Clinical and morphological substantiation of decompressive faciotomy in compartment syndrome in patients with phegmon of the upper limb
https://doi.org/10.17238/2072-3180-2023-2-68-73
Abstract
Introduction. The number of complications of surgical treatment of patients with phlegmon of the upper limb does not lose its relevance. The developed compartment syndrome against the background of a purulent-inflammatory process of the affected limb segment, left unattended, can lead to a permanent loss of limb function.
Purpose of the study. To increase the effectiveness of surgical treatment of intermuscular phlegmon of the upper limb by analyzing the pathogenetic mechanisms, the results of decompressive fasciotomy in the structure of combined treatment.
Materials and research methods. The clinical section of the work was performed on 134 patients with intermuscular phlegmon of the upper limb, who were treated in the department of purulent surgery of the MBUZ "GBSMP, Rostov-on-Don". The subjects were divided into 2 clinical groups. In both groups under study, surgical treatment of phlegmon of the shoulder and forearm was carried out according to known technologies. In 72 patients (the main study group), treatment was carried out taking into account the developed diagnostic and treatment algorithm, enshrined in Russian patents (№ 2755169, 2699964). In accordance with the algorithm, the tactics of treatment were determined. A morphological assessment of the state of the fascio-muscular structures of the upper limb was carried out on preparations from patients with different duration of the disease and the degree of tissue hypertension, which substantiate the expediency of performing the operation.
Conclusion. The developed treatment algorithm made it possible to exclude unsatisfactory results of treatment by 100 %, to achieve good results in 91.7 % compared to 54,8 %, which indicates the importance of this complex of therapeutic measures.
About the Authors
Yu. V. Krasenkov
Rostov State Medical University, Ministry of Health of
the Russian Federation
Russian Federation
Russian Federation
Yury Viktorovich Krasenkov, Candidate of Medical Sciences, Associate Professor
Department of Operative Surgery, Clinical Anatomy and Pathological Anatomy
344022
trans. Nakhichevansky, 29
Rostov-on-Don
V. K. Tatyanchenko
Rostov State Medical University, Ministry of Health of
the Russian Federation
Russian Federation
Russian Federation
Vladimir Konstantinovich Tatyanchenko, Doctor of Medical Sciences, Professor, Honored Inventor of the Russian Federation, Honored Doctor of the Russian Federation, Head of the Department
Department of Operative Surgery, Clinical Anatomy and Pathological Anatomy
344022
trans. Nakhichevansky, 29
Rostov-on-Don
A. V. Davydenko
Rostov State Medical University, Ministry of Health of
the Russian Federation
Russian Federation
Russian Federation
Andrey Viktorovich Davydenko, Candidate of Medical Sciences, Assistant
Department of Operative Surgery, Clinical Anatomy and Pathological Anatomy
344022
trans. Nakhichevansky, 29
Rostov-on-Don
Yu. V. Suhaia
Rostov State Medical University, Ministry of Health of
the Russian Federation
Russian Federation
Russian Federation
Yuliana Vasilievna Sukhaya, Candidate of Medical Sciences, Associate Professor, Associate Professor of the Department
Department of Operative Surgery, Clinical Anatomy and Pathological Anatomy
344022
trans. Nakhichevansky, 29
Rostov-on-Don
V. L. Bogdanov
Rostov State Medical University, Ministry of Health of
the Russian Federation
Russian Federation
Russian Federation
Valery Leonidovich Bogdanov, Candidate of Medical Sciences, Associate Professor, Associate Professor of the Department
Department of Operative Surgery, Clinical Anatomy and Pathological Anatomy
344022
trans. Nakhichevansky, 29
Rostov-on-Don
References
1. Al-Kanani E. S., Gostishchev V. K., Yarosh A. L., Karpachev A. A., Soloshenko A. V., Zharko S. V., Linnik M. S. Treatment of purious infection of soft tissues: from history to present (literature review. Actual problems of medicine, 2020, № 43 (1), pp. 155–164. (In Russ.)
2. Grigoryan A. Yu., Bezhin A. I., Sukovatyh B. S., Blinkov Yu. Yu. A clinical trial of the efficacy of a combination of antiseptic and antimicrobial agent in the treatment of inflammatory processes of the skin and soft tissue. Research’n Practical Medicine Journal, 2021, № 8 (2), pp. 51–61. doi: 10.17709/2410-1893-2021-8-2-5 (in Russ.)
3. Mehta V., Chowdhary V., Lin C., Jbara M., Hanna S. Compartment syndrome of the hand: a case report and review of literature. Radiology Case Reports, 2018, № 13 (1), pp. 212–215. doi: 10.1016/j.radcr.2017.11.002
4. Maniar R., Hussain A., Rehman M. A., Reissis N. Unusual presentation of acute compartment syndrome of the forearm and hand. BMJ Case Reports CP, 2020, № 13 (9), e235980. doi: 10.1136/bcr-2020-235980
5. Zhang D., Tarabochia M., Janssen S. J., Ring D., Chen N. Acute compartment syndrome in patients undergoing fasciotomy of the forearm and the leg. International Orthopaedics, 2019, № 43, pp. 1465–1472.
6. Rubinstein A. J., Ahmed I. H., Vosbikian M. M. Hand compartment syndrome. Hand clinics, 2018, № 34 (1), pp. 41–52. doi: 10.1016/j.hcl.2017.09.005
7. Krasenkov Yu. V., Tatyanchenko V. K., Davydenko A. V., Tkachev A. V., Terekhov M. Yu. A method for the treatment of acute tissue hypertension syndrome with combined intermuscular phlegmon of the upper limb. Patent RF, № 2755169. 2021 (in Russ.)
8. Byakova E. N., Krasenkov Yu. V., Tatyanchenko V. K., Sukhaya Yu. V., Edilov A. V. A method for diagnosing intermuscular phlegmon of a limb. Patent RF, № 2699964. 2019 (in Russ.)
Review
For citations:
Krasenkov Yu.V., Tatyanchenko V.K., Davydenko A.V., Suhaia Yu.V., Bogdanov V.L. Clinical and morphological substantiation of decompressive faciotomy in compartment syndrome in patients with phegmon of the upper limb. Moscow Surgical Journal. 2023;(2):68-73. (In Russ.) https://doi.org/10.17238/2072-3180-2023-2-68-73
Views:
318
Email this article 