Experience of using the method of local negative pressure in complex treatment of necrotizing soft tissue infections

Introduction. Treatment of extensive wounds as a consequence of necrotizing soft tissue infections is an important problem due to the increasing incidence of this pathology, frequent damage to the working population, the high probability of disability, and the difficulties of reconstruction in conditions of shortage of plastic material.Objectives. We aimed to asess the effectiveness of using a system for treating wounds using the local negative pressure (LNP) method in patients with necrotizing fasciitis, myositis of the extremities and/or trunk.Materials and methods. We summarized the results of treatment with the LNP method in 24 patients with necrotizing infections of the soft tissues of the extremities and/or trunk. The treatment regimen included LNP dressing; secondary surgical treatment (SST) of wounds was accompanied by a change in system components. The end point was closure of large wound defects.Results and discussion. The average number of SSTs after performing primary debridement was 5,86. The average number of changing of the LNP system’s components is 3,7. 7 out of 24 patients reached the final stage, that means the application of secondary sutures or autodermoplasty. The remaining patients were discharged for outpatient treatment with small granulating defects (total wound area less than 1 % of body area). Amputations were avoided in the entire series of cases. The average length of hospitalization was 24,95 days (median - 22, mode -21).Conclusion. The use of the LNP method in the treatment of patients with necrotizing soft tissue infections let us speed up wound cleansing and make plastic earlier. In the future, upon receipt of confirmation on a statistically significant sample, it is possible to propose the LNP method as a method of choice in the treatment of such patients.