DFS were examined after wound debridement. In the postoperative period, 21 patients received NP treatment, CCDs were applied to 21 patients, and 21 patients had standard treatment. Results. During NP therapy, there was statistically significantly intensified local microhemodynamics, as evidenced by transcutaneous oximetry (p < 0.05); the remaining two groups showed no statistically significant differences in transcutaneous oxygen tension during the treatment. Immunohistochemical examination revealed a significant increase in the number of newly formed vessels, as shown by anti-CD31 antibody staining (p < 0.05), in patients who had NP therapy and CCDs (p < 0.05). Conclusion. Vacuum (NP) therapy versus standard therapy most effectively affects wound bed neoangiogenesis. This is reflected in the increased local tissue microhemodynamics, as confirmed by immunohistochemical examination.diabetic foot syndromechronic woundsnegative pressure therapyneoangiogenesismicrocirculationimmunohistochemistryсиндром диабетической стопыхронические ранытерапия отрицательным давлениемнеоангиогенезмикроциркуляцияиммуногистохимия[American Diabetes Association. Standards of medical care in diabetes-2015 Clinical diabetes: a publication of the American Diabetes Association 2015;33:1-93. http://www.plasticsurgery.org/Documents/medical-professionals/health-policy/evidence-practice/Evidence-based-Clinical-Practice-Guideline-Chronic-Wounds-of-the-Lower-Extremity.pdf][Barbul A, et al. Wound Care Guidelines of the Wound Healing Society. Wound Repair Regene 2006;14:645-711. https://doi.org/10.1111/j.1524-475X.2006.00172.x][IWGDF Guidance on the diabetic foot 2015. International Working Group on the Diabetic Foot, Netherlands; 2015.][Gibbons Gary W. Advances in Wound Care. 2015;4(9):534-544. https://doi.org/10.1089/wound.2015.0647][Baltzis D, Eleftheriadou I, Veves A. Adv Ther. 2014;31:817. https://doi.org/10.1007/s12325-014-0140-x][Frykberg Robert G, Banks Jaminelli. Advances in Wound Care. 2015;4(9):560-582. https://doi.org/10.1089/wound.2015.0635][Kalani M, Brismar K, Fagrell B, Ostergren J, Jorneskog G. Transcutaneous oxygen tension and toe blood pressure as predictors for outcome of diabetic foot ulcers. Diabetes Care. 1999;22:147-151. https://doi.org/10.2337/diacare.22.1.147][Cullen B, Watt P, Lundqvist C, et al. The role of oxidized regenerated cellulose/collagen in chronic wound repair and its potential mechanism of action. Int J Biochem Cell Biol. 2002;34(12):1544-1556. https://doi.org/10.1016/s1357-2725(02)00054-7][Алгоритмы специализированной медицинской помощи больным сахарным диабетом. 8-й вып. Под ред. И.И. Дедова, М.В. Шестаковой. М.: ФГБУ Эндокринологический научный центр. 2017.][Lavery L, Murdoch D, Kim P, Fontaine J, Thakral G, Davis K. Negative Pressure Wound Therapy With Low Pressure and Gauze Dressings to Treat Diabetic Foot Wounds. Journal of Diabetes Science and Technology. 2014;8(2):346-349. https://doi.org/10.1177/1932296813519012][Timmers M, Le Cessie S, Banwell P, Jukema G. The effects of varying degrees of pressure delivered by negative-pressure wound therapy on skin perfusion. Ann Plast Surg. 2005;55:665-671.][Горюнов С.В., Абрамов И.С., Чапарьян Б.А., Егоркин М.А., Жидких С.Ю. Руководство по лечению ран методом управляемого отрицательного давления. М.: Издательский дом «Русский врач»; 2013.][Зайцева Е.Л., Токмакова А.Ю., Шестакова М.В., Галстян Г.Р., Доронина Л.П. Изучение влияния различных методов местного лечения на заживление ран у пациентов с нейропатической и нейроишемической формой синдрома диабетической стопы. Вестник РАМН. 2016;71(6):00-00. https://doi.org/10.15690/vramn735][Wollina U, Schmidt W, Krönert C, et al. Some effects of a topical collagen-based matrix on the microcirculation and wound healing in patients with chronic venous leg ulcers: preliminary observations. Int J Low Extrem Wounds. 2005;4(4):214-224. https://doi.org/10.1177/1534734605283001]