Therapeutic management for patients with trunk and extremities integumentary tissues defects of traumatic genesis
DOI:
https://doi.org/10.14739/2310-1237.2017.1.97791Keywords:
wound, injury, tissue cover, hyaluronic acid, flapAbstract
Objective: To improve the results of treating patients with wounds, functional and aesthetic defects of mechanical origin by developing a comprehensive program of surgery to restore the form and function of trunk and limbs.
Materials and methods. The criteria for the inclusion into the study: both genders patients aged over 17 years with diagnosed skin and adjacent soft tissues of trunk and limbs defect that needed restoration of body form and functions.
We have operated 231 patients with integumentary tissue defects of a mechanical origin in the clinic. There were 129 men, 102 women of them. The patients’ age ranged from 17 to 76 years.
Results. All the patients were divided into 4 groups depending on the size, depth and the extent of damage of soft tissues and other structures of the body and limbs. I group – 79 (34.2 %) patients with isolated soft tissues damage (to the fascia): 32 (13.85 %). II group – 67 (29 %) patients with injuries of integumentary tissues of a moderate severity whose vital activity was disturbed in a limited area with parawound zone (lower from fascia). III group – 48 (20.8 %) patients (tissues damage to a significant extent). IV Group – 37 (16 %) patients, whose trauma was accompanied by injury of a vascular-neural fascicle, partial or complete extremity abjunction.
Conclusions. 1. The choice of corrective surgical intervention method and the closure of the integumentary tissue defect depended on the size, the depth of the wound and hemodynamic characteristics of the damaged area. 2. The new method of treating the consequences of traumatic injuries using the preparation of hyaluronic acid expanded the prospects of treating patients with integumentary tissues defects. 3. The differential approach to the choice of the method of closing the wound surfaces caused by mechanical damage made it possible to achieve satisfactory results in 97.84 % of cases.
References
Kichemasov, S. Kh., & Skvorcov, Yu. R. (2012) Kozhnaya plastika loskutami s osevym krovosnabzheniyem pri ozhogakh i obmorozheniyakh IV stepeni [Skin grafting flaps with axial blood supply for burns and frostbite grade IV]. Saint Petersburg: Hippokrat. [in Russian].
Petrov, N. V., Brovkin, S. V., Kalashnik, A. D., Tadzhiev, D. D., Karev, A. S., & Petrov, E. A. (2013) Optimizaciya lecheniya otkrytykh perelomov goleni s tyazheloj travmoj myagkikh tkanej [Optimization of treatment of open fractures of the tibia with severe trauma m'yakih fabrics]. Rossijskij medicinkij zhurnal. Khirurgiya, 15, 805–808. [in Russian].
Ponomarenko, O.V., & Virskyi, N. V. (2011) (patentee) Pat. 65158 AUkrayina, IPC A61K31 / 00. Sposíb líkuvannia trofíchnykh vyrazok nyzhníkh kintsivok [Method for the treatment of venous ulcers of the lower kintsivok]. Bulleten, 22. [in Ukrainian].
Sekela, T. Ya. (2010) Patohenetychni osoblyvosti perebihu tiazhkoi travmy v poiednanni z mekhanichnym poshkodzhenniam shkiry ta pry zastosuvanni ksenodermoplastyky (Avtoref. dis…kand. med. nauk) [Pathogenetic peculiarities of severe injuries in conjunction with mechanical damage to the skin and the application ksenodermoplastyky]. (Extended abstract of candidate’s thesis). Ternopil. [in Ukrainian].
Sotnyk, A. M. (2008) Plastyka hlybokykh defektiv homilky ta stopy vaskuliaryzovanymy klaptiamy (Avtoref. dis…kand. med. nauk) [Plastic deep leg and foot defects vascularized patches]. (Extended abstract of candidate’s thesis). Donetsk. [in Ukrainian].
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).
