Kindzer S. Surgical treatment of destractive - necrotlc damages of lower extremities in patients with diabetes mellitus.

The research is devoted to the question of surgical treatment of patients with diabetes mellitus with destractive - necrotic damages of lower extremities. New approach to tactics of complex treatment taking into account basic pathomorphologic mechanisms of diabetes mellitus complication development is elaborated.159 patients with diabetes mellitus with destructive - necrotic damages of lower extremities and 54 patients with pus pathology of lower extremities without diabetes mellitus were examined. Basing on this examination the description of peculiarities of wound process duration in patients with diabetes mellitus and planimetric description of this process are made, correlation between compartment syndrome and basic pathogenesis factors is produced.Surgical tactics in conjunction with medical therapy depending on level of ischemia and neuropathy, depth and diffusion of destructive - necrotic process are suggested and based on results of instrumental, bacteriological and laboratory researches. Moreover specific orders of laser radiation are established for the ensuring of wound process staging consecution. Thus the role of carbon dioxide laser in the complex treatment of pus processes in patients with diabetes mellitus is determined.Adaptation of complex approach to common and regional status estimation, choice of indices and tactics of complex treatment using carbon dioxide laser in various work orders availed to achieve positive results in 98,7% patients.