ymjЯкутский медицинский журналYakut Medical Journal1813-19052312-1017ЯНЦ КМП10.25789/YMJ.2018.64.13ymj-1117Research ArticleМЕТОДЫ ДИАГНОСТИКИ И ЛЕЧЕНИЯMETHODS OF DIAGNOSIS AND TREATMENTОсновные принципы хирургического лечения искусственных гнойно-воспалительных заболеваний мягких тканейBasic principles of surgical treatment of artificial pyoinflammatory diseases of soft tissuesКовальА. Н.KovalA. N.

Коваль Алексей Николаевич – к.м.н., доцент, врач хирург 

Koval Alexei Nikolaevich – Candidate of Medical Science, doctor of surgical department of the 301 Military Clinical Hospital, Associate Professor of the Department of General and Clinical Surgery of the Far Eastern State Medical University

Khabarovsk, 1, Seryshev St., 680028

Khabarovsk, 35, MuravyevAmursky St., 680000 

afuolle@rambler.ruТашкиновН. В.TashkinovN. V.

Ташкинов Николай Владимирович – д.м.н., проф., зав. кафедрой 

Tashkinov Nikolai Vladimirovich – Doctor of Medical Science, professor, head of the Department of general and clinical surgery 

Khabarovsk, 35, Muravyev-Amursky St., 680000 

taschkinov@mail.ruМелконянГ. Г.MelkonyanG. G.

Мелконян Гегам Генрикович – старший ординатор 

Melkonyan Gegam Genrikovich – doctor of surgical department

Khabarovsk, 1, Seryshev St., 680028 

gegarm@yandex.ruМарочкоА. Ю.MarochkoA. Y.

Марочко Андрей Юрьевич – д.м.н., доцент 

Marochko Andrei Yurievich – Doctor of Medical Science, professor of the Department of general and clinical surgery

 Khabarovsk, 35, Muravyev Amursky St., 680000 

amarochko@mail.ruКогутБ. М.KogutB. M.

Когут Борис Михайлович – д.м.н., проф. 

Kogut Boris Michailovich – Doctor of Medical Science, professor of the Department of normal and topographic anatomy with the course of operative surgery

35, Muravyev-Amursky St., 680000 

el.kogut2012@yandex.ruБояринцевН. И.BoiarintsevN. I.

Бояринцев Николай Иванович – д.м.н., проф. 

Boiarintsev Nikolai Ivanovich – Doctor of Medical Science, professor of the Department of additional professional education of the Institute of continuous professional education and accreditation

Khabarovsk, 35, MuravyevAmursky St., 680000 

NIB777@mail.ruЯновойВ. С.IanovoiV. V.

Яновой Валерий Владимирович – д.м.н., проф., зав. кафедрой 

Благовещенск 

Ianovoi Valerii Vladimirovich – Doctor of Medical Science, head of the Department of hospital surgery with a course of pediatric surgery

Blagoveschensk, 95, Gorky St., 675000

valerian001@mail.ruКосенкоП. М.KosenkoP. M.

Косенко Павел Михайлович – к.м.н., доцент 

Kosenko Pavel Mikhailovich, FGBOU VO “FGMU” of the Ministry of Health of Russia, Associate Professor of the Department of General and Clinical Surgery, Candidate of Medical Sciences

680000g. Khabarovsk, Muravyev-Amursky 35 

ФГБОУ ВО ДВГМУ Минздрава России; ФГКУ «301 ВКГ» МО РФРоссия301 Military Clinical Hospital; Far Eastern State Medical UniversityRussian FederationФГБОУ ВО ДВГМУ Минздрава РоссииРоссияFar Eastern State Medical UniversityRussian FederationФГКУ «301 ВКГ» МО РФРоссия301 Military Clinical HospitalRussian FederationФГБОУ ВО ДВГМУ Минздрава РоссииРоссияFar Eastern State Medical University KhabarovskRussian FederationФГБОУ ВО «Амурская ГМА» Минздрава РоссииРоссияAmur State Medical AcademyRussian FederationФГБОУ ВО ДВГМУ Минздрава РоссииРоссияFGBOU VO “FGMU” of the Ministry of Health of RussiaRussian Federation201829082025044447Copyright © Коваль А.Н., Ташкинов Н.В., Мелконян Г.Г., Марочко А.Ю., Когут Б.М., Бояринцев Н.И., Яновой В.С., Косенко П.М., 20252025Коваль А.Н., Ташкинов Н.В., Мелконян Г.Г., Марочко А.Ю., Когут Б.М., Бояринцев Н.И., Яновой В.С., Косенко П.М.Koval A.N., Tashkinov N.V., Melkonyan G.G., Marochko A.Y., Kogut B.M., Boiarintsev N.I., Ianovoi V.V., Kosenko P.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://ymj.elpub.ru/jour/article/view/1117

В работе обсуждаются особенности хирургического лечения пациентов с искусственными гнойно-воспалительными заболеваниями мягких тканей (ИГВЗМТ). Проведение оперативного вмешательства при ИГВЗМТ выполнялось с учётом основных принципов лечения анаэробной инфекции, которая была выявлена в большинстве случаев. Рекомендуется начинать операцию с выполнения небольшого диагностического разреза через место введения инициирующего субстрата с обязательной ревизией подфасциального пространства и выполнением радикальной некрэктомии.

Aim

Aim. To identify the peculiarities of surgical treatment of APIDST.

Material and methods

Material and methods. The analysis of treatment of 302 men with APIDST in the department of purulent surgery of the 301 Military Clinical Hospital of Khabarovsk from 1987 to 2013 was carried out.

Results

Results. Surgical emergency procedures were performed in 40 (13.2%) patients with APIDST before admission to the hospital and in 262 (86.8%) patients with APIDST immediately after admission to the hospital. Necrectomy was performed in 6 (2.0%) patients with APIDST before admission to the hospital and in 118 (39.1%) patients with APIDST immediately after admission at the hospital. The signs of anaerobic infection were found during the surgical procedures in 260 (86.1%) patients. During hospitalization 2 or more surgical procedures were required in 188 (62.3%) patients with APIDST due to the progression of the disease.

Conclusions

Conclusions. In case of substantiated suspicion of APIDST surgical intervention should be based on the main principles of surgical treatment of anaerobic infections regardless of the duration of the disease. It is recommended to start the procedures with a small diagnostic incision through the site of introduction of the initiating substrate with a mandatory revision of the subfascial space and performing radical necrectomy.

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The authors declare that there are no conflicts of interest present.