Zinich O. Optimization of surgical and complex treatment of the complicated Diabetic Foot Syndrome depending on it's form

587 patients with complicated DFS took part in the research, they were examined and operated in the city's septic center with beds for DFS for period of 2007 - 2011 years. It was determined in the study that growth of microbial flora in patients with complicated DFS for the study period of time has changed in both quantitative and in quality correlation. The growth of gram (+) aerobic-aerobic associations was increased from 51,9 % to 58,2 %, in composition of aerobic monoinfection the number of grown gram (+) flora was increased from 54,2 % to 60,7 %, as well as the growth of cultures of MRSA from 23,3 % to 42,4 %. The microbial landscape in different forms of complicated DFS was different: in patients with neuropathic infected foot prevailed an aerobic monoinfection with frequency of growth of coagulosepositive staphylococcus from 82,3 % to 84,6 %. In this form of disease the highest growth of MRSA cultures was registered - 42,4 %. In Ischemic form in 18 - 22 % of cases the growth of microflora from the primary festering was absent or a saprophyte skin flora was determined. In this group of patients the highest percentage of growth of blue pus bacillus in a monoculture - 24,6 %, as well as yeast-like pathogenic fungi of Candida genus. In the mixed form of complicated DFS most often microbial associations were grown - 58,2 %, and in the structure of gram (+) monoculture, in difference from other forms, Ent. faecalis was grown in 9,8 %. Optimization of surgical and complex treatment of patients with complicated DFS allowed to reduce the terms of hospital stay from 33,2 ± 2,4 days, in the group of comparison to 21,4 ± 1,7 days, in a basic group, to save the support ability of lower extremity due to the providing of "small" amputations 21,9 to 36,5 %, and to decrease the amount of "high" amputations from 24,5 to 15,1 %, lethality from 25,8 to 5,3%.