Substantiation оf an adequate scope of diagnostic methods and surgical procedures in patients with diabetic foot syndrome

Katelnitskyi I.I., Trandofilov A.M.

Chair of Surgical Diseases №1 Rostov State Medical University,
Rostov-on-Don, Russia

Analysed herein are the results of treating a total of 154 patients presenting with diabetes mellitus and pyo-necrotic alterations in the lower limbs. Duration of diabetes prior to the development of necrotic complications averagely amounted to 15 years, in 76 patients of the Study Group we determined the species-specific composition of the pathogens, the number of microbial bodies in 1 gram of necrotic tissues as well as the state of cellular and humoral immunity, and the complex of therapeutic measures was supplemented by cytokine therapy: Operative treatment in 78 patients of the control group consisted of various-scope necrectomies and open management of the wounds. The operative procedures in the Study Group patients included revascularizing operations, as well as secondary surgical debridement of the wounds with placing sutures. In the control group, the limb salvage rate amounted to 57.7% (29 of 78) and that in the Study Group to 88.15% (67 of 76). In the first group, we performed a total of 29 (37.17%) major amputations and 4 (5.25%) in the study group. Conclusion was made on advantages of a comprehensive approach while assessing all impairments in the body of duibetic patients and adequate therapeutic policy aimed at re-establishing blood flow, removal of the purulent focus and decrease of tissue infectedness, correction of the immune status, as well as application of novel methods of treatment and drug therapy.

KEY WORDS: diabetes mellitus, diabetic foot syndrome, revascularization.

P. 150-154

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