Evaluation of the preoperative preparation effectiveness with the ozone therapy and NPWT usage in patients with pressure sores after spinal cord injuries.

Abstract

Surgical treatment of 178 patients with pressure sores in the rehabilitation period of traumatic illness was analyzed. A surgical approach of treatment with the use of the NPWT technique in the preoperative period was suggested. A positive effect of NPWT on local microcirculation, neoangiogenesis, bacterial decontamination and tissue repair was found. The indices of immunohistochemical markers CD34, CD68, which reflect the degree of reparative processes in the wound, were determined. The increase in the density of the CD34-expressed vessels and the quantitative index of macrophages CD68+ - 40.8 ± 1.7, with the minimal advantage of the functionally active macrophages are the objective criteria of tissue readiness for plastic closure. The use of (local) musculocutaneous flaps with axial blood supply in combination with anatomical and functional resection of the underlying bones was suggested as a method of plastic surgery of pressure-trophic ulcers, which reduced the number of early postoperative complications. Good and satisfactory results were achieved in 109 (90.8%) patients.