Effect of Programmed Sanitation on the Dynamics of Cytological Picture in the Surgical Treatment of Soft Tissue Phlegmon

Abstract

The aim of the study was to investigate cytological features of healing processes in patients with soft tissue phlegmons using programmed sanitation technologies.Materials and methods. The study involved 245 patients with purulent phlegmon of soft tissues of various localizations. The patients were randomized into two groups. The patients of the main group (n=127) were exposed to programmed sanitation with AMP-01 device in the postoperative period. After the phlegmon opening and surgical treatment, tubular drains were installed into the wound cavity, the wound was sutured tightly, and the drains were removed through separate incisions and connected to the device. The device was used to detect the parameters of sanitation (speed, time, volume during injection or aspiration). The patients of the comparison group (n=118) received conventional local treatment after surgery. The dynamics of the healing processes of purulent wounds was assessed by the cytological examination findings of the material taken during surface or puncture biopsy.Results. A higher rate of cellular reactions was registered in patients of the main group. There was a statistically significant faster decrease in degenerative forms of neutrophils, higher values of the regenerative-degenerative index (p0.001) indicating an acceleration of the relief of the inflammatory process. In addition, in patients of the main group, the appearance of macrophages and fibroblasts (p0.001) was statistically significantly observed at an earlier time, which evidenced a higher rate of proliferative processes; on the 9th day of the postoperative period the cytological picture corresponded to the regenerative type of cytograms. In patients of the comparison group, a prolonged inflammation and regeneration phase was recorded.Conclusion. Cytological examination of smears in patients with soft tissue phlegmons exposed to programmed sanitation revealed a higher rate of cellular reactions, which contributed to a reduced inflammation phase and accelerated wound reparative processes.