[Revascularization of the lower limbs for ischemic diabetic foot with pyonecrotic tissue lesions]. / Revaskuliarizatsii nizhnikh konechnostei pri ishemicheskoi forme diabeticheskoi stopy s gnoino-nekroticheskimi porazheniiami tkanei.

This paper analyzes the results of the treatment of 213 patients with ischemic diabetic foot marked by pyonecrotic tissue lesions. On examination of the patients the authors were governed by the clinical findings as well as by the data supplied by the research methods such as ultrasound Doppler, percutaneous oxymetry, contrast angiography and laser flowmetry. Altogether 89 patients underwent revascularisation of the lower limbs by means of restoring arterial circulation; 72 patients were provided lumbar sympathectomy. The indications were elaborated for use of one or another revascularization technique. It has been established that of the 161 patients provided limb revascularization, the satisfactory results with limb salvage were obtained in 132 (81.9%) patients; high amputations were performed in 22 (13.6%) cases; 7 (4.3%) patients did not improve; after operation no lethal outcomes were recorded. Of the 52 patients who did not undergo lower limb revascularization, the beneficial results were obtained in 37 (71.1%), high amputations were performed in 15 (28.9%) patients. The conclusion is drawn that limb revascularization allows to minimize the number of high amputations more than two fold.

[Restorative operations on main vessels for diabetic angiopathy of lower extremities with purulent-necrotic complications]. / Vosstanovitel'nye operatsii na magistral'nykh sosudakh po povodu diabeticheskoi angiopatii nizhnikh konechnostei s gnoino-nekroticheskimi oslozhneniiami.

There were analyzed the results of treatment of 75 patients with diabetic angiopathy of the lower extremities and purulent-necrotic affection of the foot tissues, to whom restoration operation on the main vessels was accomplished. In 11 patients aorto-femoral bilateral shunting together with lumbar sympathectomy was performed, in 7--femoro-femoral shunting, in 38--femoro-popliteal, in 12--iliofemoral shunting together with lumbar sympathectomy, in 7--thrombendarterectomy from a. femoris communis in conjunction with the vessel dilatation using the patch. In 89.2% of patients satisfactory result with the extremity preservation was noted. In 10.8% of patients high amputation of extremity was done, all the patients are alive.