Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC37810.15690/vramn.v69i11-12.1192SHORT MESSAGESКРАТКИЕ СООБЩЕНИЯPATHOPHYSIOLOGICAL ASPECTS OF WOUND HEALING IN NORMAL AND DIABETIC FOOTПАТОФИЗИОЛОГИЧЕСКИЕ АСПЕКТЫ ПРОЦЕССА ЗАЖИВЛЕНИЯ РАН В НОРМЕ И ПРИ СИНДРОМЕ ДИАБЕТИЧЕСКОЙ СТОПЫMaksimovaN. V.МаксимоваН. В.
Russian Federation

кандидат медицинских наук, ассистент кафедры эндокринологии лечебного факультета Первого МГМУ им. И.М. Сеченова Адрес: 119992, Москва, ул. Трубецкая, д. 8, стр. 2, тел.: +7 (495) 530-32-16

maximova.nadezhda@gmail.comLyundupA. V.ЛюндупА. В.
Russian Federation

кандидат медицинских наук, заведующий отделом биомедицинских исследований НИИ молекулярной медицины Первого МГМУ им. И.М. Сеченова Адрес: 119992, Москва, ул. Трубецкая, д. 8, стр. 2, тел.: +7 (495) 609-14-00

lyundup@gmail.comLyubimovR. O.ЛюбимовР. О.
Russian Federation

аспирант Первого МГМУ им. И.М. Сеченова Адрес: 119992, Москва, ул. Трубецкая, д. 8, стр. 2, тел.: +7 (495) 530-32-16

lubimov@onet.ruMel'nichenkoG. A.МельниченкоГ. А.
Russian Federation

академик РАН, доктор медицинских наук, профессор кафедры эндокринологии лечебного факультета Первого МГМУ им. И.М. Сеченова Адрес: 119992, Москва, ул. Трубецкая, д. 8, стр. 2, тел.: +7 (495) 609-14-00

teofrast2000@mail.ruNikolenkoV. N.НиколенкоВ. Н.
Russian Federation

доктор медицинских наук, профессор кафедры анатомии человека Первого МГМУ им. И.М. Сеченова, заведующий кафедрой нормальной и топографической анатомии факультета фундаментальной медицины МГУ им. М.В. Ломоносова Адрес: 119992, Москва, ул. Трубецкая, д. 8, стр. 2, тел.: +7 (495) 609-14-00

nikolenko@mma.ruSechenov First Moscow State Medical University, Russian FederationПервый Московский государственный медицинский университет им. И.М. Сеченова, Российская ФедерацияSechenov First Moscow State Medical University, Russian Federation M.V. Lomonosov Moscow State University, Russian FederationПервый Московский государственный медицинский университет им. И.М. Сеченова, Российская Федерация Московский государственный университет имени М.В. Ломоносова, Российская Федерация171220146911-12Vestnik Rossiiskoi akademii medetsinskikh nauk / Annals of the Russian academy of medical sciencesВестник Российской академии медицинских наук11011707082015Copyright ©; 1970, "Paediatrician" Publishers LLCCopyright ©; 1970, Издательство "Педиатръ"1970"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/about/submissionshttps://vestnikramn.spr-journal.ru/jour/article/view/378

The main cause of long-term healing of ulcers in patients with diabetic foot is considered to be direct mechanical damage when walking due to reduced sensitivity to due to neuropathy, hyperglycemia, infection and peripheral artery disease. These factors determine the standard approaches to the treatment of diabetic foot, which include: offloading, glycemic control, debridement of ulcers, antibiotic therapy and revascularization. Recently, however, disturbances in the healing process of the skin in diabetes recognized an additional factor affecting the timing of healing patients with diabetic foot. Improved understanding and correction of cellular, molecular and biochemical abnormalities in chronic wound in combination with standard of care for diabetic foot gives new hope to solve the problem of ulcer healing in diabetes.

Традиционно причинами длительного заживления язв при синдроме диабетической стопы (СДС) считаются прямое механическое повреждение при ходьбе в связи со снижением болевой чувствительности на фоне нейропатии, гипергликемия, инфицирование и нарушение кровоснабжения. Данные факторы определяют стандартные подходы к лечению СДС, включающие в себя: разгрузку пораженной конечности, гликемический контроль, хирургическую обработку язв, антибактериальную терапию и реваскуляризацию. Однако в последнее время нарушения непосредственно в процессе заживления кожных покровов при сахарном диабете (СД) признаются отдельным фактором определяющим вероятность и сроки излечения пациента с СДС. Улучшение понимания и коррекция клеточных, молекулярных и биохимических нарушений в хронической ране в сочетании с соблюдением стандартов лечения СДС дает новую надежду в решении проблемы заживления язв при СД.

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