Features of preoperative preparation of patients with occlusive diseases of the lower limbs arteries

Abstract

The aim of the work. To analyze the main stages of preoperative diagnostics and features of antibiotic therapy in patients with occlusive diseases of the arteries of the lower extremity, who underwent non-traumatic amputations. Materials and methods. There were performed analysis of clinical examination and treatment of 189 patients with obliterating diseases of the lower extremity arteries. The retrospective phase of the study included 115 patients who were underwent lower extremity amputations at various levels during 2010-2014. The prospective phase of the study included 74 patients in whom lower limb amputation was performed during 2015-2018. Results and Discussion. In retrospective patients, signs of SIRS were more common (<0.01). According to ultrasound, occlusion of the arteries of the tibiawas most common in the retrospective stage (p <0.01) and prospective (p <0.001). In 12 patients (10.4±2.85%) of the retrospective stage and 31 patients (41.89±5.74%) of the prospective stage, a computed tomographic examination of the arterial of the lower extremity was performed for preoperative assessment of the probable level ofa mputation, itevaluate not only the level of occlusion or stenosis, but also the state of collateral circulation, which in fluenced the choice of the level of limb amputation. There was analyze the dynamic of the use of different groups of antibacterial drugs in different years, the decrease of cephalosporins and fluoroquinolones and increase of carbapenems and aminoglycosides were noted. Conclusions. The duration of preoperative preparation was dependent on the presence of the SIRS. Between 2015 and 2018, the number of patients with occlusive disease increased in which pre-operative diagnostics included, besides ultrasound Doppler scanning, computed tomography. Changes in the prescriptions of antibacterial drugs were noted.