Prevention and treatment of postoperative complications in high amputations of lower extremities in patients with diabetic gangrene

A.R. Kodirov, S.S. Yusupova

Department of Endocrine Surgery of Dushanbe Medical Center
Chair of General Surgery №2 Avicenna TSMU

The work is based on the experience of surgical treatment of 155 patients who were underwent amputation of lower extremities for diabetic gangrene in period from 2002 to 2012.

In 86 observations were made amputation at the shin level. The main methods of amputation at shin level were: stump formation by Burgess (n = 34), and amputations with two equal anterior and posterior flaps formation (n = 48), in 4 cases the tactics of primary-delayed amputation was used.

Based on morphological changes in muscle in ischemic form of diabetic foot in patients with severe infection, sepsis, after high amputation are most appropriate to use the flow-flushing drainage of the stump (FFD). In 30 cases, the FFD were set in patients with amputation on thigh level and in 27 - after cutting at the shin level. In 46 observations for amputation at the shin level and in 30 cases - at the thigh, we applied a newly developed method of hemostasis.

Keywords: diabetic gangrene, amputation of lower limbs.

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