Priority in choosing the method of surgical stump correction after amputation оf the distal foot in patients with different forms of diabetic foot syndrome
DOI:
https://doi.org/10.11603/2414-4533.2021.1.12025Keywords:
diabetic foot syndrome, transmetatarsal amputation, electromechanical debridement, xenoplasty, autodermoplastyAbstract
The aim of the work: to improve the results of surgical treatment of patients with various forms of diabetic foot syndrome by choosing adequate closure of the stump defect after transmetatarsal amputation.
Materials and Methods. The analysis of the results of treatment of 72 patients with complicated type II diabetes mellitus was performed. The neuropathic form predominated and amounted to 65.3 %, neuro-ischemic – 29.2 % and ischemic – 5.5 % of all operated patients. All had stage III and IV distal foot lesions according to the Meggit-Wagner classification. All patients underwent transmetatarsal amputation. To prevent complications in the postoperative period, amputations of the distal part of the foot were performed by electromechanical vibration technique with closure of the stump in neuropathic form with a free lower flap and in neuro-ischemic or ischemic forms of diabetic foot syndrome using early xeno- or autodermoplasty after the heliotic method of amputation.
Results and Discussion. This approach allowed us to close the defect of the distal stump in those groups of patients with neuro-ischemic and ischemic forms of diabetic foot syndrome, where vascular reconstructive surgery was not possible on clinical and diagnostic grounds.
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