This report presents the results of complex surgical management of 78 patients with neuroishemic type diabetic foot syndrome. The strategy for surgically managing a purulo-necrotic complications of diabetic foot including several steps: revascularization by endovascular intervention, aggressive and extensive surgical debridement. And the final step consist soft tissue and skeletal reconstruction after infection eradicated to obtain wound closure and limb salvage. Active surgical treatment allows to increasing percentage of preserved limbs in 91.1% of patients with diabetic foot syndrome.