WAYS TO OPTIMIZE THE CHOICE OF THERAPEUTIC TACTICS FOR BEDSORES IN PATIENTS IN A CHRONIC CRITICAL CONDITION DUE TO BRAIN DAMAGE

Aim: to evaluate the effectiveness of the modernized Bates-Jensen` scale as a method of objectify the choice of treatment for bedsores in patients with brain damage who are in a chronic critical condition.

Methods: a survey of patients with severe brain damage and grade III DL who underwent reconstructive surgery – autodermoplasty (ADP) for the period 2017-2019 was conducted. A total of 30 people: 23 (76.7%) of them men and 7 (23.3%) women aged 27 to 63 years. Depending on the outcome of the operation 2 groups were formed: 17 patients with a positive outcome of the intervention and 13 patients with a negative outcome of ADP (rejection of the flap, further progression bedsore). For a quantitative assessment of the healing dynamics we used the Bates-Jensen` scale and its modernized analogue supplemented by 3 new criteria. Scoring and statistical analysis of the results showed that a total score of ≥50 according to the adapted Bates-Jensen` scale at the time of hospitalization should be considered an absolute contraindication for ADP. A predictor of a positive outcome for ADP is ≤40 points by adapted Bates-Jensen` scale after two weeks of conservative therapy (p<0,05).

Conclusion: The modified Bates-Jensen` scale allows for a comprehensive assessment of pressure sores, monitoring of the wound hilling process and objectifying cure tactics.  

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