Morphological prerequisites for the formation of compartment syndrome and rationale for decompressive fasciotomy in patients with phlegmon of the upper limb

Introduction. Questions of morphological changes in phlegmon of the upper limb, occurring in the anatomical formations against the background of the compartment syndrome, remain insufficiently disclosed.

Purpose of the study. To study the effect of increased tissue pressure (compartment syndrome) on fascio-muscular structures in the area of development of phlegmon of the upper limb and to substantiate the expediency of decompressive fasciotomy.

Materials and methods. The study included 134 patients with deep intermuscular phlegmon of the upper limb, who were treated in the period from 2016 to 2022 in the conditions of the department of purulent surgery of the GBU RO "GBSMP" in Rostov-on-Don. Group I (comparison) included 62 patients, group II (study) included 72 people. Treatment of patients of group I was carried out according to known technologies. In group II, patients were treated according to original methods protected by patents of the Russian Federation. 3 subgroups were formed according to the severity of the course of the pathological process.

Treatment results. The conducted morphological study through the use allowed us to establish statistically significant differences in morphological changes depending on the severity (which was dependent on the tissue pressure index).

Conclusions. In patients with intermuscular phlegmon of the upper limb, tissue pressure should be monitored. With an increase in tissue pressure by 10–20 mm Hg. from the physiological norm, decompressive fasciotomy prevents the development of non-standard morphological changes in muscle tissue, especially in grades II and III of the course of the pathological process (at grade III, this process slows down).

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