Vasylyuk S. The pathogenic foundation of complex surgical treatment of patients with the diabetic foot syndrome

The scientific work deals with the problems of treatment of the suppurative and necrotic complication of the diabetic foot syndrome including pathogenetic peculiarities of this pathologic development. On the basis of study of the glucose exchange peculiarities, liver blood supply, its proteinsynthetic function and the activityof organospecific enzymes, the state of humoral and cellular immunity, IL-1?, IL-8 and IL-10 levels, peroxide oxidation of lipids and antioxidant protection midmolecular peptides level and the characteristics of the microcirculabory bed of affected limbs: erythrocytes cytoarchitectonics, endothelial disfunction and level of fibrinolysis inhibitors in patients with diabetic foot syndrome with the suppurative and necrotic processes of various degrees of severity, methods and main principles of complex surgical treatment were worket out. The paracentetic transplantation of the newborn pigs pancreatic fragment with further catheterization of the inferior epigastric artery and simultaneous surgical intervention on the foot in the complex surgical treatment was proposed to introduce. Through the catheterized artery in postoperative period the intraarterial prolonged regional infusion of medicines on the affected limb by means of pulse dosator for 7-10 days was proposed to perform. On the basis of the carried out analysis of the obtained results the advantage of the proposed complex approach to the treatment of patients with diabetic foot syndrome was revealed. Among patients with the used traditional treatment in 70,4 % of cases of wound healing the sucess has been achieved. In 29,6 % the amputations of lower limb in the hip area were performed. Amond patients with the performed intraarterial prolonged regional infusion by means of medicines in 86,9 % of wound healing the sucess has been achieved. In 13,1 % of cases the amputation of lower limb in the hip area was perfomed. Among patients with the performed transplantation of pancreatic fragments of the newborn pigs in 97,4 % the wound washealed. In 2,6 % – the amputation was performed.