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Vol. 23, Art. 49 (pp. 801-811)    |    2022       

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Possibilities of excision objectivization in early tangential necrectomy in severe burned patients

Zinoviev E.V.1, Soloshenko V.V.1, Kostyakov D.V.1, Gogokhia T.Z.1, Pyatakov S.N.2, Derii E.K1
1.State Healthcare Institution «Saint-Petersburg Research Institute of Emergency Medicine named after I. I. Dzhanelidze»
2.State Healthcare Institution «City Hospital ?4»

Brief summary

The study is devoted to assessing the results of tangential necrectomy followed by autodermotransplantation in the early stages after injury, before the formation of a demarcation line in severely burned patients. The results of surgical treatment of 74 patients with extensive dermal and deep skin burns, who were treated in the department of thermal injuries of the institute in 2017-2021, were studied. The viability of the wound surface after necrectomy was assessed by laser Doppler flowmetry using the LAKK device (NPO Lazma, Russia). In the region of the upper extremities, the results of simultaneous skin grafting after tangential necrectomy turned out to be optimal: engraftment in 90-100% of cases. The results of tangential necrectomy and autodermotransplantation in the trunk area were worse: the frequency of skin engraftment in most cases was 60-70%. When wounds were localized in the lower extremities, the indicator most often corresponded to 80-90%. The results of skin grafting after tangential necrectomy in the early stages after a burn injury significantly depend on the localization of the burn. To objectify the viability of the wound surface after necrectomy, it is advisable to use laser doppler flowmetry


Key words

burns, tangential necrectomy, laser doppler flowmetry, skin plasty, autodermoplasty

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