Antoshchuk R. Comprehensive treatment tactics in the prevention of unsatisfactory results of surgical treatment of purulent-necrotic complications of diabetic foot syndrome

Surgical tactics with individualized choice of stages and volume of surgical interventions under conditions of critical ischemia and purulent-necrotic processes of the lower extremity have been optimized. The use of MRI scanning in combination with transnory contrast to substantiate the informativeness of the method, according to the Kappa-Cohen coefficient, in the detection of purulent-necrotic complications of DFS was justified. In patients with a combination of critical ischemia and DFS with a high degree of reliability, the determination of transcutaneous oxygen tension has been shown to be the most informative means of assessing the degree of critical lower extremity ischemia before and after revascularization operations. And based on its results, the stages of surgical interventions in purulent-necrotic complications of DFS was provided in combination with endovascular surgery of arterial blood flow of the lower extremity. As a result of complex treatment of patients with purulent-necrotic complications of DFS reduction the average bed-day, postoperative mortality, as well as the number of high amputations due to the progression of critical ischemia by 6.9 %, and with the use of MRI contracted study the number of amputations due to osteomyelitis progression by 2.37 % was managed.