DETERMINATION OF CLINICAL INDICATORS OF INTERSTITIAL PRESSURE IN DEEP AND BORDERLINE BURNS DEPENDING ON THE TIME OF THERMAL INJURY

  • O. V. Kravtsov
  • T. A. Kurbanov
  • Yu. I. Kozin
  • A. A. Tsogoev
  • A.O. Gopko
Keywords: burns, compartment-syndrome, interstitial pressure.

Abstract

Summary. Objective. Improvement of the diagnosis of compartment syndrome depending on the time of thermal injury and the establishment of indications for draining operations.

Materials and methods. Interstitial pressure was studied in 66 victims who were admitted to the burn center in the first 24 hours after the injury. The patients were divided into groups depending on the relative extent of the lesion and the length of hospitalization.

The results of the study and their discussion. Upon admission of the patient to the department, a thorough sanitation of the burn surfaces was performed with antiseptic solutions (chlorhexidine, dekasan). In the burn area, the interstitial pressure was measured in all muscle groups deeper than the superficial fascia with a Kompartment druck Monitor System (MIPM Mammen dorfer Institut für Physik und Medizin Gmbh) apparatus for measuring interstitial pressure. Depending on the level of interstitial pressure, patients underwent conservative drug and infusion therapy aimed at reducing edema and hypoxia of damaged tissues. In the case of critical indicators of interstitial pressure, an urgent surgical intervention was performed for the purpose of decompression. When assessing the dependence of the pressure level in the tissues on the timing of burns, there is a clear dependence in all observation groups: late hospitalizations are accompanied by a large increase in pressure, the level of circular location of burns on the extremities is of great importance for high blood pressure.

Conclusion. It has been determined that objectification of the diagnosis of the compartment syndrome in order to prevent ischemic tissue damage plays an important role in deep and borderline burns. Clinical indicators of tissue pressure in deep and borderline burns have been established, depending on the time of thermal injury, which allows the diagnosis of compartment syndrome and the establishment of indications for drug, infusion therapy and urgent drainage operations.

References

1. Tkach AV. Sposoby diagnostiki mestnogo gipertenzionno-ishemicheskogo sindroma u patsiyentov s ozhogami konechnostey. Tavricheskiy mediko-biologicheskiyvestnik, 2012,T. 15, no. 1 (57),pp. 245–247.(in Russian).
2. Boccara D, Lavocat R, Soussi S, et al. Pressure guided surgery of compartment syndrome of the limbs in burn patients. Ann Burns Fire Disasters, 2017; 30(3): p. 193–197. (in English).
3. Strafun SS, Tkach AV, Strafun AS, Saliy AP. Risk razvitiya mestnogo gipertenzionnogo ishemicheskogo sindroma pri travme. Travma, 2014;15(3):5-10. (in Russian).
4. Butts CC, Holmes JH, Carter JE. Surgical escharotomy and decompressive therapies in burns. J Burn Care Res. 2020;41(2):263-9. doi: 10.1093/jbcr/irz152. PMID: 31504609.(in English).
5. Boody AR, Wongworawat MD. Accuracy in the measurement of compartment pressures: a comparison of three commonly used devices. J Bone Joint Surg Am. 2005;87(11):2415-22. doi: 10.2106/JBJS.D.02826. PMID: 16264116. (inEnglish).
Published
2020-12-14
How to Cite
Kravtsov, O. V., Kurbanov, T. A., Kozin, Y. I., Tsogoev, A. A., & Gopko, A. (2020). DETERMINATION OF CLINICAL INDICATORS OF INTERSTITIAL PRESSURE IN DEEP AND BORDERLINE BURNS DEPENDING ON THE TIME OF THERMAL INJURY. Kharkiv Surgical School, (5-6), 44-50. https://doi.org/10.37699/2308-7005.5-6.2020.08
Section
QUESTIONS OF BURN DISEASE

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