Cytological characterization of wound healing in diabetic patients on the background of the VAC-therapy.

Abstract

Recently the vacuum therapy of wounds (Vacuum-assisted closure, VAC) is traditionally used method of treatment of wound complications in patients with diabetes in the majority of surgical departments of relevant profile in Ukraine. Due to publications of Ukrainian authors including the popularization of this treatment method, its therapeutic effects and significant advantages as compared with the traditionally used method of treating wounds by dressing in a moist environment (Moist Wound Healing) has led to a number of unresolved issues relating to the application VAC-therapy. One of those is the way of assessment of wound process course on a background of the VAC-therapy. One of the most accessible and easy means of diagnostics of wound healing course is the cytological smear of wounds. Despite the long-term use of cytological method of diagnosis of wounds, peculiarities of phase course of wound process in diabetic patients on the background of VAC-therapy remain poorly studied. As a result of our research it was determined that a statistically significant difference between the basic cytological indices in the vacuum group and conventional treatment are revealed by 9-10 days of treatment. A more favorable course of wound healing on the background of vacuum therapy of wounds was reflected in the reduction of neutrophils number from 186,2±10,13 in the first cytogram to 87,3±6,12 in the fourth, presence of fibroblasts on an average of 0.8 in the field of vision on 9-10 days of treatment, absence of a smear microflora print on 7-8 days of treatment. At the end of the treatment in the conventional treatment group degenerative-regenerative index was 0,65±0,37, in the vacuum group – 1,31±0,63.