DIFFICULTIES OF LOWER LIMB AMPUTATION IN PURULENT SURGERY (LITERATURE REVIEW)

The analysis of modern literature shows that the methods proposed so far for studying the viability of tissues of the affected limbs to optimize the level and method of amputation have a number of shortcomings, or are not sufficiently reliable. Injury of the extremities, gangrene of the foot and lower leg in vascular diseases and diabetes mellitus, tumors, osteomyelitis, defects and deformities of the lower extremities, trophic ulcers may be an indication for amputations at various levels of the lower extremities. Therefore, the search and development of new criteria for determining the level of amputation of the lower extremities continues. Despite significant advances in the modern treatment of occlusive peripheral arterial disease, acute lower limb ischemia is still characterized by significant morbidity, the threat of limb loss, reduced quality of life and mortality, and continues to pose a problem for the vascular surgeon. When preparing for limb amputation, special attention should be paid to correcting the rheological and coagulation properties of blood, normalizing the functional state of the myocardium, as well as specialized psychotherapeutic training for timely and adequate psychological adaptation of the patient.