Experience in the treatment of extensive diabetic phlegmon of the foot against the background of affected limb lymphedema

Abstract

The article presents the experience of treating a patient with diabetic foot syndrome complicated by the development of osteomyelitis of the first metatarsophalangeal joint and cuboid bone, putrid phlegmon of the left foot. The disease proceeded against the background of a pronounced systemic reaction of the body to the presence of purulent infection focus in a polymorbid patient (IHD: postinfarction cardiosclerosis, chronic heart failure of grade 2 (FC1), chronic lymphovenous insufficiency). The complex treatment of the patient included surgical debridement of the purulent left foot focus with a hydrosurgical scalpel, disarticulation of the first toe, NPWT in the postoperative period, pathogenetic and symptomatic treatment, which were aimed at the early transition of the wound to the reparative stage. The second phase of the wound healing process was reached by the 18^th day of treatment, which made it possible to perform skin grafting. On the 29^th day of treatment, the patient was discharged in satisfactory condition with good cosmetic and functional results.