COMPARATIVE ANALYSIS OF THE RESULTS OF COMPLEX OPERATIVE-MEDICAL TREATMENT OF PATIENTS WITH COMPLICATED FORMS OF THE DIABETIC FOOT SYNDROME
Objective: Conduct a comparative evaluation of the effectiveness of the surgical and medicamentous treatment of the complicated forms of the diabetic foot syndrome (DFS). Methods: The results of complex diagnostics and treatment of 310 patients with the complicated form of DFS for the period 2013-2016, hospitalized in the Surgical Department of the State Clinical Hospital № 3 in Dushanbe, were analyzed. The men were 132 (42.5%), women - 178 (57.5%). The age of the patients variated from 38 to 84 years. Duration of treatment from the moment of its fluctuation from 2 to 21 years. The absolute majority of patients who suffered from serious forms of diabetes mellitus (DM): DM type I - 8.2%, DM type II - 91.8%. Results: With the purpose to distalize the level of amputation to support function of the foot, against the background of appropriate conservative therapy, a two-stage operational tactic was used. At the first stage, opening rots and small surgical interventions on the foot were carried out, on the second stage the plastical substitution of shortcoming tissue of foot and forming of the stump on the level of under the one-third of the shin. A reduction of the lethality has come after amputation to 1.9%, in total lethality to 7.1%. Metatarsal resections and exarticulation of toes of foot in 92.5% of cases where the reason for the repeated hospitalization of patients with an ipsilateral limb in consequence of amiss orthopedical correction of the impaired supporting function. Conclusions: The main point of the treatment for patients with complicated forms of DFS is the timeliness and correctness of the choice of methods of surgical and medicamentous treatment. At the same time, it is necessary to adhere to the organo-saving and functionally-effortless tactics of the operative interventions.