Application of direct endolymphatic ozone therapy in the treatment of purulent-necrotic complications of diabetic foot syndrome

Introduction. The high frequency of amputations at the level of the shin and hip in patients with purulent-necrotic complications of diabetic foot syndrome is an urgent medical and social problem.

The purpose of the study. To evaluate the effectiveness of the method of direct antegrade endolymphatic ozone therapy in the complex treatment of patients with purulent necrotic lesions in the neuroischemic form of diabetic foot syndrome.

Materials and methods of research. 107 patients with the neuroischemic form of diabetic foot syndrome were treated. Balloon angioplasty of the arteries of the affected lower limb was performed in block I, and endovascular correction of blood flow was not performed in block II patients. In each block of studies, the main group was identified, in which the method of direct antegrade endolymphatic ozone therapy was used, and the control group, where the developed method was not used.

Treatment results. The patients of the main groups showed positive dynamics: in the I block, more than 80 % of patients noted the absence of pain or mild pain; in the II block – 65,2 %. In the main group of block I, compared with the control group, an increase in the duration of treatment was noted by 5,4 %, but the severity of operations was statistically less, 1,08 versus 1,39. Also, in the main groups, there was a decrease in the level of peripheral blood leukocytes and the degree of bacterial contamination of the wound.

Conclusion. Direct endolymphatic application of ozonated solution allows to accelerate the relief of purulent-necrotic processes in patients with chronic lower limb ischemia with diabetic foot syndrome by stimulating the body's own enzyme systems, antihypoxic, antibacterial and detoxifying properties of ozone, reduces the number of high amputations.

1. Esipov A.V., Alekhnovich A.V., Musailov V.A., Markevich P.S., Potapov V.A. Actual problems of diagnosis of diabetic foot syndrome. Bulletin of the National Medical and Surgical Center named after N.I. Pirogov, 2023, vol. 18, № 2, pp. 115–120. (In Russ.). https://doi.org/10.25881/20728255_2 023_18_2_115

2. Zolotukhin O.V., Аralova M.V., Glukhov A.A., Аlimkina Y.N. Direct Endolymphatic Ozone Therapy in Patients with Diabetic Foot Syndrome: Analysis of the Effectiveness. Journal of Experimental and Clinical Surgery, 2023, vol. 16, № 1, pp. 27–32. (In Russ.). https://doi.org/10.18499/2070-478X-2023-16-1-27-32

3. Sukovatykh B.S., Grigoryan A.Yu., Bezhin A.I. The role of microbial biofilm in the development of the wound process. Bulletin of Experimental and Clinical Surgery, 2022, vol. 15, № 1, pp. 92–96. (In Russ.). https://doi.org/10.18499/2070-478X-2022-15-1-92-96

4. Abdukarimova E.E. The effectiveness of ozone therapy in the treatment of endotoxicosis in patients with pleural empyema. Bulletin of the Kyrgyz-Russian Slavic University. 2023, vol. 23, № 5, рp. 4–8. (In Russ.). https://doi.org/10.36979/1694-500X-2023-23-5-4-8

5. Mamatov A.M., Zhaparov K.A., Anarbayev N.A. The effectiveness of surgical treatment of acute hematogenous osteomyelitis in children in combination with ozone therapy and lymphogenic technology. Bulletin of Science and Practice, 2023, vol. 9, № 10, pp. 176–180. (In Russ.). https://doi.org/10.33619/2414-2948/95/16

6. Vinnik Yu.S., Kochetova L.V., Kulikova A.B., Medvedeva N.N. The effectiveness of ozone therapy and ultrasound in the regeneration of an infected wound in an experiment. Siberian Medical Review, 2022, vol. 3, № 135, pp. 100–104. (In Russ.). https://doi.org/10.20333/25000136-2022-3-100-104

7. Zhukembayeva A.M., Latkina K.S., Kaparova K.M., Kuat A.K., Athan Zh.K., Athan G.K., Kaliev Zh.A., Niyazova G.I., Muten N.S., Mustafa B.J. The effect of ozone therapy on the dynamics of indicators of humoral immunity in exacerbation of COPD. Pharmacy of Kazakhstan, 2021, № 4, pp. 60–64. (In Russ.).

8. Suslova E.V. The effect of ozone therapy on the state of immunity in patients with severe childhood atopic dermatitis. Bioradicals and antioxidants, 2020, vol. 7, № 4, pp. 33–46. (In Russ.).

9. Kytikova O.Yu., Gvozdenko T.A. The phenomenon of the multiplicity of therapeutic effects of ozone therapy. New Science: Problems and Prospects. 2015, vol. 5, № 2, pp. 62–65. (In Russ.).