[The role and place of long-term intraarterial catheter therapy in the treatment of pyo-necrotic lesions of the foot in the presence of diabetes mellitus]. / Dlitel'naia vnutriarterial'naia kateternaia terapiia pri lechenii gnoino-nekroticheskogo porazheniia stopy na fone sakharnogo diabeta.

Results were studied of examination and treatment of 127 patients with diabetes mellitus complicated by pyo-necrotic lesions of the foot. Group I (control group) comprised 90 patients who were given a long-term intraarterial catheter therapy involving administration of antibiotics on a continuous drop-by-drop basis. Group II (main group) was 37 patients who received the above therapy with a stream-like (half the daily dose) intraarterial administration of antibiotics at regular intervals against the background of their drop-by-drop administration. Exudation and necrotic tissues taken from the wound served as material for the microbiological procedures to be done. In the control group, results were considered to be good, satisfactory, unsatisfactory in 24 (36.4%), 36 (40.5%), 25 (27.5%) patients respectively. There were five fatalities (5.6%). Eight patients were reoperated on. In the main group, good results were obtained in 37.7 percent of cases (n = 12), with 24 (59.8%) patients having displayed satisfactory, 1 (2.7%) patient--unsatisfactory results. There were two deaths. Four patients were reoperated on.

[Characterisation of microbial growth and role of the foot tendinous-synovial formation in pathogenesis of diabetic gangrene of the lower extremity]. / Otsenka kharaktera mikrobnoi obsemenennosti i roli sukhozhil'no-sinovial'nykh obrazovanii stopy v patogeneze diabeticheskoi gangreny nizhnei konechnosti.

The paper is based on the analysis of results of treatment of 74 patients with diabetes mellitus complicated by pyo-necrotic injuries of the foot. In all patients, microbiological procedures were done besides general clinical studies. The material for microbiological assays was the purulent exudation taken from the deeper portions of the wound immediately after lancing the pathological focus. The microbial content was studied separately in fragments of the tendon from its distal (adjacent to the wound) and proximal (every other 6 to 7 cm within the confines of the intact common integument) ends. In the wound, it came up to 6.45 +/- 0.16 lg/ml and 5.2 +/- 0.31 lg/ml (P < 0.05), in the distal end it was 5.93 +/- 0.19 lg/ã and 4.81 +/- 0.24 lg/ã (P < 0.005) for aerobs and anaerobs respectively. In the proximal end of tendons 6-7 cm from the primary pathological focus, aerob gradient was 2.8 +/- 0.19 lg/ã, that for representatives of anaerobic microbes being 1.71 +/- 0.161 lg/ã (P < 0.001). In one third of patients the anaerobic microflora gradient was not found out.