HIGH LEVEL LOWER EXTREMITY AMPUTATION METHOD FOR TREATING DIABETIC ANGIOPATHY AND OBLITERATING VASCULAR DISEASE PATIENTS FOR GANGRENE

摘要

FIELD: medicine.;SUBSTANCE: method involves cutting out anterior and posterior fasciocutaneous flap with R₁=L/2&Pgr; R₂=2L/3&Pgr;, where R₁ is the anterior flap length, R₂ is the posterior flap length and &Pgr; is the coefficient &pgr;=3.14. Muscle bulk is transected at the level of distal edge of contracted fasciocutaneous flap. The anterior muscle group is transected in perpendicular to longitudinal femur axis. The posterior muscle group is obliquely transected in the direction from bone amputation level to posterior fasciocutaneous flap edge. Individual femoral blood vessels exposure (arteries and veins under individual ligation), sciatic nerve exposure with 2-5 ml of 2% novocaine solution and 2-3 ml of 96% alcohol being injected, mechanical cross-clamping and placing descendant ligature is carried out. Subperiosteal saw bone cut is carried out without treating medullary canal thereafter. Thorough primarily postponed hemostasis is carried out after preliminary hemostasis. It includes covering wound surface of anterior and posterior muscle bulk with napkin wetted with 3% hydrogen peroxide solution for 4-6 min and point-mode hemostasis at the points the napkin is impregnated with blood. Fasciomuscular bulk are sutured layer-by-layer: first, anterior muscle group is sutured with the posterior one with widely spaced sutures over perimysium with all muscles of anterior and posterior muscle group being involved and then, fascia is sutured with close spaced sutures separated with 8-9 mm big gaps.;EFFECT: reduced postoperative complications frequency.;1 tbl