VAK-therapy as a variant of local treatment of destructive forms of erysipelas

Abstract

Purpose of the study. Improve postoperative treatment of phlegmonous and necrotic forms of erysipelas by alternating HAC therapy of wounds and staged necrectomies, reduce the time of cleaning and preparation of the wound for dermatoplasty. Materials and metods. The results of treatment of 87 patients with complicated forms of erysipelas who were treated in the purulent-septic center of KNP «City Hospital № 3» in Zaporozhye for the period 2020–2021 were analyzed. Results. The effectiveness of treatment, including topical therapy, was evaluated by improving laboratory parameters (leukocyte formula), the number of microbial bodies per 1g of tissue and the duration of wound cleansing. In the phlegmonous form of erysipelas, normalization of the leukocyte formula was observed on day 3, which is probably faster than among patients in the control group – on day 4 (t = 4,01375; P = 0,000182). In patients with necrotic form of erysipelas in the main group, the normalization of the leukocyte formula occurred probably faster, almost 2 days, than in the control group – 4 and 6 days, respectively (t = 2,16682; P = 0,042499). At the same time there was a decrease in microbial contamination of wounds. The terms of wound cleansing in the postoperative period in patients of the main group were probably shorter than in patients of the control group – by 1,87 ± 0,23 days in phlegmonous form (t = 3,75213; P = 0,000320) and 2,89 ± 0,34 in necrotic (t = 2,33969; P = 0,026659). Conclusion. Improvement of postoperative local treatment of patients with phlegmonous and necrotic forms of erysipelas allowed to significantly reduce the length of stay of patients in the hospital by 3,26 ± 0,43 days (t = 6,47461; P < 0,000001).