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№3' 2019

SURGERY

International Medical Journal, Vol. 25., Iss. 3, 2019, P. 24−28.

DOI (https://doi.org/10.37436/2308-5274-2019-3-4)

EFFICIENCY OF NECROTOMY AND CONTINUOUS DRAINAGE OF BURN ZONE WITH SUBFASCIAL LESIONS

SI "V. T. Zaytsev Institute of General and Emergency Surgery of the National Academy of Medical Sciences of Ukraine", Kharkiv, Ukraine

Thermal injuries occupy the 3rd−4th places in the structure of injuries, being an urgent problem of modern clinical medicine. A critical increase in intra−tissue pressure in various injuries leads to an irreversible necrobiotic process in the tissues. In these cases an emergency fasciotomy, helping to normalize intra−tissue pressure is indicated. In order to evaluate the clinical effectiveness of the necrotomy in a tissue compartment syndrome, providing an optimal drainage of the affected tissues and an active effect on the near−wound zone by lymphotropic therapy, a survey of patients with deep subfascial burns was performed. It has been found that necrotomy and flow drainage of the burn zone in case of subfascial lesions by improving microcirculation and lowering the level of intoxication reduce the readiness of burn wounds for primary necrectomy and accelerate the complete cleansing of the lesion area from necrotic tissues. The quality of the granulation cover made it possible to perform operations aimed at restoring the skin in optimal terms with a sufficiently high engraftment of autografts.

Key words: burns, tissue compartment syndrome, necrofasciotomy, ozone therapy.

REFERENCES

1. Tkach A. V. Sposoby diagnostiki mestnogo gipertenzionno−ishemicheskogo sindroma u patsientov s ozhogami konechnostei / A. V. Tkach // Tavricheskii mediko−biologicheskii vestn.− 2012.− T. 15, № 1.− S. 245−247.

2. Strafun S. S. Diagnostika kompartment−sindroma u patsientov s ozhogami konechnostei / S. S. Strafun, G. P. Kozinets, A. V. Tkach // Tavricheskii mediko−biologicheskii vestn.− 2012.− T. 15, № 4 (60).− S. 394−398.

3. Kezlya O.P. Ostryi kompartment−sindrom kak oslozhnenie kostei goleni / O. P. Kezlya, L. V. Givoino // Novosti khirurgii.− 2010.− T. 18, № 4.− S. 146−156.

4. Cooper G. G. Delayed presentation of bilateral popliteal artery injury / G. G. Cooper // Eur. J. Vasc. Surg.− 1992.− № 6.− P. 659−661.

5. Contemporary approaches to necrotomy and fasciotomy in surgical practice / S. N. Khunafin, R. M. Zinatullin, T. R. Gizatullin [i dr. ] // Meditsinskii vestn. Bashkortostana.− 2011.− № 6 (1).− P. 45−48.

6. Efteev A. A. O subdermal'nykh nekrektomiyakh okaimlyayushchim razrezom pri "pogranichnykh" porazheniyakh funktsional'no aktivnykh i kosmeticheski znachimykh zon / A. A. Efteev, Yu. I. Tyurnikov // Sb. tezisov III s"ezda kombustiologov Rossii; 15−18 noyabrya 2010 g., g. Moskva.− M., 2010.− S. 203−204.

7. Pat. 2342909 S1 Rossiiskaya Federatsiya, MPK A61 V 17/00 Sposob nekrotomii pri termicheskoi travme / S. N. Khunafin, A. Zh. Gil'manov, Sh. N. Galimov, T. R. Gizatullnn, P. M. Zinatullin, K. P. Zinatullina; Bashkirskii gosudarstvennyi meditsinskii universitet.− h№2007130462/14; Zayavl. 27.07.07; Opubl. 10.01.09, Byul. № 1.

8. Pat. 95223 u UA; A61B 17/00 Sposіb nekrotomії pri opіkovikh urazhennyakh / O. V. Kravtsov, V. V. Boiko, Yu. І. Kozіn; DU "Іnstitut zagal'noї ta nevіdkladnoї khіrurgії іm. V. T. Zaitseva NAMN Ukraїni".− u201407883, Zayavl.14.07.2014; Opubl. 10.12.2014, Byul. № 23.

9. Fayazov A. D. Patogeneticheskie aspekty protivoshokovoi terapii pri tyazheloi ozhogovoi travme / A. D. Fayazov, U. R. Kamilov, D. B. Tulyaganov // Vestn. ekstrennoi meditsiny.− 2018.− № 4.− S. 55−60.

10. Ostrovskii V. K. Leikotsitarnyi indeks intoksikatsii pri ostrykh gnoinykh i vospalitel'nykh zabolevaniyakh legkikh / V. K. Ostrovskii, Yu. M. Svitich, V. R. Veber // Vestn. khirurgii im. I. I. Grekova.− 1983. − T. 131, № 11.− S. 21−24.