CHOICE OF THE METHOD OF RECONSTRUCTION OF DEFECTS OF COVER TISSUES AND EXTREMITIES IN INJURED PATIENTS

Abstract

The volume of reconstructive interventions to restore the defects of the epithelial tissues, resulting from traumatic injury, determines the result from both a functional and aesthetic point of view.

The aim of the study – to choose the optimal method of restorative and reconstructive intervention to close the wound defects of the trunk and limbs after injury.

Materials and Methods. The study analyzed data of 242 patients with defects in the epithelial tissues of the trunk and extremities, which arose as a result of mechanical damage in the period 2008–2016. 697 surgical interventions were performed to patients, 492 of which (70.6 %) were surgery for the restoration of damaged tissues.

Results and Discussion. The patients were divided into 4 groups depending on the size, depth and degree of damage of the soft tissues and other structures of the trunk and limbs. Group I – 44 (18.2 %) patients with a limited (up to 5 cm in diameter) area of ​​damage to the skin and underlying tissues to the deep fascia. It completed 61 (8.8%) interventions. Group II – 67 (27.7 %) patients with extensive wound surface and soft tissue damage below the deep fascia. 144 (20.6 %) surgical interventions were performed in this group. The group III consisted of 90 (37.2 %) patients with defects in the epithelial tissues arising together or as a result of damage to the bone and joint apparatus. 272 (39 %) operations were performed. Group IV – 41 (16.9 %) patients with a combined or multiple injury, which was accompanied by damage to the great vessels, nerves, partial or complete separation of the limb. In this group, 220 (31.6 %) operations were performed.

Conclusions. 1. The use of vascular flaps in 21.3 % of all possible reconstructions increased the functional and cosmetic results of treatment, reduced the number of ischemic disorders and inflammatory processes (1.9 % of postoperative complications). 2. A careful approach to the choice of the restorative intervention of the defects of the epithelial tissues caused by mechanical damage made possible to achieve positive results in 98.9 % of cases.