Pathogenetic Approach in Complex Treatment of Diabetic Foot Syndrome with Critical Lower Limb Ischemia

Comparative analysis of the results of complex treatment of 330 patients showed that when choosing tactics of treatment of diabetic foot syndrome with signs of critical ischemia of the lower extremities, preference should be given to a complex effect on all parts of the pathological process (infection, inflammatory reaction, critical reduction of hemopoiesis), which will contribute to a reliable advance in terms of cleansing the wound from infection, terms of resorption of infiltration around the wound, oxygen saturation of tissues, the appearance of granulation and epithelialization. For this purpose, it is advisable to simultaneously combine the use of intra-arterial injections of oxygenated perfluorocarbons (Perftoran) and local laser photodynamic therapy, which leads to a reduction in the duration of hospital treatment from 23.5±3.5 to 14.5±1.5 bed days and a significant reduction in the number of forced high amputations of the lower limbs from 36% to 6.25%, as well as the number of deaths from 14.11% to 2.5% of cases