The Limb Salvage Center is the first private surgical center in Tashkent that provides specialized medical care to patients with ulcers, necrosis, or a gastrointestinal disease (gangrene), which most often have leg injuries in diabetes. Similar centers have been established in St. Petersburg and Grozny, Russian Federation. The center will coordinate its work with these centers.
The center is part of the HAPPY LIFE private clinic, which includes a team of surgeons, an endocrinologist, a vascular surgeon, a cardiologist, an interventional surgeon, an anesthetist and an orthopedist. The clinic is equipped with all necessary equipment and tools of the latest model.
Safarov Khayriddin Chorievich was born in 1976 in Bukhara. In 1998, he graduated with honors from the medical faculty of Altai State Medical University. In 2000 he graduated from the clinical residency of the Bukhara State Medical Institute. From 2001 to 2002 he worked as a surgeon in the Medical Association of Biysk, Russian Federation.
Diabetes and its complications
Diabetes occurs when the body cannot maintain the proper level of sugar in the blood.
According to the World Health Organization, more than 420 million people currently have diabetes worldwide. This is 25% more than it was 40 years ago.
Diabetes is a chronic disease that cannot be completely eradicated. Nevertheless, modern methods for controlling blood sugar levels are currently being developed. This will help patients with diabetes live longer and happier than other healthy people. At the same time, a person can achieve a stop by changing his lifestyle and certain habits.
There are several types of diabetes. The most common of these is type 2 diabetes. In this type of diabetes, the production of the hormone insulin, which is responsible for the absorption of sugar in the blood by the cells of the body, either decreases or (or) causes some complete obstruction. These changes usually occur in middle and middle-aged people.
Если человек ведет малоподвижный образ жизни, страдает ожирением, недоедает (высокая и высокая калорийность) и имеет высокое кровяное давление, вероятность того, что он / она станет преждевременным.
Наследственность играет роль в возникновении болезни.
All healthy people contain a certain amount of sugar (glucose) as the main source of energy in the blood. Blood enters the blood in two ways:
With foods that contain carbohydrates.
From the stores of glucose (glycogen) in the liver.
As a source of energy, sugar enters muscle cells (for working purposes), adipose tissue and liver tissue (for reserve purposes). The insulin hormone produced by the pancreas enters the cells of sugar (glucose).
The amount of sugar in the blood rises after eating. However, the pancreas immediately produces and distributes insulin into the bloodstream, which opens the gate of all cells to glucose. After glucose enters the cells, blood sugar returns to normal. Blood sugar is replenished from the liver reserve during meals and during sleep. This process is also controlled by insulin.
In type 2 diabetes, the pancreas produces insulin.
Insulin is not produced at the right time and in the right amount, and over time, insulin production decreases.
Usually, for example, if one cell “door” opens one glucose, one insulin molecule is required, and for one type of diabetes, several insulin molecules are required. In other words, the body’s resistance to insulin increases.
To diagnose diabetes, blood sugar levels must be measured by laboratory methods.
Diabetes is manifested by constant fatigue, frequent thirst, excessive weight loss, hunger, frequent and frequent urinary incontinence, short ulcers, decreased sensitivity in the legs, loss of vision and vision.
At the onset of diabetes, the patient is not known for a long time. In most cases, the symptoms of the disease are diagnosed. Late diagnosis and late treatment can lead to complications and complications.
Complications of diabetes can be divided into early and late manifestations. Early complications are associated with a sharp drop or increase in blood sugar. These include hypo- and hyperglycemia, diabetic ketoacidosis and others.
The late complications of diabetes are due to exposure to many organs and systems of the body. This mainly affects the brain, eyes, heart and vascular system, kidneys, nerve fibers, feet and other internal organs.
In patients with diabetes, prolonged high blood sugar causes eye disease (diabetic retinopathy). This can lead to loss of vision and even loss of vision. The effects of diabetes on the eyes begin long before vision deteriorates. Therefore, patients with diabetes should be constantly monitored by an ophthalmologist.
Vascular complications are the leading cause of disability and mortality in diabetes. These include angina pectoris (chest pain and pain), stroke, vascular diseases in the legs (purulent wounds and abdominal pain caused by bleeding feet), chronic heart failure with accumulation of water in the lungs and other tissues. These complications are exacerbated by high blood pressure, high blood cholesterol and high blood sugar.
Diabetes is the main cause of chronic kidney disease. This is due to the most severe damage to the renal vessels, which can lead to impaired and even delayed renal function.
Damage to nerve fibers in diabetes (diabetic neuropathy) is also associated with a prolonged increase in blood sugar. Most often, peripheral neuropathy occurs in the legs. This condition is accompanied by a decrease in sensitivity in the legs, forearms, and pain. As a result of a decrease in sensitivity, the patient may not notice the wounds that he received on his leg. These injuries can lead to deep ulcers and even amputations due to secondary infections. These complications are commonly referred to as a diabetic foot, diabetic heel, or diabetic foot.
In addition, patients with diabetes suffer from vascular obstruction and circulatory disorders. Circulatory disorders are another important factor affecting wounds and increased amputations. This risk can be avoided if the patient timely checks his legs and maintains high blood sugar.
Women with diabetes require regular medical supervision during pregnancy. In men, erectile dysfunction can lead to digestive disorders (diabetic enteropathy) and problems with urination.
Diabetic foot syndrome
Most of our people know a certain amount of diabetes. Unfortunately, he often lacks sufficient knowledge about the complications that can lead to a decrease in the patient’s quality of life and disability. One of the complications of diabetes is the “diabetic foot” syndrome (“diabetic foot”, “diabetic foot”).
