Clinical and morphological substantiation of decompressive faciotomy in compartment syndrome in patients with phegmon of the upper limb

Introduction. The number of complications of surgical treatment of patients with phlegmon of the upper limb does not lose its relevance. The developed compartment syndrome against the background of a purulent-inflammatory process of the affected limb segment, left unattended, can lead to a permanent loss of limb function. Purpose of the study. To increase the effectiveness of surgical treatment of intermuscular phlegmon of the upper limb by analyzing the pathogenetic mechanisms, the results of decompressive fasciotomy in the structure of combined treatment. Materials and research methods. The clinical section of the work was performed on 134 patients with intermuscular phlegmon of the upper limb, who were treated in the department of purulent surgery of the MBUZ "GBSMP, Rostov-on-Don". The subjects were divided into 2 clinical groups. In both groups under study, surgical treatment of phlegmon of the shoulder and forearm was carried out according to known technologies. In 72 patients (the main study group), treatment was carried out taking into account the developed diagnostic and treatment algorithm, enshrined in Russian patents (№ 2755169, 2699964). In accordance with the algorithm, the tactics of treatment were determined. A morphological assessment of the state of the fascio-muscular structures of the upper limb was carried out on preparations from patients with different duration of the disease and the degree of tissue hypertension, which substantiate the expediency of performing the operation. Conclusion. The developed treatment algorithm made it possible to exclude unsatisfactory results of treatment by 100 %, to achieve good results in 91.7 % compared to 54,8 %, which indicates the importance of this complex of therapeutic measures.