Danylova O. Improving diagnosis and surgical treatment of pingless-necrotic complications in patients with a mixed form of diabetic foot syndrome.

The dissertation is devoted to solving the problem of improving the treatment outcomes of patients with ply-necrotizing complications of SDS. The work is based on the analysis of the treatment results of 320 patients with ply-necrotistic complications of a mixed form of diabetic foot syndrome. The main group consisted of 150 patients and a comparison group of 170. A study of histostructure of wound bioptates in a mixed form of SDS showed that pathogenetetic patients can be divided into two groups: with the predominance of ischemic and with a predominance of neuropathic soft tissue lesions. Different degrees of peripheral nerve stems were found - from mild demyelination in the 1st group up to total demyelination in the 2nd group. Vascular changes allow to distinguish two types: with pronounced vascular changes, when VN'10.2-0.44 and IR 0.74 and unexpressed, in which Dvn-11.8 to 0.4, and IR 0.49 to 0.06 (r 0.05). It has been established that all patients with a mixed form of SDS and ply-necrotic process on the foot in the absence of changes in bones on X-rays and at macroscopic their integrity, regardless of the prevalence of ischemia or neuropathy, there are destructive changes in the bones in all samples in all samples. In patients who have previously undergone angiocorrection, histologically found signs of bone regeneration. The proxymal interphalanic joints have been resected with hammer-shaped deformation of the fingers using improved technique, which provides not only the sanitization of the infection center, the correction of the existing deformation and prevention of recurrence of ulcers. It is proven the feasibility of the use of stabilizerography to assess changes in biomechanics in patients who have undergone surgical interventions on the foot for HNU SDS. The resulting data are used in the further management of patients. The use of improved tactics allowed to avoid high amputations, perform simulated operations, reduce the bed-day from 40.21 to 2.8 to 32.21 to 3.4 (p 0.05). Keywords: mixed form of diabetic foot syndrome, stabilography, joint resection.