Leg amputations: a differentiated approach to performance depending on the lesion of the arterial basin
Abstract
Aim: to improve the results of lower leg amputations with a differentiated approach in patients with critical lower limb ischemia (CLLI) on the background of diabetes mellitus (DM).Material and research methods. This study is aimed at improving the results of amputations at the levelof the lower leg, taking into account the affected part of the foot (angiosomes) and the appearance of theprimary pathological focus. This paper presents an analysis of the results of examination and treatment of73 patients with gangrene of the lower extremities on the background of diabetes mellitus. The patientswere hospitalized in 2018–2021. in the center of the department of purulent surgery at the multidisciplinary clinic of the Tashkent Medical Academy. The main instrumental research method was multislicecomputed tomography of the arteries of the lower extremities (MSCT) and duplex scanning of the arteriesof the lower extremities, which provided final information about the state of the peripheral arterial bed.All patients underwent amputation of the lower leg at the level of the upper third by a new differentiatedmethod.Results and their discussion. Analysis of the results of treatment of patients with diabetic gangrene ofthe extremity showed that with the correct determination of the strategy for performing amputation ofthe lower leg in 97.3% of cases, it is possible to ensure a smooth course of the postoperative period, withprimary wound healing. These results were achieved due to the correct selection of the level of lower legamputation according to the differentiated method developed by us.