The role of collagen dressings in the complex treatment of diabetic foot ulcers

The prevalence of diabetes mellitus (DM) in the population aged 20–79 years has reached more than half a billion people, representing about 10.5 % of the adult population on the planet. The risk of developing diabetic foot ulcers ranges from 19 to 34 % with a recurrence rate of 65 % within 5 years.

The aim of the study: to evaluate the efficacy of dressings containing lyophilized collagen solution in the complex treatment of chronic diabetic foot ulcers.

Materials and methods. 101 patients with diabetic foot ulcers (degree of foot lesions I–II according to Wagner) were under observation: in I (main) group — 52 patients — we used dressings containing lyophilized collagen solution (Zelenaya Dubrava, ZAO, RF), in II (comparison group) — 49 patients — traditional local treatment. Planimetric indices of the wound surface were measured using the MultiSpec program, and the assessment of treatment efficacy was determined as the ratio of the final area and depth of the wound to the initial values in percent.

Results and their discussion. On admission, the wound area in the main group was 4.3 ± 3.7 cm², whereas in the comparison group it was 4.1 ± 3.6 cm². The final wound area (by 4-week measurement) decreased to 1.2 ± 1.3 cm² in group I, whereas it was 2.6 ± 3.5 cm² in group II. On 8–10 days after removal of purulent-necrotic tissues in the first group clinically there was a significant reduction of finger edema, cytologically there was no microflora in the wound discharge, phagocytosis was completed, whereas in the second group there was an inflammatory reaction (single areas of lysed leukocytes alternated with accumulation of leukocytes up to ¼ in f/v).

Conclusions. Cytologically the effectiveness of collagen dressings application in complex treatment of diabetic foot ulcers was proved: by the end of the second week absence of inflammatory reaction and presence of proliferation signs in the majority of 69,4 % of patients. Planimetrically positive dynamics of the wound process was established: reduction of the area by the end of the 4th week in comparison with the initial one by 45,1 ± 33,8 % at traditional methods of treatment and by 79,9 ± 16,4 % at local use of collagen dressings, and depth — 53,1 ± 37,5 % and 76,8 ± 18,6 % respectively.

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