This complication occurs in 16-18% of patients with diabetes.
In diabetes, the generic word “diabetic compensation” is all changes that occur in the patient’s legs with diabetes (loss of legs, damage to the nails and hair on the legs, cold hardening, scratches, weakness, decreased sensitivity (no pain). Incurable purulent wounds, floods from ulcers, necrosis and, in most cases, carcinomas). In most cases, these changes begin with the fingers, especially with the first finger and silhouette, nails and foot area. These changes can be seen in signs of inflammation, such as swelling, redness, pain, local temperature, and more.
These changes include diabetic neuropathy (damage to nerve fibers in the foot), micro- and macroangiopathy (damage to small and large blood vessels) caused by high blood sugar for a long time.
Diabetic neuropathy is the degeneration of nerve fibers in diabetes mellitus, malnutrition (atrophy) and structure degeneration. This group is manifested in patients with diabetic neuropathy at the onset of pain and temperature sensitivity in the legs, night traction and seizures. Changes in the shape of the foot are due to diabetic polyneuropathy, the formation of packaging on the lower surface of the heel due to redistribution of body weight, which in turn leads to pressure sores. These ulcers can be infected by an infection (leak).
Another group of patients with vascular obstruction (diabetic angiopathy) with circulatory disorders. These patients have severe ulcers, pus, and cancer, which can lead to 28% amputations with necrosis. It begins with dry acrylic necrosis at the fingertips or on the thigh. Unlike a neuropathic wound, these wounds are painful. The addition of infection can lead to complications of the purulent process – phlegmon, purulent-necrotic ulcers and even the gastrointestinal tract. Karazon disease can be amputated if it is not treated properly by a narrow specialist, using modern equipment. According to international data, 70-75% of amputations are associated with diabetes.
The most dangerous aspect of large purulent wounds is that toxins in the human body become chronic, poisoning the kidneys, heart, lungs, brain and other internal organs. This is manifested in weakness, weakness, palpitations, shortness of breath, decreased urine, decreased appetite, increased body temperature and nervousness. Local atonement is cold, pale and, in some cases, blue. Pulse in the trunk, ankle and even in the thigh can be reduced or not detected. This is clearly illustrated by ultrasound dopplerography and computed tomography. If it turns out that the body is clogged, the patient will be able to open the vessel using a group of operations performed by a cardiovascular surgeon.
BASIS OF SUCCESSFUL TREATMENT
One of the foundations of successful treatment is the development of individual tactics and treatment algorithms for diabetes complications on the legs. At the same time, the doctor must carefully evaluate the extent of the disease and its complications, the vascular system, microcirculation of the foot and the state of the nervous system. In most cases, it is necessary to determine, evaluate and choose the treatment tactics most closely associated with diabetes. Examples of these diseases are high blood pressure (arterial hypertension), coronary heart disease, heart attack and post-stroke, renal failure (chronic renal failure), and autoimmune diseases.
An interdisciplinary approach is another key to successful treatment. What does it mean?
The development of medicine has reached such a level that information about diseases and their complications, methods of diagnosis and treatment is growing. In the field of medicine, 1 news item is created every 3 minutes. It is inconceivable that one or more doctors have mastered such a huge flow of information. That is why we (a pediatric surgeon, a vascular surgeon, a general practitioner, an endocrinologist, a cardiologist, an orthopedist, a neuropathologist, etc.) work as one team. Our patients are under the constant supervision of a cardiologist, endocrinologist, surgeon and other specialists. Patients are prescribed medications that regulate blood sugar and are adjusted as necessary, are adjusted with the help of cardiac and cardiovascular, digestive, sedative, pain medication and other drugs.
Modern, proven, highly effective, harmless and minimal side effects are the key to successful treatment. During the treatment of our patients, antibacterial (several groups) are antifungal, improve intravenous blood flow, increase blood fluid, increase its suspension stability, strengthen the vascular wall, antioxidant, antihypoxic, anti-inflammatory, anti-inflammatory and anti-inflammatory. In addition, they take drugs such as “capillary” reserve capillaries. Intravenous administration of these drugs is considered less effective for the foot. In our clinic, drugs are transmitted directly through the arteries to only one leg of the patient. The concentration of drugs in the legs is higher than in the body. This is done over a long period of time (3-4 days) through a catheter (thin tube) inserted into the femoral artery using a syringe dosing device (DVAKT). More than three thousand patients received 15 years of experience using this method.
Performing surgical procedures with minimally invasive, maximum preservation of organs and tissues, with many years of experience in modern, modern equipment is another key to successful treatment. In our center, all the complex operations necessary to maintain your legs are carried out in accordance with international standards. If necessary, the operation can be performed in two or three stages. Ultrasonic cavitation of the wound was established during surgery and irradiation using low-power laser radiation
It was proved that washing the wounds with hydrogen peroxide, washing furatsillina and tasting ligaments (levomekol) is ineffective, often ineffective, and in some cases harmful.
In our center, wounds are reanimated by the method of “gauze absorption”. Interactive polyacrylic, hydrocolloid, alginate special binders, bacterial biofilters and a wide range of bacterial killer (bactericidal) gels developed in developed countries are used to treat wounds to create the most favorable tissue for wound healing.
Effective treatment of wounds under adverse pressure using a special vacuum has been proven worldwide and is widely used in our society.
In the future, it is planned to treat purulent wounds with live sterile surgical larvae (larval therapy, larval therapy). This method is common in America, Europe, Malaysia and Iran.
Tashkent, Yunusabad district, quarter 19, Dehkanabad street, 12a