Ultrasonic cavitation in treatment of soft tissue purulent diseases in HIV-infected patients

Abstract

The aim — improvement of a soft tissue purulent diseases treatment in HIV­infected patients by a surgical treatment with ultrasound cavitation combination.Materials and methods. The analysis of complex surgical treatment of soft tissues apostasies and phlegmon in 124 HIV­infected patients was conducted. Patients were divided into 2 groups, depending on the strategy of treatment. In the first (main) group (n = 26) the combination of surgical treatment with ultrasonic cavitation was applied. Ultrasonic cavitation was used in post­operative period during I (exudative) phase of wound process before incarnation appeared. By comparison, in the second group (n = 62) only surgical treatment was applied.Results and discussion. The ultrasonic cavitation in treatment of soft tissue purulent diseases in HIV­infected patients allowed to stop local inflammation and achieve partial incarnation of wound surface on the average in 13.2 ± 0.5 days in the first group and in 15.9 ± 0.6 days in the second group. The level of bacterial titer of wound secretion by 15.5 ± 0.6 days was not higher than the commonly accepted critical one in comparison to the classic situation, in the second group it was on the 16.8 ± 0.7 days. Terms of inpatient treatment were: 16.2 ± 0.8 days in the first group and 21.2 ± 0.9 days in the second group accordingly.Conclusions. The usage of ultrasonic cavitation in the complex surgical treatment of soft tissue purulent diseases in HIV­infected patients significantly increases the time of wound cleaning, accelerates incarnation by 1.2, reduce the time of treatment of patients with concomitant HIV infection by 1.3 times in comparison to the classical approach of cleaning, by means of mechanical cleaning of the wound from purulence and necrotic tissue by ultrasound of low frequency in combination with antiseptic.