The main trends in the surgical practice of lower limb amputations in the Kyrgyz Republic

The purpose of the study : to study the features of the frequency and nature of high amputations performed in the Kyrgyz Republic. Materials and methods . The statistical indicators of the database "Treated case" of the Compulsory Medical Insurance Fund of the Kyrgyz Republic from January to December 2022 were studied, which included gender, age, ways of hospitalization, main and concomitant diagnoses, duration of hospitalization, duration of stay in the intensive care unit, main and repeated surgical interventions, frequency and structure of complications, outcome. Research results . In the Kyrgyz Republic, from January 1 to December 31, 2022, amputations of the lower extremities were performed in 923 patients. Of these, 41.5 % are women, 58.5 % are men. By age, there was a predominance of elderly (36.7 ± 1.6%) and middle-aged (35.5 ± 1.6%), less senile (14.1 ± 1.1%) and young (13.7 ± 1.1%). The main causes of amputations were complicated forms of diabetic foot syndrome (65.7 %), less often vascular diseases without diabetes mellitus (18.3 %) and other causes: injuries, purulent bone diseases and others (16.0 %). The average duration of hospitalization was 13.4 ± 1.8 days. High amputations were performed in 34.1 %, and small amputations in 65.9 % of cases. The ratio of transtibial to transfemoral amputations was 1 : 9.1. Reamputations in the early postoperative period after high amputations were performed in 8.6% of cases due to the development of purulent necrotic complications. The mortality rate for all amputations in the early postoperative period was 2.3 %, and in the group of patients after high amputations, the mortality rate was 7.7 times higher (5.4 %) than after small amputations. Conclusions. The high proportion of high amputations in patients of working age, mainly due to purulent-necrotic complications of diabetic foot syndrome, confirms the high social significance of the medical problem. The predominance of transfemoral amputations over transtibial amputations in the structure of high amputations, the high proportion of reamputations in the early postoperative period indicates the need to develop and implement a strategy for surgical treatment of purulent necrotic lesions of the lower extremities in patients with diabetes mellitus and in its absence.