Introducere: Diabetul zaharat (DZ) în 2016 a fost estimat la 428 milioane de bolnavi la nivel mondial, Pentru micæora dezvoltarea
complicaåiilor DZ (gangrena æi infecåiilor severe) este necesar sã se menåinã permanent un nivel al glucozei sanguine sub 11.1
mmol/l. DZ, æi precedã 84% din toate amputaåiile netraumatice.
Materiale æi metode: A fost efectuat un studiu prospectiv pe 89 pacienåi cu PD, gangrene æi necroze la nivelul membrului inferior,
cuprinæi între vîrsta 35-89 ani, raport barbat/femei 59/30. Aceætia au fost internaåi în secåia Chirurgie Generalã al IMSP SCR Chiæinãu,
departamentul PD, în perioada 2014- decembrie 2017, efectuîndu-se tratamentul etapizat al proceselor necrotico-purulente
neuropatic (42%) æi neuroischemic (58%), iar gradul de ischemie a fost stabilit prin examinari Dulpex-Color al aa.membrilor
inferioare æi angiografie. La pacienåi a fost aplicat tratamentul: 1. Sanarea flegmoanelor (SF)-36(40,90%) cazuri; 2. SF+ amputatie
(AP)+plastia defectelor -28(31,81%)cazuri; 3. endovascular+ SF+AP+plastia defectelor- 24(27,27%) cazuri.
Rezultate: Sanarea focarilor septice la limita tesuturilor viabile cu plastia ulterioara s-a rezolvat într-o perioadã de 6-9 sãptãmîni,
tramentul endovascular în complex cu o sanarea adecvatã s-a rezolvat într-o perioadã de 7-10 sãptãmîni.
Concluzie: Tratamentul endovascular apoi reconstuctiv în PD are cea mai inalta ratã de succes æi evitarea amputaåilor înalte în 83%.
Problema economico-socialã a PD poate fi redusã doar printr-o abordare complexã æi multidisciplinarã al fiecãrui caz în parte.

Introduction: Diabetes mellitus (DZ) in 2016 was estimated at 428 million worldwide. To reduce the development of DZ complications
(gangrene and severe infections) it is necessary to maintain a blood glucose level below 11.1 mmol / l. DZ, and precedes 84%
of all non-traumatic amputations.
Materials and methods: A prospective study was conducted on 89 patients with PD, gangrene and necrosis in the lower limb, aged 35-
89 years, male / female report 59/30. They were hospitalized in the Department of General Surgery of IMSP SCR Chiæinãu, department
PD, during the period 2014- December 2017, and the stage of the necrotic-purulent neuropathic (42%) and neuro-ischemic (58%)
treatment was performed and the degree of ischemia was determined by Dulpex-Color examinations of the inferior inferior members and
angiography. Patients were treated with:1. Relief of phlegm (SF) -36 (40.90%) cases, 2. SF + amputation (AP) + defect plaster -28
(31.81%) cases, 3. endovascular + SF + AP + defect plaster - 24 (27.27%) cases.
Results: Septic focusing at the boundary of viable tissue with subsequent plaster resolved within a period of 6-9 weeks, the
endovascular tract in the complex with adequate nutrition was resolved within a period of 7-10 weeks.
Conclusion: The endovascular treatment then reconstituted in PD has the highest rate of success and the avoidance of high amputations
in 83%. The economic and social issue of PD can only be reduced by a complex and multidisciplinary approach to each case.