REAL POSSIBILITIES TO DECREASE A QUANTITY OF LOWER EXTREMITIES AMPUTATIONS IN PATIENTS WITH PURULO-NECROTIC COMPLICATIONS OF DIABETIC FOOT SYNDROME

The number of patients with purulo-necrotic lesions of foot in diabetes mellitus increases by 12% annually. The quantity of high amputations of lower extremities in connection with the development of critical ischemia and diabetic gangrene in these patients reaches 50-60% and has no tendency to decrease. The extent and optimum terms of operation remain the subject of discussion. The aim of the study was to investigate the character of purulo-necrotic processes in diabetic foot syndrome and to assess the accepted treatment approach for its optimization and improvement of results. Experience of treatment of 838 diabetic patients with purulo-necrotic complications of foot is presented. Methods of complex surgical treatment of these patients were applied in a clinic setting. Emergency, urgent and delayed necrectomies, disarticulations of fingers, metatarsal resections and minor foot amputations were carried out with intensive conservative treatment. High amputations were performed in 79 (9.4 %) patients. The method of complex surgical treatment allowed to decrease the quantity of high amputations of lower extremities from 11.9 % to 9.4 %.