[Problems in the surgical treatment of diabetic gangrene]

Parallel to life expectancy prolongation and constantly improving life style of diabetic patients in this country, observed during the last decade, the problems relating to complications in diabetes become of primary importance. From 60 to 70 per cent of the diabetics with foot ulcerations have neuropathy. The serious forms of nerve involvement appear to be a major cause of lower extremity amputation. Analysis of the clinical case material, covering 382 patients with diagnosis diabetic gangrene, is done with the purpose to reduce the percentage of disabling high-level amputations, and determine with precision the scope of operative activity, indications for operative intervention and type of surgical procedure in diabetic patients. A total of 58 major amputations are performed, with their overall rate amounting to 13.6 per cent. The main trends of the therapeutic approach to diabetic foot are aimed at performing sparing, economically more beneficial operations, not leading to invalidization.