METHOD OF LOWER LIMB TISSUE ANALYSIS FOR VIABILITY IN DIABETIC GANGRENE Russian patent published in 2009 - IPC A61B5/107 A61B6/00 G01N33/48 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to pathological anatomy. Lower limb tissues are analysed for viability in diabetic gangrene, namely: state of cutaneous covering, great vascular permeability, stage of atherosclerosis morphogenesis, arterial luminal narrowing, X-ray signs of osteopathy; it is followed with evaluating the histologic factors of skin, muscular, vascular and nervous tissues of lower limb; wall thickness and internal arteriole diametre are measured; then activity of "НАД"·H₂-dehydrogenase, alkaline and acid phosphotases is evaluated in derma and muscles. In case complete, damp, pake pink cutaneous coverings are observed with maintained great vascular permeability, atherosclerosis of morphogenesis stage II-III with 25% intima lesion, absence of arterial luminal narrowing, absence of X-ray signs of osteopathy, in histologic examination - distinguished differentiation of cutaneous covering on epidermis and derma, indistinct interstitial hypostasis of muscular fibres, "sorbtion" atherosclerosis, plasmatic impregnation and thickenings of arteriole and capillary basic membranes, hydropic degeneration of nerve cells, absence of inflammatory reaction in all the tissues, arteriole wall thickness 17.8±1.2 mcm, internal arteriole diametre 29.4±0.9 mcm, activity of "НАД"·H₂-dehydrogenase in derma 169.7±8.3 standard units, in muscle 339.4±7.4 standard units, activity of alkaline phosphotase in derma 116.3±7.8 standard units, in muscle 90.5±4.3 standard units, activity of acid phosphotase in derma 115.9±11.6 standard units, in muscle 68.6±3.5 standard units, lower limb tissues are considered to be viable. If pastose, dense, dark-cherry and black coloured cutaneous covering is observed with skin defects 100-200 cm² and more and ichorous smell, obstructed great arteries with atherosclerosis of morphogenesis stage III-VI of lesion over 50% of intima area, severe arterial luminal narrowing, X-ray guided diffuse osteoporosis, osteolysis, regional osteophytes, joint narrowing and deformations, in histologic examination - ulcerative skin defects with evident inflammatory cell reaction, derma thinning, atrophic processes of epidermis and derma with necrosis nidi, evident interstitial hypostasis of muscular fibres, considerable focal myolysis and fibrosis with evident mesenchymal reaction, "destructive" atherosclerosis, microcirculation arterial luminal narrowing due to circular hyalinosis to their obliteration, hydropic degeneration of evident dissociation and demyelination of nerve fibres, diffuse leukocytic and macrophage infiltration, histolysis, arteriole wall thickness more than 31.6±0.9 mcm, internal arteriole diametre less than 11.2±0.7 mcm, activity of "НАД"·H₂-dehydrogenase in derma less than 109.5±6.9 standard units, in muscle less than 273.6±8.4 standard units, activity of alkaline phosphotase in derma less than 99.4±4.2 standard units, in muscle less than 69.2±9.3 standard units, activity of acid phosphotase in derma more than 144.8±6.5 standard units, in muscle more than 111.2±7.6 standard units, lower limb tissues are considered to be devitalised.

EFFECT: higher objectivity and reliability of lower limb tissue analysis for viability in diabetes with progressing necrotic suppurative process.

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