SURGICAL TREATMENT RESULTS OF PATIENTS WITH PHLEGMONS OF THE NECK USING A PORTABLE SYSTEM FOR TREATING WOUNDS UNDER NEGATIVE PRESSURE

Abstract

Abstract. The failure of high e ffi ciency of treatment of phlegmons in the deep tissue spaces of the head and neck is to some extent explained by the rapid and sometimes fulminant complications development of that threaten the patient’s life, such as thrombosis of the neck veins, sepsis, erosive bleeding, mediastinitis, and others.Research objective: to study the eff ectiveness of portable systems using for the treatment of wounds under negative pressure in the postoperative period in patients with phlegmons of the neck.Material and methods. The results of the treatment of 54 patients undergoing treatment for deep phlegmons of the neck were analyzed.All patients were divided into two groups. The main group included 30 patients with intraoperative installation of a portable system for the treatment of wounds under negative pressure.The comparison group consisted of 24 patients with the classic installation of glove-tube drains in the anatomical locations indicated below.Research results. In all 54 patients, collar Razumovsky V. I. mediastinotomy was applied. The transition to serous discharge from the wound occurred in both groups: in the comparison group, on average, 267.4 hours after the end of surgery, while in the main group, on average, 38.9 hours after the end of surgery. On the 15th postoperative day, an average of 3.6 ml per group – in the main group, 58.7 ml – in the comparison group.In the postoperative period, 4 (7.4 %) patients developed purulent mediastinitis: 1 (3.3 %) patient from the main group, and 3 (12.5 %) patients from the comparison group. All patients underwent identical intensive treatment measures. Two of these patients from the comparison group died due to the development of acute cardiovascular insu ffi ciency, which made the total mortality for the group, respectively, 2.2 %. There were no fatal consequences in the main group. It should be noted that the average length of hospital stay in the main group was 14 days (336.1 hours), while in the comparison group, it was 27 (657.8 hours) days.In the postoperative period, 3 (13.64 %) patients of the comparison group had cicatricial stenosis of the esophageal anastomosis, in connection with which one of them had an esophageal stent installed, and the other two underwent courses of dilation procedures.Conclusions. In general, in the main group, the use of a mobile portable system for the treatment of wounds under negative pressure refl ects a signifi cantly more favorable postoperative course in patients of the main group and contributes to the prevention of infectious complications after surgical interventions and wounds, improves the drainage process by eff ectively emptying wounds and cavities from the accumulated exudate and allows signifi cantly improve the results of surgical treatment of deep phlegmons of the neck.