Ошибки и осложнения при лечении больных с отслойками покровных тканей

Abstract

The complexity of the condition, lack of clear routes for patients with degloving injury of integumentary tissues, inadequate and untimely diagnosis, lack of clinical guidelines and a paucity of literature lead to a great number of failures and complications in treatment of the cohort of patients. The objective of the study was to analyze failures and complications encountered in treatment of patients with degloving injury of integumentary tissues, and identify ways for the prevention. Material and methods Medical records of 40 patients with degloving injury of integumentary tissues were retrospectively reviewed. The patients treated in trauma departments and the Burn Center in Chelyabinsk between 2008 and 2014 were divided into two groups according to the time of admission to the burn center. The first group of patients was hospitalized within 6 days of injury and over. The second group of patients was admitted to the combustiology department in the first 5 days of injury. Results Failures in diagnosis and treatment were mostly observed in patients who were admitted for treatment after 5 days of injury. Most common complications included necrosis of integumentary tissues, infected wounds, necrosis of skin autografts. Discussion Most of the complications seen in patients with extensive degloving injury of integumentary tissues resulted from organizational, diagnostic, therapeutic, strategical and technical failures, and several adverse events were associated with the severity and extent of the involved tissues. Conclusion A number of recommendations have been offered for prevention of failures and complications in treatment of the cohort of patients.