Clinical and experimental justification for decompressive fasciotomy in the complex treatment of patients with intermuscular phlegmon of the thigh

Abstract

Introduction. The issues of substantiation of decompressive fasciotomy in patients with thigh phlegmon, against the background of compartment syndrome, remain insufficiently disclosed.

Purpose of the study. To improve the results of surgical treatment of intermuscular phlegmon of the thigh by using technology for diagnostics and treatment of acute tissue hypertension (compartment syndrome).

Materials and methods. The experimental, pathomorphological study included 24 preparations of fascial structures of the thigh, as well as preparations from patients with intermuscular phlegmon of the thigh (IMF), taken during surgery. Biomechanical studies were conducted according to the method of Tatyanchenko VK. (patent of the Russian Federation № 2271740). The promising stage of the work was carried out in the form of a comparative cohort study, which included 65 patients with IMF.

Results and discussion. In the treatment of patients with hip phlegmon at normal tissue pressure values (8-10 mm Hg), early postoperative complications significantly (by 1,9 times) decreased and pain syndrome was completely relieved (according to the Khabirov A.F. scale) on the 14th day. In the control group, pain syndrome persisted in 56,3 % 6 months after surgery, which was associated with the formation of pain trigger zones.

Conclusions. The developed treatment algorithm allowed to exclude unsatisfactory treatment results in patients of group I (n=33) by 100 %, to achieve good results in 91,7 % compared to 54,8 %, which indicates the importance of the developed technology of the treatment and diagnostic algorithm (RU Patent № 2826879).