Plastic component in the algorithm of surgical treatment of patients with phegmon of the upper limb

Abstract

Introduction. Wound healing after purulent processes of soft tissues against the background of developed compartment syndrome is of scientific and practical interest, because in most cases, wounds after opening the phlegmon are wide, and bringing the edges together is technically impossible.
Purpose of the study. To improve the results of treatment of patients with phlegmon of the upper limb and compartment syndrome by using the developed method of plastic surgery at the final stage.
Materials and methods of research. The study included 134 patients undergoing treatment for phlegmon of the upper extremity (localization: shoulder, forearm) against the background of compartment syndrome, according to a developed algorithm protected by a patent of the Russian Federation, in the purulent surgery department of the State Budgetary Emergency Hospital in Rostov-on-Don, State Budgetary Institution RO "Central City Hospital" in Bataysk from 2016 to 2023. The control group included 62 patients. The patients were comparable by gender, age, and degree of the pathological process. A set of laboratory and diagnostic measures was carried out in accordance with generally accepted standards for the treatment of purulent pathology. When tissue hypertension was established (TD above 10 mm Hg), a Z-shaped fasciotomy was performed (RF Patent № 2755169). In 10 patients of series II (main group), an original plastic method was used to close the wound defect (RF patent № 2709726).
Conclusion. An integrated approach to the treatment of wounds and compartment syndrome and the use of a cutaneous subcutaneous fascial flap showed positive results. The results obtained allow us to recommend the developed complex of treatment measures, including a plastic component, in the treatment of patients with intermuscular phlegmon of the upper limb.