Reasons for unsatisfactory results of treatment of destructive forms of erysipelas
DOI:
https://doi.org/10.34287/MMT.1(56).2023.5Abstract
Goal. Find out the cause of unsatisfactory treatment outcomes in patients with destructive forms of erysipelas.
Materials and methods. Retrospectively and prospectively analyzed 284 case histories of patients who were hospitalized in the center of purulent - septic surgery KNP "City Hospital G3" Zaporizhzhia for the period 2016-2022.
Results. It was found that most often the local focus was localized on the upper and lower extremities. The most common clinical manifestations of intoxication in bullous and phlegmonous forms of erysipelas were: general weakness, hyperthermia, muscle pain. In the necrotic form of erysipelas, patients showed signs of severe intoxication with nausea, vomiting and confusion. In the complex treatment of patients with erysipelas, the main place belongs to the early surgical treatment of the area of the pathological process and antibiotic therapy (ABT).
Conclusions. Radical surgery and timely targeted ABT are key elements of success in the treatment of surgical forms of erysipelas and are not subject to revision. The main causes of unsatisfactory consequences in patients with erysipelas are: late referral of patients to the hospital, aggravation of the disease at the time of hospitalization by septic shock and multiple organ failure, severe decompensated comorbidities.
References
Brazhnik EA, Ostroushko AP. Rozhistoe vospalenie v xirurgicheskoj praktike. Nauchnoe obozrenie. Medicinskie nauki.. 2016;4:14-17.
Dikij BM, Kondrin OE, Farbishevskij VV. Sovershenstvovanie kompleksnoj terapii bol`ny`x dizenteriej. Medicina transporta Ukrainy`. 2011;2:88-90.
Vasylevska LA. Mortality in necrotic form of erysipelas. Modern medical technology [Internet]. 2021;(3(50)):19-21. Available from: doi:10.34287/mmt.3(50).2021.4..
Shapoval SD, Vasylevska LA. The use of procalcitonin in patients with surgical forms of erysipelas. Medicni perspektivi (Medical perspectives) [Internet]. 2021;26(1):196-200. Available from: doi:10.26641/2307-0404.2021.1.228011.
Shapoval SD, Vorontsova LL, Vasylevska LA. Application of the immune-correcting therapy in complex treatment of surgical forms of erysipelas. Klinicheskaia khirurgiia [Internet]. 2021;88(5-6):53-55. Available from: doi:10.26779/2522-1396.2021.5-6.53.
Saka B, Kombaté K, Mouhari-Toure A, Akakpo A, Boukari T, Pitché P, et al. Bacterial dermohypodermitis and necrotizing fascitis: 104-case series from Togo. Med Trop (Mars). 2011;71(2):162-164.
Shimizu T, Tokuda Y. Necrotizing Fasciitis. Internal Medicine [Internet]. 2010;49(12):1051-1057. Available from: doi:10.2169/internalmedicine.49.2964.
