RESULTS OF OPTIMIZATION OF AUTODERMOPLASTY WHEN TREATING GRANULATING PURULENT WOUNDS

Abstract

Introduction. When treating granulating purulent wounds, some patients will need surgical interventions to restore the integrity of the skin. In this case, autodermoplasty using the split method occupies a special place. However, complete engraftment of the skin graft on the surface of the wound is not always possible. Purpose of the study. To evaluate the results of autodermograft engraftment in the treatment of granulating purulent wounds of various etiologies based on the intraoperative and postoperative wound management algorithm after free split autodermoplasty. Materials and methods of research. A total of 100 patients with granulating purulent wounds of various origins were treated under non-randomized clinical observation. In the main group, when treatment was used in 50 patients, an intraoperative and postoperative algorithm for wound management was developed after the use of free split autodermoplasty. The comparison group also included 50 patients who underwent traditional local treatment of wounds with autodermal graft using bandages. Research results. In general, graft engraftment by 7 days after autodermoplasty was assessed as complete engraftment of the graft in the main group of patients, and in the comparison group - partial engraftment to the recipient site. The best results were in the group of patients with granulating wounds of surgical and traumatic origin, the worst - with wounds after frostbite. Conclusion. When using the developed algorithm for intraoperative and postoperative management of granulating purulent wounds after autodermoplasty, the percentage of autodermograft engraftment increases both relative to the amount of autodermograft performed from 76% to 96% (χ2 = 6.728; p = 0.01), and relative to the area of the transplanted autodermograft from 77.34 ±0.33% to 96.06±0.2% (t = 48.51; p <0.05) compared with patients treated with traditional wound management with a 7.6-fold reduction in the chance of developing wound complications.