Mykhal'chuk D. Combined Surgical Treatment of the Diabetic Foot Syndrome Considering Clinic-Metabolic Changes

166 patients with the diabetic foot syndrome were examined and the results of combined surgical treatment were studied. The diabetic foot syndrome was shown to develop in patients with subcompensated and decompensated diabetes mellitus on the background of angiopathy, osteoarthropathy, polyneyropathy, nephropathy and cardiomyopathy. At has been shown that the severity course of purelent necrotic process on the foot depends upon the type of diabetes mellitus, the disturbance of acid-base aquilibrium, the processes of peroxide oxidation of lipids and the state of antioxidant system of defence. Combined surgical treatment of different forms of the diabetic foot syndrome was developed. Clinical metabolic changes were taken into consideration. At has been proved that the opening of deep noncloctridial anaerobic phlegmons of sole surface with H like incission and exarticulation of gangrenously changed toe with the resection 2/3 of instep bone is advisable. The results of intravenous laser blood irradiation i n combined surgical treatment of patients with ischemic-gangrenous foot were studied. The main results of the work were practically used.