IMPROVEMENT OF THE DERMATENSION METHOD IN THE RECONSTRUCTIVE-RECOVERY SURGERY OF DEFECTS OF SOFT TISSUES OF VARIOUS ETIOLOGY.

The problem of treating patients with loss of the skin and with a complicated course of the wound process remains topical. The problem is that, despite the relative technical simplicity of the dermatension method, the most significant complication is the decubitus of the stretchable flap, which is associated with a relatively high incidence of acute blood circulatory disturbances in the stretch tissues due to vascular compression with an excessive amount of injected fluid. The aim of the work is to improve the method of dermatension in reconstructive and recovery surgery of soft tissue defects of various genesis by planning and implementing dermatension at all its steps with instrumental control of the process using ultrasound and ICT in a complex. The results of surgical treatment of patients with a wound defect of different etiology of the scalp with which dermatension was performed in order to obtain additional plastic material in the burn center of the Kharkov City Clinical Hospital of Emergency and Urgent Care. prof. A.I. Meshchaninov for the period 2016-2018. There were only men aged 30 to 60 years among the patients. The average age of the operated patients was 45 years. In the first stage of dermatension, after filling the implanted expander with NaCl 0.9% physiological solution to achieve hemostasis, ultrasound was performed on the first day to measure the thickness of the cutaneous flap above the balloon and ICT (using the FLIR ONE Gen3 Pro thermal imager), to determine the state of the blood circulation above its dome. 10 days after the implantation of the expander, the second stage of dermatension was started (filling the tissue expander with 0.9% NaCl solution), taking into account the blood circulation parameters of the stretched flap with the help of a thermal imager and with constant monitoring of the thickness of the cutaneous flap over the balloon by ultrasound. There were stopped injecting fluid to the expander when the temperature in the center of the flap was reduced by more than 10C. With a further decrease in temperature, some of the liquid from the expander was evacuated. The results of ultrasound and ICT in the course of the operation planning (step I of dermatension), when filling the expander (step II of dermatension) and at the completion of dermatension (step III), according to the change in the thickness of the stretch flap and the formed connective tissue capsule, the dynamics of thermoreaction in the dermatitis flap allow to assess the state of blood circulation (perfusion) with a high probability, which is undoubtedly important for the prevention of such serious complications as ischemia, decubitus, necrosis of the flap, which carries stretches.

[THE ELECTRICAL CONDUCTIVITY OF THE TISSUE IN THE EXPERIMENT AS A MODERN METHOD OF VIABILITY SCALPED LIMB INJURIES DIAGNOSTIC].

In experimental research the method for determining of viability of tissue and device for its realization were developed to improve treatment results degloving injuries of limbs.