Plastic Surgery
doi: 10.25005/2074-0581-2024-26-3-519-526
COMPREHENSIVE APPROACH TO SURGICAL TREATMENT OF NEUROTROPHIC FOOT ULCER BY LOCAL PLASTIC METHOD: CASE REPORT
1Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2Khatlon State Medical University, Dangara, Republic of Tajikistan
3Republican Scientific Center for Cardiovascular Surgery, Dushanbe, Republic of Tajikistan
Among all types of trophic ulcers, the prevalence of neurogenic ones is relatively low, comprising only 1%, but despite its low occurrence rate, treating it remains a complex and unresolved problem of reconstructive plastic surgery. This paper analyzes a clinical case of a neurotrophic foot ulcer in a 25-yearold female patient. The patient underwent circular excision of the ulcer to healthy tissues and transfer of the flap to the defect site using a local plastic method in combination with ntravenous laser blood irradiation (ILBI), which ultimately allowed to avoid complications and relapses.
Keywords: Neurotrophic ulcer, soft tissue defect of the foot, local plastic methods, flap transfer, intravenous laser blood irradiation, case report.
References
- Vlasov AP, Shibaev EYu, Fayn AM, Ivanov PA, Kisel DA, Lazarev MP, i dr. Sokhranenie oporosposobnosti stopy pri posttravmaticheskikh defektakh metodami mikrokhirurgicheskoy autotransplantatsii tkaney [Preservation of the weight-bearing ability of the foot with post-traumatic defects using microsurgical tissue autotransplantation methods]. Neotlozhnaya meditsinskaya pomoshch'. 2020;9(3):434-41. https://doi.org/10.23934/2223-9022-2020-9-3- 434-441
- Valeev MM, Biktasheva ME, Khalikov RA, Khalikova LN, Nigmatullin RKh. Khirurgicheskoe lechenie i posleoperatsionnoe vedenie patsientov s neyrotroficheskimi yazvami nagruzhaemoy zony pyatochnoy oblasti stopy s ispol'zovaniem slozhnosostavnykh loskutov [Surgical treatment and postoperative management of patients with neurotrophic ulcers of the load-bearing area of the heel area of the foot using composite flaps]. Vestnik sovremennoy klinicheskoy meditsiny. 2016;9(6):33-8. https://doi.org/10.20969/VSKM.2016.9(6).33-38
- Kutyapov DI, Rodomonova LA. Sovremennye printsipy i tendentsii ispol'zovaniya osevykh krovosnabzhaemykh loskutov v rekonstruktivnoy khirurgii konechnostey [Modern principles and trends in the use of axial blood-supplied flaps in reconstructive surgery of the extremities]. Travmatologiya i ortopediya Rossii. 2015;1:106-15.
- Biktasheva EM, Minasov BSH, Valeev MM. Mikrokhirurgicheskie tekhnologii pri lechenii bol'nykh s obshirnymi defektami myagkikh tkaney proksimal'nykh otdelov stopy [Microsurgical technologies in the treatment of patients with extensive soft tissue defects of the proximal foot]. Prakticheskaya meditsina. 2015;6:90-3.
- Shikhaleva NG, Ivanov GP, Gokhaeva AN, Dolganova TI, Shchudlo NA. Rezul'tat khirurgicheskogo lecheniya neyrotroficheskoy yazvy pyatochnoy oblasti, osnovannogo na sochetanii chreskostnogo osteosinteza i mikrokhirurgicheskoy tekhnologii [The result of surgical treatment of a neurotrophic ulcer of the heel area, based on a combination of transosseous osteosynthesis and microsurgical technology]. Geniy ortopedii. 2011;3:42-6.
- Kovalyova NS, Zabaznov KG. Debyut ekzogennoy polineyropatii u patsienta s troficheskimi yazvami nizhnikh konechnostey [Debut of exogenous polyneuropathy in a patient with trophic ulcers of the lower extremities]. Vestnik natsional'nogo mediko-khirurgicheskogo tsentra im. N.I. Pirogova. 2019;14(2):142-4. https://doi.org/10.25881/BPNMSC.2019.40.10.031
- Rodomanova LA, Medvedev GV, Afanasyev AO, Tsybul ES. Atipichnye sposoby revaskulyarizatsii krovosnabzhaemykh kompleksov tkaney v retsipientnoy zone [Atypical methods of revascularization of blood-supplied tissue complexes in the recipient area]. Annaly plasticheskoy, rekonstruktivnoy i esteticheskoy khirurgii. 2018;1:100-1.
