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Aim. To present results of combined surgical treatment of the ischemic form of diabetic foot syndrome complicated by pyonecrotic process. To show thatthe use of modern diagnostic tools and the choice of adequate treatment strategy permits to substantially reduce the number of above-the-knee amputations. Materials and methods. A total of 140 patients with diabetes mellitus and critical ischemia of lower extremities were under observation during 2004-2008.All of them had purulent and/or necrotic foot lesions. The patients were examined by X-ray, computed and magneto-resonance tomography of the feet,duplex scanning of lower leg vasculature, transcutaneous measurement of PO2, pelvic and lower leg arterial angiography. Results. A strategy of surgical treatment was developed to be used depending on the patients health status, clinical features and severity of pyonecroticprocesses in the foot, and the degree of involvement of the main blood vessels of lower extremities. Conclusion. Combination of endovascular surgery with various methods for plastic wound closure permits to extend the range of possibilities for the treatmentof high-risk patients, such as those with pyonecrotic lesions and neuroischemic form of diabetic foot syndrome. This approach opens up prospects fora significant decrease of percentage of above-the-knee amputations and improves the quality of life in these patients.

The article presents the experience of successful complex treatment in a patient of high anesthetic risk with chronic postoperative sternum and ribs osteomyelitis developed after sternotomy for cardiac tamponade (perforation during radiofrequency ablation of the pulmonary veins mouths and cavotricuspidal isthmus) and retrosternal abscess associated with the presence of foreign bodies.

The article presents a method of surgical treatment that may be used for therapy of diabetic osteoarthropathy in the cases of complete loss of support ability of limbs due to purulent complications: total purulent destructive osteoarthritis of the ankle joint, panflegmona involving the middle and posterior skeletal sections of the foot (patent application No. 2014142790 dated 23.10.2014). The method is in two-stage surgical treatment of this category of patients. The 1st stage is guillotine amputation of the lower third of the shin that allows removing the purulent center, which causes severe intoxication in patients and determines, in particular, the severity of their condition, radically, completely and quickly (within 5–7 min), and significantly reducing intraoperative blood loss and "energy loss" through the wound in the postoperative period (the small size of the wound with guillotine amputation), which leads to rapid recovery in the postoperative period; as well as stopping swelling of the leg as soon as possible and creating the conditions for reamputation with saving of the knee joint. The 2nd stage is reamputation of the affected extremity on the border of the upper and the middle third of the shin with the fasciomyoplastic method as a scheduled surgery. Due to application of the two-staged surgical, it is possible to prevent development of generalization of the infection and death, save the knee joint, reduce the rehabilitation period, and significantly improve the quality of life of patients.