[Peculiarities of the occurrence of soft tissue disorders and prospects of their closure in patients with diabetes mellitus].

Cause and mechanisms of the foot soft tissues defect (FSTD) and efficacy of its closure were analyzed in 62 patients with diabetes mellitus. FSTD presented as chronic infected (in 7 observations) or uninfected (in 4) ulcer of foot or it occurred acutely immediately after excision of necrotized tissues (in 32) and after the operation due to disordered healing of wound or to necrosis of her edge (in 12). In presence of osteoarthropathy, purulent inflammation as a consequence of trauma or isolated affection of toes II or III the conduction of intensive antibacterial therapy permits to eliminate purulent inflammation during 4-7 days and than to close FSTD using existing methods. Occurrence of FSTD on background of disordered blood supply of foot forces to conduct not only systemic, but intensive local antibacterial therapy as well, yet it is not possible to achieve clearing of all the wound. In such a case it is expedient to perform staged closure of little-infected places of wound and sawn surfaces of the bones, what reduces the wound cachexia of patient and promotes the foot stump preservation. Closure of chronic ulcer of the foot by the cutaneous flap transposition must be done on background of alprostan injections.