- Minasov BSh, Valeev MM, Biktasheva EM. Taktika khirurgicheskogo lecheniya i posleoperatsionnogo vedeniya patsientov s neyrotroficheskimi yazvami zadnego otdela stopy na osnove funktsional'nykh loskutov [Tactics of surgical treatment and postoperative management of patients with neurotrophic ulcers of the hindfoot based on functional flaps]. Geniy ortopedii. 2016;3:58-62. https://doi.org/10.18019/1028-4427-2016-3-58-62
- Mullin RI, Masgutov RF, Salafutdinov II, Rizvanov AA, Bogov AA. Kombinirovannoe lechenie troficheskoy yazvy pyatochnoy oblasti s ispol'zovaniem vakuum-terapii v sochetanii s pryamoy gennoy terapiey: klinicheskiy sluchay [Combined treatment of trophic ulcer of the heel area using vacuum therapy in combination with direct gene therapy: A clinical case]. Kletochnaya transplantologiya i tkanevaya inzheneriya. 2013;8(3):125-8.
- Gizatulina LYa, Bogov AA, Mullin RI, Ibragimov YaKh. Primenenie vaskulyarizirovannoy kozhnoy plastiki zadnim fastsial'no-zhirovym loskutom goleni na retrogradnom krovotoke dlya zameshcheniya defekta myagkikh tkaney nizhney treti goleni i stopy [The use of vascularized skin grafting with a posterior fascial fat flap of the leg on retrograde blood flow to replace the soft tissue defect of the lower third of the leg and foot]. Prakticheskaya meditsina. 2017;8:53-5.
- Sannikov AB. Rekonstruktivno-vosstanovitel'naya khirurgiya konechnostey s ispol'zovaniem kozhno-fastsial'nykh ostrovkovykh loskutov s osevym krovosnabzheniem [Reconstructive surgery of the extremities using fasciocutaneous island flaps with axial blood supply]. Annaly plasticheskoy, rekonstruktivnoy i esteticheskoy khirurgii. 2015;1:77-8.
- Lazzarini PA, Crews RT, van Netten JJ, Bus SA, Fernando ME, Chadwick PJ, Najafi B. Measuring plantar tissue stress in people with diabetic peripheral neuropathy: A critical concept in diabetic foot management. Diabetes Sci Technol.2019;13:869-80. https://doi.org/10.1177/1932296819849092
Authors' information:
Fayzullaeva Mukhabbat Fozilovna,
Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University
Researcher ID: JZD-0741-2024
ORCID ID: 0009-0003-0500-2128
SPIN-код: 2432-5502
Author ID: 1232476
E-mail: ff.muhabbat@gmail.com
Kurbanov Ubaydullo Abdulloevich,
Corresponding Member of the National Academy of Sciences of the Republic of Tajikistan, Doctor of Medical Sciences, Full Professor, Professor of the Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University; Rector of Khatlon State Medical University
Researcher ID: E-1476-2019
ORCID ID: 0000-0002-5546-7180
SPIN-код: 5959-8681
Author ID: 845057
E-mail: kurbonovua@mail.ru
Odinaeva Mukhayo Saidmukhammadovna,
Candidate of Medical Sciences, Resident of the Department of Reconstructive and Plastic Microsurgery, Republican Scientific Center for Cardiovascular Surgery
Researcher ID: JZD-0778-2024
ORCID ID: 0009-0009-9381-1310
SPIN-код: 4955-3010
Author ID: 1232477
E-mail: muhayoodinaeva@gmail.com
Saidov Iskandar Saiddzhafarovich,
Candidate of Medical Sciences, Resident of the Department of Reconstructive and Plastic Microsurgery, Republican Scientific Center for Cardiovascular Surgery
Researcher ID: KAM-6822-2024
ORCID ID: 0009-0002-0748-2391
SPIN-код: 6188-6388
Author ID: 1030015
E-mail: mediskandar29m@mail.ru
Murodov Dzhovidon Kamolovich,
Resident of the Department of Reconstructive and Plastic Microsurgery, Republican Scientific Center for Cardiovascular Surgery
Researcher ID: KAM-6887-2024
ORCID ID: 0009-0002-0316-1101
E-mail: dzhovidon.murodov@mail.ru
Information about support in the form of grants, equipment, medications
The authors did not receive financial support from manufacturers of medicines and medical equipment
Conflicts of interest: No conflict
Address for correspondence:
Fayzullaeva Mukhabbat Fozilovna
Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 2 named after Academician N.U. Usmanov, Avicenna Tajik State Medical University
734026, Republic of Tajikistan, Dushanbe, Sino str., 29-31
Tel.: +992 (918) 645551
E-mail: ff.muhabbat@gmail.com
This work is licensed under a Creative Commons Attribution 4.0 International License.
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