А.K. FEISKHANOV¹, L.I. FEISKHANOVA², E.Z. FATYKHOVA², A.V. MAKSIMOV^1,3

¹Republican Clinical Hospital of the Ministry of Healthcare of the Republic of Tatarstan, 138 Orenburgskiy Trakt, Kazan, Russian Federation, 420064

²Kazan State Medical University, 49 Butlerov Str., Kazan, Russian Federation, 420012

³Kazan State Medical Academy — Branch Campus of the FSBEI FPE RMACPE MOH Russia, 36 Butlerov Str., Kazan, Russian Federation, 420012

Feiskhanov A.K. — surgeon of the Department of Vascular Surgery №1, e-mail: aygizf@rambler.ru, ORCID ID: 0000-0002-9547-1395

Feiskhanova L.I. — PhD (medicine), Associate Professor of the Department of Hospital Therapy, e-mail: ljuts@rambler.ru, ORCID ID: 0000-0001-7830-5283

Fatykhova E.Z. — resident of the Department of Hospital Therapy, e-mail: elzafatykhova@mail.ru

Maksimov A.V. ― D. Sc. (medicine), Head of the Department of Vascular Surgery №1, Associate Professor of the Department of Cardiology, Endovascular and Cardiovascular Surgery, tel. (843) 237-32-51, e-mail: maks.av@mail.ru

The aim of the study was to evaluate the influence of diabetes mellitus on the likelihood of development of trophic disorders and infectious lesions in patients with lymphedema.

Material and methods. Between October 2014 and January 2018, 443 patients with lymphedema were treated at the Center for Lymphology of the TerraVita Health Center in Kazan. A retrospective analysis of outpatient charts of patients with an assessment of the frequency of changes in the skin of the affected limb was carried out. Patients were divided into 2 groups: the 1^st group ― patients with lymphedema and diabetes, 47 patients. The 2^nd group ― patients with lymphedema without diabetes mellitus, 396 patients.

Results. In the 1^st group of patients with diabetes, trophic disorders were found in 46.8% (22 patients), in the 2^nd group ― 20.9% (83 patients), p=0.02. Infections of the skin and subcutaneous fat of the affected limb were found in 42.6% of cases in the group with diabetes mellitus (20 patients) and 25.5% ― in the second group (101 patients). Conclusion. In the course of the study, a higher probability of development of trophic disorders in patients with concomitant lesion-development of lymphedema and diabetes mellitus was proved.

Key words: diabetes mellitus, trophic ulcer, lymphedema, limb swelling.

(For citation: Feiskhanov A.K., Feiskhanova L.I., Fatykhova E.Z., Maksimov A.V. Influence of diabetes mellitus on the development of trophic disorders of the skin in patients with lymphedema. Practical Medicine. 2018)

REFERENCES

1. Fionik O.V., Bubnova N.A., Petrov S.V. et al. Lower limb lymphedema: an algorithm for diagnosis and treatment. Novosti khirurgii, 2009, vol. 17, no. 4, pp. 49-64 (in Russ.).
2. Shestakova M.V., Yarek-Martynov I.R., Koshelʹ L.A. Prevention of vascular complications of diabetes mellitus: resolved and unresolved issues. Consilicum Medicum, 2002, no. 10, pp. 527-30 (in Russ.).
3. Feyskhanov A.K., Fatykhova Eh.Z., Feyskhanova L.I., Maksimov A.V. Erysipelas and lymphedema. Prakticheskaya meditsina, 2016, no. 4, vol. 1, pp. 161-164 (in Russ.).
4. Dedov I.I., Udovichenko O.V., Galastyan G.V. Diabetic foot. Prakticheskaya meditsina, 2005, 175 p (in Russ.).
5. Bruhn-Olszewska B. et al. Molecular factors involved in the development of diabetic foot syndrome. Acta Biochim. Pol, 2012, vol. 59, no. 4, pp. 507-13.
6. Anderson H., Gjerstad M.D., Jakobsen J. Atrophy of foot muscles: a measure of diabetic neuropathy. Diabetes Care, 2004, vol. 27, no. 10, pp. 2382-85.
7. Esato K. et al. Neovascularization induced by autologous bone marrow cell implantation in peripheral arterial disease. Cell Transplant, 2002, vol. 11, no. 8, pp. 747-52.
8. Jockenhöfer F., Gollnick H., Herberger K. et al. Aetiology, comorbidities and cofactors of chronic leg ulcers: retrospective evaluation of 1 000 patients from 10 specialised dermatological wound care centers in Germany. Int. Wound J, 2016, Oct, 13 (5), pp. 821-8.