Features of the skin grafting in patients with purulent-necrotic defects of the skin

Abstract

Background. Patients with purulent-necrotic defects of the soft tissues account for 45 % of all patients in surgical hospitals. Conservative treatment leads to healing of only 50 % of wounds and ulcers. Consequently, the question about closure of wound defects remains relevant. The purpose of this research is to improve the results of treatment of patients with purulent-necrotic defects of the skin and soft tissues by application plastic closure of wound defects. Materials and methods. For the period from 2015 to 2017, 92 patients aged 36 to 80 years with purulent-necrotic defects of the skin and soft tissues were treated. All patients were subjected to plastic closure of wound defects as the final stage of the treatment program. Results. We used one differentiated approach for conducting plastic operations. Plastic closure of wounded defects was performed depending on the nature of the wound defect, depth of damage and localization. For example, the primary plasty was carried out only with wounds of the head. Flat major defects were closed using autotransplantation. When the favorable conditions in the wound were achieved, plastic surgery with local tissue flaps was performed. Defects in the area of the fingers and feet, as well as of the metatarsals and tarsus, were closed only with the help of vascularized island flaps. As a result, it was possible to achieve complete healing of wound defects. Conclusions. Plastic closure of purulent-necrotic skin defects under certain conditions and a differentiated approach leads to complete wound healing.