Clinical and hemodynamic predictors of regenerative success in patients with purulent-inflammatory soft tissue infections and type 2 diabetes: a prognostic model
DOI:
https://doi.org/10.15574/PS.2025.4(89).1014Keywords:
purulent-inflammatory soft tissue diseases, type 2 diabetes mellitus, muramyl peptides, prostaglandin E1, wound healing, regenerative plateauAbstract
Surgical management of purulent-inflammatory soft tissue diseases (PISTD) in patients with comorbid type 2 diabetes mellitus (T2DM) remains a critical challenge for modern healthcare. The fundamental problem is the formation of a "regenerative plateau" - a state of metabolic stagnation where the healing process stalls in a prolonged inflammatory phase.
Aim - to enhance the surgical treatment efficacy in patients with PISTD and T2DM by implementing a synergistic therapeutic protocol based on muramyl peptide-derived immunomodulators and prostaglandin E1 (PGE1) analogues.
Materials and methods. A prospective clinical study included 148 patients with PISTD and T2DM, randomized into a Control group (CG, n=72) and a Main group (MG, n=76) receiving systemic muramyl peptide immunocorrection and PGE1 therapy. Microcirculation was evaluated using laser Doppler flowmetry (LDF), and wound dynamics were assessed via computer planimetry. Statistical analysis was performed using Statistica 12.0 software (p≤0.05).
Results. It was established that in the MG, clinical resolution of local edema and pain syndrome occurred 1.57 times faster than in the CG (p≤0.05), and body temperature normalization was 1.69 times faster. The use of PGE1 helped eliminate capillary sludge syndrome, ensuring a 59.3% reduction in wound area by day 10 and a decrease in the length of hospital stay (9.4±1.3 days in the MG vs 16.1±2.2 days in the CG). The obtained data indicate that the synergistic strategy can effectively overcome metabolic stagnation.
Conclusions. The integrated use of muramyl peptides and PGE1 significantly improves PISTD treatment outcomes by synchronizing regional blood flow with a targeted immune response.
The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from all participants.
The author declares no conflict of interest.
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