THE CHOICE OF SURGICAL TACTICS METHOD IN DIABETES MELLITUS

Abstract

Despite the development of medical science, the problem of surgical infection remains a pressing problem, since complications with surgical infection in diabetes mellitus account for up to 30-40% of all patients of the surgical profile. Among the causes of sepsis, inflammatory, purulent-necrotic complications of soft tissues in diabetes mellitus prevailed in 44% of cases. Under our observation, 64 patients with diabetes mellitus and diabetic foot complicated by necrotizing fasciitis were receiving inpatient treatment. Timely diagnosis of purulent-necrotic complications of soft tissues and of diabetic foot is the key to success in the treatment of this pathology. In order to clarify the severity of macro- and microvascular lesions, all patients underwent ultrasound, X-ray (radiography of the extremities, fluoroscopy of the chest) and Doppler examination. If necessary, CT and MSCT were performed. All our patients underwent timely surgical treatment, that is, opening of phlegmons and abscesses of the buttock, thigh and shin through wide incisions with removal of necrotic tissues. In individual cases, because of the severity of the patients' condition, it is impossible to perform a complete necrectomy.