Development of a therapeutic and diagnostic algorithm for selecting treatment strategies for patients with deep paraproctitis in the context of diabetes mellitus.

Deep paraproctitis in patients with diabetes mellitus is characterized by a severe clinical course and a high risk of purulent-necrotic complications. This study presents a stepwise diagnostic and therapeutic algorithm for selecting the optimal treatment strategy in this patient population, based on a risk stratification scoring system incorporating clinical, laboratory, and instrumental parameters. The analysis included 101 patients treated in surgical hospitals between 2010 and 2025. The proposed algorithm enables personalization of diagnostic and surgical management and improves the rationale for clinical decision-making.