COMPARATIVE ANALYSIS OF EXISTING CLASSIFICATIONS OF SOFT TISSUE DEFECTS OF THE LOWER EXTREMITIES FOR OPTIMAL METHODS OF THEIR CLOSURE

Abstract

Abstract. Aim. To compare the existing classifications of soft tissue defects of the lower extremities and analyze them taking into account metric characteristics, localization of defects and the degree of tissue change in the area of defects. Materials and methods. During the two-year period of the war, a great experience has been gained in the treatment of soft tissue defects of different structures, localization, sizes, and volume, especially of the lower extremities, since this is the predominant injury. The great variety of defects made it necessary to revise their classifications and calculation methods. The following methods are widely known for calculating the size of soft tissue defects of the lower extremities: elementary, analog, digital, etc., which allow distributing the injuries according to metric characteristics. The use of analog, elementary methods of determining the metric characteristics of soft tissue defects is too cumbersome in practice and inaccurate due to a significant error. Therefore, preference is given to digital calculation methods. Among the classifications of soft tissue defects, there are: according to the degree and details of damage, according to the area of soft tissue damage, according to localization, according to the composition of the defect tissues, according to the type of damage and methods of their reconstruction, etc. Results and discussion. The implementation of modern methods of assessing the characteristics of soft tissue defects using digital methods will allow choosing the optimal method of surgical closure of the defect, increasing the effectiveness of surgical closure methods, and shortening the rehabilitation period. The use of selected basic criteria for evaluating soft tissue defects in the perioperative period will allow to choose the optimal method of reconstruction, speed up the process of restoring the limb’s anatomical integrity, functional activity, and achieve a better aesthetic effect. Conclusions. The most optimal and convenient method of assessing the metric characteristics of soft tissue defects of the lower extremities is the use of appropriate software and applications for calculating dimensions with the possibility of 3-D modeling of the volume of the defect. To assess the viability of tissues, it is advisable to use infrared thermography in combination with dopplerography. In the absence of appropriate technical and software, it is possible to use the metric classification of soft tissue defects proposed by Ya.L. Zarutskyi and co-authors. Improving the metric classification of soft tissue defects of the lower extremities, taking into account all criteria, will provide an opportunity to develop a complex surgical approach to their surgical reconstruction and their subsequent perioperative treatment.