mossjМосковский хирургический журналMoscow Surgical Journal2072-3180ООО «ПРОФИЛЬ – 2С»10.17238/issn2072-3180.2021.2.77-86mossj-481Research ArticleЛИТЕРАТУРНЫЕ ОБЗОРЫLITERARY REVIEWSАКТУАЛЬНЫЕ ВОПРОСЫ ХИРУРГИЧЕСКОЙ КОРРЕКЦИИ ДЕКУБИТАЛЬНЫХ ЯЗВ (ОБЗОР)ACTUAL ISSUES OF SURGICAL CORRECTION OF PRESSURE ULCERS (REVIEW)https://orcid.org/0000-0003-1451-1015ОсмановЭ. Г.OsmanovE. G.

Османов Эльхан Гаджихан оглы - д.м.н., профессор

119991, Москва, ул. Трубецкая, д. 8, стр. 2

Osmanov Elkhan Gadzhihan oglu - Sechenov, professor119991, Moscow, Trubeckaya str., 8 /2

mma-os@yandex.ruhttps://orcid.org/0000-0002-8001-1601ШулуткоА. М.ShulutkoА. M.

Шулутко Александр Михайлович - д.м.н., профессор

119991, Москва, ул. Трубецкая, д.8, стр.2

Shulutko Аleksandr Mihajlovich - MD, PHD, professor

119991, Moscow, Trubeckaya str., 8 /2,

shulutko@mail.ruhttps://orcid.org/0000-0003-2103-6689СлепневС. Ю.SlepnevS. Ju.

Слепнев Сергей Юрьевич - к.м.н., заведующий отделением гнойной хирургии

109263, Москва, ул. Шкулева, д. 4

Slepnev Sergej Jur’evich - Head of the Department of Purulent Surgery

109263, Moscow, Shkuleva st., 4

slepnev@68gkb.ruhttps://orcid.org/0000-0002-8482-1249ЯковлевА. А.YakovlevA. A.

Яковлев Александр Алексеевич – заместитель руководителя НИИ реаниматологии

141534, Московская область, Солнечногорский район, д. Лыткино, 777

Yakovlev Aleksandr Alekseevich - head of the surgical department, MD

141534, Moskovskaya oblast’, Solnechnogorskij rajon, Lytkino, 777

Ayakovlev@fnkcrr.ruhttps://orcid.org/0000-0001-8306-2538АлтуховЕ. Л.AltukhovE. L.

Алтухов Евгений Леонидович - врач-хирург хирургического отделения с дневным стационаром НИИ реаниматологии

141534, Московская область, Солнечногорский район, д. Лыткино, 777

Altukhov Evgeniy Leonidovich - head of the surgical department, MD

141534, Moskovskaya oblast’, Solnechnogorskij rajon, Lytkino, 777

Ealtuhov@fnkcrr.ruhttps://orcid.org/0000-0003-2125-693XГогохияТ. Р.GogohijaT. R.

Гогохия Тристан Ражденович - к.м.н., ассистент

Москва, ул. Трубецкая, д. 8, стр. 2

Gogohija Tristan Razhdenovich - assistant, MD, PHDD

119991, Moscow, Trubeckaya str.8 /2,

tristan5959@mail.ruФГАОУ ВО Первый МГМУ им. И.М. Сеченова (Сеченовский университет) Минздрава РФ, кафедра факультетской хирургии № 2 Института клинической медицины им. Н.В. СклифосовскогоРоссияSechenov University, department of Faculty Surgery № 2Russian FederationГБУЗ Городская клиническая больница им. В.П. Демихова ДЗМРоссияV.P. Demikhov Clinical Hospital of the Moscow Department of Public HealthRussian FederationФГБНУ Федеральный научно-клинический центр реаниматологии и реабилитологииРоссияFederal Research and Clinical Center of Intensive Care Medicine and RehabilitologyRussian Federation202110092021027786Copyright © Османов Э.Г., Шулутко А.М., Слепнев С.Ю., Яковлев А.А., Алтухов Е.Л., Гогохия Т.Р., 20212021Османов Э.Г., Шулутко А.М., Слепнев С.Ю., Яковлев А.А., Алтухов Е.Л., Гогохия Т.Р.Osmanov E.G., Shulutko А.M., Slepnev S.J., Yakovlev A.A., Altukhov E.L., Gogohija T.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mossj.ru/jour/article/view/481

Введение. Цель данной работы: анализ основных проблем, связанных с хирургической коррекцией декубитальных язв.Материалы и методы. Проведен поиск и анализ литературных источников по ключевым словам в международной реферативной базе PubMed. gov, а также российской системе РИНЦ за последние 20 лет. Изучено свыше 50 научных публикаций.Заключение. Проблема оказания качественной хирургической помощи пациентам с пролежнями III–IV степени еще далека от разрешения. Пластика перемещенными многослойными лоскутами — метод выбора, позволяющий адекватно восполнить дефицит тканей, предотвратить рецидив обширных и глубоких декубитальных язв (ДЯ), улучшить качество жизни данных пациентов. Однако конечные результаты сильно зависят от качества подготовки пролежневой раны, выбора оптимальной методики и послеоперационного ухода. Комплексная оценка хронических пролежневых ран и персонифицированный подход к лечению, базирующиеся на понимании глубинных патофизиологических механизмов развития ДЯ, их специфики с учетом анатомической локализации, протяженности и глубины поражения позволят в будущем оптимизировать результаты корригирующих вмешательств. Не менее важны тщательное соблюдение техники пособия, грамотный послеоперационный уход. Тем не менее, данная сфера клинической практики остается зоной высочайшего риска развития послеоперационных осложнений. Этот факт является ведущей причиной низкой хирургической активности при ДЯ.

Introduction. Objective: analysis of the major problems of surgical correction of pressure ulcers.Material and methods. Searching of data was carried out by keywords in the database PubMed.gov, as well as in the Russian scientific system – on last 20 years. More than 50 publications have been studied. underlying disease.Conclusion. The problem of providing high-quality surgical care to patients with grade III-IV pressure ulcers is still far from being resolved. Plasty with displaced multilayer flaps is the method of choice that allows to adequately fill the tissue deficit, prevent the recurrence of extensive and deep decubital ulcers, and improve the quality of life of these patients. However, the final results are highly dependent on the quality of the pressure ulcer preparation, the choice of the optimal technique and postoperative care. A comprehensive assessment of chronic pressure ulcers and a personalized approach to treatment, based on an understanding of the deep pathophysiological mechanisms of the development of DU, their specificity, taking into account anatomical localization, length and depth of the lesion, will make it possible to optimize the results of corrective interventions in the future. Careful adherence to the aid technique and competent postoperative care are no less important. Nevertheless, this area of clinical practice remains the area of the highest risk of postoperative complications. This fact is the leading reason for the low surgical activity in DU.

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The authors declare that there are no conflicts of interest present.