Sepsis in patients with complicated forms of diabetic foot syndrome
Keywords:diabetes, diabetic foot syndrome, decompensation, toxic syndrome, sepsis, surgical treatment
The study of special features of septic states development and sepsis in patients with DFS allows prognosticate the clinical course of pyonecrotic processes in aforesaid patients and optimize the schemes of complex pathogenetic treatment.
Methods. There were studied the special features of sepsis development and treatment in 117 patients with complicated forms of diabetic foot syndrome. The results of sepsis development in patients with complicated forms of diabetic foot syndrome are the decompensation of diabetes mellitus, toxic syndrome, the raise of anti-inflammatory cytokines (IL-1, IL-6, TNF), the current pyonecrotic process progresses rapidly and assumes an uncontrolled character.
Results. An adequate surgical treatment combined with complex medicamental therapy allows save extremities in 54,7 %. The operations of choice for these patients are distal guillotine amputations with surgical treatment of foot to the level of Lisfranc joint or amputations of extremity on the level of shin or thigh. The high amputations are 35,1 % of general postoperative lethality.
Conclusions. Depending on character of the clinical course of pathologic process it is necessary to carry out one-phase or multiphase operative interventions on the background of complex multicomponent pathogenetic therapy. The operations of choice for these patients are distal guillotine amputations with surgical treatment of foot to the level of Lisfranc joint or amputations of extremity on the level of shin or thigh. Postoperative lethality in patients with DFS complicated with sepsis is 13,7 % and in most cases it is connected with high amputations of extremities
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