Plastic Surgery in Patients with Soft-tissue Infection


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Abstract

The purpose of the study To improve the results of the treatment of patients with purulent wounds through the development and introduction of a differentiated approach to the selection of skin plastic and reconstructive surgeries into clinical practice. Materials and methods The results of the treatment of 312 patients with purulent wounds of various etiologies were analyzed. The age of the patients ranged from 15 to 82 years. The wounds with the area of no more than 100 cm2 were observed in 152 (48,7%) patients, 100-200 cm2 - in 109 (34,9%), more than 200 cm2 - in 51 (16,3%) patients. The large size of the wound defect served as an indication for performing skin grafting. Results and their discussion We noted that if the area of the wounds was less than 100 cm2 , skin flaps were used (115 (75,7%) patients). For the area of the wounds between 100 and 200 cm2 , the use of split flaps prevailed (75 (68,8%) patients). For the wounds of more than 200 cm2 , plastic by split flaps was most commonly performed as the only possible form of the wound closure (24 (47,1%) patients) or in combination with plastic by local tissues (15 (29.4%) patients). Conclusion Full-thickness skin grafting can be used for the closure of the wounds that are located in the bearing areas as well as cosmetically and functionally important zones as well as during the recovery phase of the treatment of pressure ulcers, neurotrophic ulcers and deep frostbites. A differentiated approach to the selection of skin plastic and reconstructive operations allowed to achieve 91,4% short-term and 80% long-term positive results in the treatment of patients with surgical infection.

About the authors

City Clinical Hospital № 23 named Medsantrud, Moscow, Russian Federation

Author for correspondence.
Email: author@vestnik-surgery.com
MD, Prof. of the Department of General Surgery of the First Moscow State Medical University named after I.M. Sechenov, Honored Doctor of the Russian Federation, Chief Physician of the City Clinical Hospital № 23 «Medsantrud»

I.M.Sechenov First Moscow State Medical University, Moscow, Russian Federation

Email: author@vestnik-surgery.com
MD, Prof. of the Department of General Surgery of the First Moscow State Medical University named after I.M. Sechenov, Head of Purulent Surgical Department of the City Clinical Hospital № 23 «Medsantrud»

I.M.Sechenov First Moscow State Medical University, Moscow, Russian Federation

Email: author@vestnik-surgery.com
Candidate of Medicine, Assistent Prof. of the Department of General Surgery of the First Moscow State Medical University named after I.M. Sechenov, Physician of the Purulent Surgical Department of the City Clinical Hospital № 23 «Medsantrud»

I.M.Sechenov First Moscow State Medical University, Moscow, Russian Federation

Email: author@vestnik-surgery.com
Senior Laboratory Assistant of the Department of General Surgery of the First Moscow State Medical University named after I.M. Sechenov

City Clinical Hospital № 23 named Medsantrud, Moscow, Russian Federation

Email: author@vestnik-surgery.com
Ph.D., Resident Physician of the Purulent Surgical Department of the City Clinical Hospital № 23 «Medsantrud»

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