부산대학교 도서관

Diabetes mellitus (DM) worldwide has acquired pandemic proportions and the number of cases continues to rise permanently, which is one of the most important medical and socio-economic problems. The structure of late complications of diabetes; diabetic foot syndrome is a leader causing the increased morbidity and mortality in this group of patients. It complicates the course of diabetes in 4.6–25 % of patients, with an annual diagnosis of new lesions within 2.2–5.9 % of patients with diabetes. The aim of the study – to evaluate the effectiveness of methods and developed complex pathogenetic differentiated treatment of diabetic foot syndrome. Materials and Methods. The results of treatment of 1716 patients with the syndrome of diabetic foot were analyzed. On the basis of the features of the pathological process, microbiological, cytological and morphological studies, the study of central and peripheral hemodynamics of the lower limbs, x-ray survey developed objective criteria integrated differential treatment, and performance criteria for surgical treatments and minor amputations in the foot. Results and Discussion. The research allowed to state that the formation of a differentiated approach to surgical treatment of purulent necrotic lesions of the lower extremities against diabetes should be considered pathogenic form of diabetic foot, depth and distribution of lesions, topographical location, natural flora inflammatory lesions, and indicators of peripheral hemodynamics of limbs. In order to preserve the lower extremity in the presence of reasonable evidence, preference should be given one-step radical debridement and small foot amputation. Conclusions. Timely and proper use of differentiated pathogenesis of complex treatment regimens allow the diabetic foot syndrome quantitatively and qualitatively improve treatment above named diseases, resistance to save limbs and reduce the number of high amputations of the lower limbs to 9.6 %, and reduce the term inpatient treatment 5.8 ± 1.4 bed-days to improve the quality of life of patients and their social adaptation.