Staged revascularization and delayed organ-conserving surgery of complicated forms of diabetic foot syndrome

Abstract

The article presents short-term results of the implementation of staged treatment of purulent-necrotic complications of diabetic foot syndrome with various approaches to revascularization of lower limb tissues. The purpose of the study is to evaluate the clinical effectiveness of staged revascularization and delayed organ-preserving operations for purulent-necrotic complications of the mixed form of diabetic foot syndrome. The essence of the technique described by the authors includes primary sanitation of the purulent focus, the formation of limited dry necrosis in the area of the initial wet tissue necrosis and achieving the maximum possible level of revascularization, reperfusion and reoxygenation of limb tissues, followed by delayed necrectomy, amputation and reconstructive plastic organ-preserving operations on the feet. Results and conclusions. Taking into account the modern variety of methods used for revascularization of the extremities, the main features of the clinical course after open, endovascular and angiogenesis-stimulating methods of reperfusion and tissue reoxygenation are presented, taking into account the pathophysiological effects of the methods and means used. Based on clinical experience in the treatment of this category of patients, priority directions for diagnosis and treatment tactics at the inpatient and outpatient stages of monitoring this category of patients have been identified.