Changes in rheological parameters of blood, microcirculation, and accumulation of antibiotic in the focus of acute inflammation of patients with maxillofacial phlegmon

Abstract

BACKGROUND: Despite the modern development of dentistry, the frequency of purulent inflammatory diseases of complicated caries tends to increase. Up to 60%–70% of patients had odontogenic phlegmon in maxillofacial hospitals. With the spread of the process to the neck and mediastinum, mortality reaches 60%, and with the generalization of infection leading to septic shock, it increases to 90%. This study aimed to examine the state of rheological parameters and blood microcirculation in cases of acute purulent inflammation in patients with maxillofacial phlegmon based on blood viscosity, analysis of the microcirculatory bed according to laser Doppler flowmetry, and concentration of the antibiotics in the blood. This study will allow us to analyze pathophysiological changes and coordinate adequate drug therapy.
 AIM: To examine the state and rheological properties of blood in the microcirculation and antibiotic concentration in cases acute purulent inflammation in patients with maxillofacial phlegmon to improve the effectiveness of treatment.
 MATERIALS AND METHODS: The study enrolled 20 patients. Their age ranged from 28 to 62 years, and there were 13 (65%) men and 7 (35%) women. The average body weight of the patients in the study group was 79–95 kg. All patients under endotracheal anesthesia underwent phlegmon dissection. During the operation and treatment, microcirculation, blood viscosity, and laser Doppler flowmetry were evaluated, and the antibiotic concentration in the inflammation area was assessed.
 RESULTS: The results of the study of 20 patients were analyzed. As a result of studying the rheological parameters of blood obtained from the peripheral vein in patients with phlegmon of the maxillofacial region of various localization, changes in blood viscosity towards thickening compared with normal values were revealed.
 CONCLUSION: With acute purulent inflammation of the maxillofacial region, pathophysiological changes occur in the microcirculatory bed, which must be considered when prescribing adequate antibacterial therapy.