[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.