METHOD OF CULTURAL PROCESSING AFTER COMPLETION OF HIGH TRANSMETATARAL FEET AMPUTATION BY SHOPAR
DOI:
https://doi.org/10.11603/1811-2471.2019.v0.i2.10386Keywords:
diabetes mellitus, diabetic foot syndrome, purulent necrotic lesions of the feetAbstract
Today, worldwide diabetes mellitus (DM) has been acknowledged by leading medical specialists as one of the most important non-communicable diseases, the prevalence of which has become pandemic. This is largely due to an increase in the population and age of the planet population, urbanization of the territory, obesity and sedentary lifestyles. In general, patients with diabetes mellitus, complicated by diabetic foot syndrome (DFS) undergo 40–70 % of amputations of the lower limbs of nontraumatic genesis, which in this group of patients are performed 10–15 times more often than in the general population.
The aim of the study – on the basis of the proposed optimization of the technique of "small" amputations to improve the known method of high amputation of foot by Shopar by reducing the number of acute angles of the dent of the affected part of the bone.
Material and Methods. The technique, improved by us, was used for 52 patients aged 42 to 80 years who were treated at the surgical vascular departments of the Ternopil University Hospital with purulent necrotic lesions of the distal foot on the basis of diabetes mellitus. The results were compared with the control group of patients undergoing high transmetatarsal amputation by the classic Jigli saw blade.
Results. For amputation of bone tissue, a cut metal disk with a diameter of 22 mm was used which, with the help of the electric drive, rotates at a speed up to 20000 revolutions per minute. Spotted bones where the faces of diaphysics and bacillus face at an angle are treated by gradual grinding with a corundum grinding nozzle of 5 mm in the form of a layer for 1–3 minutes at a speed of 10.000 per minute and a 5 mm corundum nozzle with a cone for 2–4 minutes at a speed of 15.000–20000 revolutions per minute until the sharp edges of the diaphyses and backside faces did not turn into the most rounded shape. Separating sites and sanding bones were covered with soft fabrics, forming a token thus.
Conclusions. The proposed method of treating bone sputum after performing high transmetatarial amputation of the foot on the Shapora ensured the absence of sharp corners in the spit areas, which made it possible to uniquely traumatize the surrounding soft tissues, greatly reduced the patient's sensation, shortened the period of healing of the wound surfaces, and accelerated the medical and social rehabilitation of the patient.
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