[Lower limb critical ischaemia in patients of a pyoseptic surgery unit]

The authors retrospectively analysed therapeutic results of treatment in a total of 749 patients of the Pyoseptic Surgery Unit with signs of lower limb critical ischaemia. Of these, 101 (13.5%) patients were found to have a pronounced septic process (successfully arrested in 88 patients). A further 86 (11.5%) patients were diagnosed with extended trophic alterations making revascularization unpromising. The incidence rate of "major" amputations in this group amounted to 34.2%, with a lethality rate of 5.9%. Severe somatic pathology was revealed in 106 (14.2%) patients, with the incidence of "major" amputation in this group equalling 27.4% and lethality rate - 10.4%. The neuropathic form of diabetic foot syndrome with no evidence of ischaemia was noted observed in 174 (23.2%) patients, "major" amputations in this group were performed in 3 (1.7%) patients, with a lethality rate of 0.6%. Impossibility of revascularization had previously been ascertained in 98 (13.1%) patients; "major" amputations in this group were performed in 38 (38.8%) patients, with a lethality rate of 6.1%. Sixty-nine (9.2%) patients were admitted for further treatment after previously performed reconstructive operations, including unsuccessful ones; the frequency of major amputations and lethality rate in this group amounted to 13.0 and 2.9%, respectively. Of the total number of the analyzed patients, 207 (27.1%) required considering the problem concerning possibility of revascularization. Surgical revascularization was performed later on in 34 (16.7%) patients in this group, and the incidence of "major" amputations amounted to 5.9% remaining at the same level in the remote period of follow up. In patients who were not subjected to revascularization, the incidence of "major" amputations during 3 months amounted to 9.5% reaching 27.2% by 42 months of follow up. The survival rate after 42 months in these groups amounted to 72.7 and 68.0 %, respectively.