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 level
of the lower leg, taking into account the affected part of the foot (angiosomes) and the appearance of the
primary pathological focus. This paper presents an analysis of the results of examination and treatment of
73 patients with gangrene of the lower extremities on the background of diabetes mellitus. The patients
were 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 multislice
computed tomography of the arteries of the lower extremities (MSCT) and duplex scanning of the arteries
of 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 differentiated
method.
Results and their discussion. Analysis of the results of treatment of patients with diabetic gangrene of
the extremity showed that with the correct determination of the strategy for performing amputation of
the lower leg in 97.3% of cases, it is possible to ensure a smooth course of the postoperative period, with
primary wound healing. These results were achieved due to the correct selection of the level of lower leg
amputation according to the differentiated method developed by us.