DYNAMICS OF CLINICAL LABORATORY TEST INDICES IN PATIENTS WITH POSTOPERATIVE STERNAL AND COSTAL OSTEOMYELITIS

Abstract

Aim. To study the dynamics of the results of traditional clinical laboratory tests in process of surgical treatment of patients with the postoperative sternal osteomyelitis. Materials and methods. Complex clinicolaboratory examination of 57 patients with the postoperative sternal osteomyelitis after cardiosurgical interventions was carried out. Bulk blood analysis, leukocytic formula, C-reactive protein, aminotransferase, whole blood serum protein and whole bilirubin levels at admission to the hospital and in the postoperative period were studied. These analyses were fulfilled using up-to-date hematological and biochemical analyzers. Results. Already at the stage of hospitalization, all patients had significant rise in C-reactive protein level, ESR indices were higher than the referent values. At the same time, leukocytosis was detected only in 9 out of 57 patients (15 %). After the surgery, indices of all investigated nonspecific inflammatory markers significantly increased. Against this background, erythrocyte, hemoglobin and especially serum protein number significantly lowered. Twenty four cultures of five bacterial types were isolated from the wound in 21 patients. There predominated Staphylococcus aureus and Pseudomonas aerugenosa . The same patients indicated a maximum level of nonspecific inflammatory factors. Conclusions. C-reactive protein is the most informative marker of inflammation in patients with the postoperative sternal osteomyelitis. The serum protein level is significantly decreased after surgical intervention. For patients with positive results of bacteriological examination, the terms of hospitalization were essentially longer.