Differentiated treatment of diabetic foot syndrome, complicated by purulent-necrotic processes

D.A. Abdulloev, Sh. Yusupova, U.M. Begakov, M.H. Nabiyev, K.M. Saidov

Chair of General Surgery № 2 Avicenna TSMU

The results of the investigation 1415 patients with complicated forms of diabetic foot syndrome are presented in article. Three components of integrated treatment included: revascularizingosteotrepanati on, pyonecroticfocusdebridementand autodermoplastyof wound defect.

In the setting of severe course of diabetes, the presence of vascular complications and comorbidities, necrotic lesions developed in 1190 (84,2%) patients.

Revascularizingosteotrepanation given result in 69 patients with recurrent critical chronic lower limb ischemia in an isolated form. Due to the lack of blood flow in 43 patients at the distal tibial artery segments lower limb amputation at the thigh in 13 patients, leg - at 30were performed.

Autodermoplastyof foot skin defects carried out for 56 patients. In 69,6% (n=39) of cases revealed a complete engraftment in 28,57% (n=16) - partial engraftment and only 7,14% (n=4) - there was complete necrosis of the graft.

The use of prostaglandin E1 drugs in combination of conservative and surgical treatment of purulent wounds after the transition in the reparative stage resulted in a decrease of high amputations from 21,4% to 4,1% and in-hospital mortality - from 17,8% to 7,4%.

Keywords: diabetic foot syndrome, critical limb ischemia, revascularizingosteotrepanation, autodermoplasty.

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