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CURRENT ISSUE

№3' 2020

SURGERY

International Medical Journal, Vol. 26., Iss. 3, 2020, P. 28−33.


DOI (https://doi.org/10.37436/2308-5274-2020-3-6)

MORPHOLOGICAL EVALUATION OF EFFECTIVENESS OF NECROFASCIOTOMY AND INFILTRATION WITH OZONATED SALINE AREA OF DEEP CIRCULAR BURN OF SKIN WITH UNDERLYING TISSUES COMPLICATED BY COMPARTMENT SYNDROME


Valerii Volodymyrovych Boiko, Teimur Ahaliievich Kurbanov, Kravtsov O. V., Myroshnychenko M. S., Isaev Yu. I.

V. T. Zaitsev Institute of General and Emergency Surgery, National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
Kharkiv National Medical University, Ukraine

Compartment syndrome is one of the complications of tissue damage of various origins, the basis of which is the compression of blood vessels and disruption of blood supply to tissues due to an increased local pressure in the closed space of the fascial sheath. The consequences of compartment syndrome can be local and general. An effective treatment of compartment syndrome in burns is to perform a necrotomy, which due to decompression helps to reduce intra−tissue pressure and diminish the scale of necrotic changes in tissues. In order to morphologically evaluate the effectiveness of necrofasciotomy, as well as the one in combination with infiltration of ozonated saline area of deep circular skin burns with underlying tissues, complicated by compartment syndrome, an experimental study was conducted. Circular deep burns, complicated by the formation of compartment syndrome, were simulated in 18 WAG rats. To reduce the pressure in the burned and surrounding tissues, surgical interventions such as necrofasciotomy were performed, which provided a notable reduction in pressure. In parallel, infiltration of damaged tissues with ozonated saline was performed, which was bubbled for 15 minutes at a dissolved ozone concentration of 4.0±0.2 mg / l, which improved microcirculation and reduced tissue hypoxia. The findings indicate that the compartment syndrome is characterized by a significant severity of general pathology. Performance of necrofasciotomy of a burn wound with its infiltration by ozonated physiological solution in comparison with just necrofasciotomy has more positive medical effect, and efficiency of these medical measures increases when they are performed at early terms (day 1) of formation of a burn wound in comparison with late terms (day 3).

Key words: burns, surgical treatment, compartment syndrome, histological examinations.


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