Study of the Dosing Tissue Distraction Clinical Efficacy in the Soft Tissue Defects Treatment of Various Etiologies in the Lower Extremities

Abstract

Justification The most methods of extensive skin and soft tissue defects are aimed at accelerating wound healing and preventing infectious complications. To improve the effectiveness of such defects treatment, a method of dosed tissue distraction (MDTD) is used, consisting in the application of a continuously acting load to the area of healthy soft tissue in close proximity to the wound defect. Purpose It performed the evaluation of the medico-social effectiveness of the introduction into clinical practice of developed methods and devices for implementing MDTD in the treatment of skin and soft tissue defects of the extremities. Methods 407 patients were treated with wound defects of the extremities, which were divided into two groups: the main group – 198 patients in whose treatment MDTD was applied using original methods and devices; comparison group – 209 patients, in whose treatment standard treatment methods were applied. Comparison of the long-term results of treatment according to the frequency of repeated operations, complications, indicators of quality of life, frequency of disability. Results The use of MDTD is characterized by better performance compared with the use of standard approaches. There is a decrease in the frequency of performing reconstructive plastic surgery after inpatient treatment (9-10 times), remote complications by 2.6 times, a reduced value of the Vancouver scale (by 28.8%), quality of life indicators higher levels. The use of the proposed approach is characterized by a shorter duration of treatment (by 26.0%), duration of disability (1.4 times), cases of disability (2.2 times). Conclusion The use of MDTD is characterized by high medical and social efficiency, allows to reduce the cost of treating extensive skin and soft tissue defects by reducing the length of hospitalization, the frequency of repeated rehabilitation and reconstructive operations, accelerated recovery of patients, improving the quality of life and reducing the incidence of disability