[Specific aspects of pathogenesis and strategies in the comprehensive surgical treatment of the diabetic foot in patients with diabetes mellitus]. / Osoblyvosti patohenezu, taktyka i stratehiia kompleksnoho khirurhichnoho likuvannia nekrotychno-zapal'noho urazhennia stopy u khvorykh na tsukrovyi diabet.

Retrospective analysis of complex surgical treatment of 590 patients with diabetes mellitus (DM), complicated by necrotic-inflammatory affection (NIAF) of foot for 1991-2000 yrs period was conducted. At the time of first hospitalization age of patients had constituted at average (60.3 +/- 0.4) yr, duration of DM--(14.1 +/- 0.3) yr, in 11.2% patients DM was revealed for the first time. High amputation of lower extremity was done in 147 (35.1%) of 419 patients with disorders of its arterial blood supply, postoperative lethality had constituted 10.2%, general lethality--6.4%. Duration of stay in hospital had constituted at average (52.8 +/- 0.4) days. Strategy of complex surgical treatment of NIAF envisages: survival of the patient; complete healing (epithelization) of operative wound; securing the supportive function of foot. Disorder of sequence of this principles causes the increase of the reoperations frequency, lethality and material expenses. The problem solution envisages not so much the struggle with vascular consequences of DM, as prophylaxis of occurrence of these complications.

[Risk factors of the lower extremity amputation and mortality of necrotic inflammation of the foot in patients with diabetes mellitus]. / Faktory ryzyku vykonannia vysokoï amputatsiï nyzhn'oï kintsivky i letalnosti pry nekrotychno-zapal'nomu urazhenni stopy u khvorykh na tsukrovnyi diabet.

The comparative analysis of the clinical examination, biochemical and morphological investigations data in 75 patients with diabetes mellitus (DM) of the 1st type and in 341 patients with DM of the 2nd type, complicated by necrotically-inflammatory damage of foot (NIDF), was done. Amputation of lower extremity (LE) on the hip level was performed in 21.1%, on the knee one--in 3.6% of patients. Twenty eight, or 6.7%, patients died. There were following risk factors for the high level of the LE amputation and mortality: the senior age of patients, long duration of the DM course, the presence of the metabolism and rheologic properties of blood disorders, progressing atherosclerosis of the main arteries of hip and crus, the anamnesis data concerning other DM complications (nephropathy, anemia), and an ischemic heart disease, myocardium infarction, disorders of cerebral blood supply as well.

[Causes of unsatisfactory outcome in patients with diabetes mellitus complicated by necrotic inflammation of the foot]. / Prychyny nezadovil'noho rezul'tatu likuvannia khvorykh na tsukrovyi diabet, uskladnennyi nekrotychno-zapal'nym urazhenniam stopy.

Retrospective analysis of the conservative and surgical treatment results of 222 patients with diabetes mellitus, complicated by necrotic-inflammatory affection of foot, was performed for the 1991-1996 period. In 25.2% of observations the extremity amputation was done on the hip level, 13 (5.8%) of patients died. The unsatisfactory result causes were the reoperation performance on foot in a critical ischemia zone, the decrease of the first operation volume, nonadequate correction of metabolic, haemorheologic disturbances, antibacterial therapy.

[Types of microflora in acute suppurative-destructive diseases of the lungs and pleura]. / Kharakter mikroflory pri ostrykh gnoino-destruktivnykh zabole- vaniiakh legkikh i plevry.

By means of the modern bacteriologic methods, including gas-liquid chromatography, the microflora of the sputum, bronchial contents, pus from the abscess cavities and pleura in 106 patients with acute purulent destructive diseases of the lungs and pleura was studied.