Asociaţia chirurgilor “Nicolae Anestiadi” din Republica Moldova
Abstract
Plastic, Reconstructive and Microsurgery Clinic, State University of Medicine and Pharmacy ”Nicolae Testemițanu” Republic of Moldova, Al VIII-lea Congres Naţional de Ortopedie și Traumatologie cu participare internaţională 12-14 octombrie 2016Purpose: Analysis of the posttraumatic damage coupled with diabetic polyneuropathy of the pelvic limb and possibilities
of healing the defects.
Material and methods: A retrospective study was carried out over a period of two years (2014-2016) and included 15 patients
with diabetic polyneuropathy. The patients were treated at the Clinic of Plastic Surgery and Reconstructive Microsurgery.
The selection criteria included:
- Diagnosis of diabetes with skin and soft tissue ulceration.
- Non-healing traumatic or surgical wounds, with no tendency of healing in diabetic patients.
The 15 patients were divided in 4 subgroups according to the type of surgical procedure performed: split skin grafts, the
neighboring flaps, distant flaps, amputation at different levels. The descriptive parameters included: age, gender, the presence
of type I or type II diabetes, the location. Additionally, the post-surgery complications were monitored.
Results: 15 patients included in this study, out of which 4 women and 11 men were divided into four subgroups based on
type of performed surgeries: the neighboring flaps - 4, distant flaps - 2, split skin grafts - 7, amputation in 2 cases. 12 patients
had diabetes of type II, and the remaining 3 patients were insulin dependent. The 6 patients who had reconstruction through flaps, had distal defects (foot or ankle), whereas the patients who suffered per primam amputation had lesions at the ankle
which were skin and soft tissue necrosis, with bone disease and osteitis, with signs of severe vascular disease. The majority
of patients who had benefited from split skin grafts, suffered from skin lesion at the ankle level.
Conclusions: Posttraumatic defects in patients with diabetic polyneuropathy of the pelvic limb can be treated through flaps
or split skin grafts, so the amputation rate decreases significantly
