Open AccessTreatment of the diabetic foot infections in septic surgery unit of the municipal versatile hospital
Author(s) -
A.A. Protasov,
Н. А. Бубнова,
М. А. Шатиль,
Avigail Soloveichik,
K. S. Suprun,
J. M. Gomon,
N. B. Vedernikova,
E. M. Staroselskiy,
O.N. Dobrydin,
L. G. Akinchits,
R. O. Cheptsov,
R. U. Malin
Publication year - 2015
Publication title -
regionarnoe krovoobraŝenie i mikrocirkulâciâ
Language(s) - English
Resource type - Journals
eISSN - 2712-9756
pISSN - 1682-6655
DOI - 10.24884/1682-6655-2015-14-1-60-66
Subject(s) - medicine , diabetic foot , surgery , microcirculation , shunting , foot (prosody) , blood flow , radiology , diabetes mellitus , linguistics , philosophy , endocrinology
Experience of surgical and complex treatment more than 2500 patients with the purulent and necrotic complications of various forms of a diabetic foot syndrome was generalized. The number of such patients in our unit for the last fifth anniversary in comparison with previous years was doubled. At an ischemic form vasodilating complex therapy was carried out. At the femoral and popliteal block with a limited distal necrosis autovenous shunting with the subsequent economical necretomy was carried out, without sending of the patient from the septic surgical unit. In a case of the neuropathic form of a diabetic foot syndrome drainage of suppurative focuses, economical and sometimes repeated necretomies at various levels of the foot was made. It allowed us to keep foot of the patient for an extremity support in 80 % of the all cases. Frequency of high amputations in recent years was reduced, at the level of a femur from 13 to 1.4 %, at the level of a shin - from 11.5 to 5.8 %. In diagnostics, operation scoping and an assessment of effectiveness of treatment, researches of microcirculation by means of the device «Minimax-Doppler-К» were used. When the indexes of the peripheral speed of a linear bloodflow more than 1.6 mm/sec and rate of volume flow more than 0.0128 ml/min reamputation was not required.