Year 2012 Vol. 20 No 5

GENERAL AND SPECIAL SURGERY

L.N. RUBANOV1, Y.I. YARETS2, Z.A. DUNDA-ROV2

CLINICAL AND LABORATORY CONFIRMATION OF EFFICIENCY OF CHRONIC WOUND ULTRASOUND DEBRIDEMENT IN THE PREPARATION OF PATIENTS TO SKIN GRAFTING

SME “Gomel City Clinical Hospital ¹1”
Gomel Regional Center of Thermal Trauma, Wounds, Wound Infection and Reconstructive Surgery1
ME “Gomel State Medical University” 2,
The Republic of Belarus

Objectives. The efficiency estimation of the ultrasound debridement method in the preparation of chronic wounds (CW) to skin grafting (SG).
Methods. 25 patients with CW of various etiology are included in the investigation. The first group was composed of patients (n=12), who were subjected to a single ultrasound debridement before SG. 2 procedures of ultrasound diagnostics were performed to the patients of the 2nd group (n=13): 3 days after hospitalization (the 1st procedure) and immediately before SG (the 2nd procedure).
Results. The using of two ultrasound debridement procedures while preparing chronic wounds to skin grafting is accompanied with shortening of graft healing time up to 9 (6; 10) days (p=0,015 in comparison with the results of the 1st group of patients – 12 (10; 15) days), skin graft outcome improving (complete graft healing was registered in 100% of the patients), decrease of positive results of bacteriological examination up to 70% (V2=4,22, ð=0,04 in comparison with the results of the 1st group of patients) and of bacterial wound contamination up to ≤103 CFU/ml (V2=10,6, ð=0,001 as opposed to the 1st group) and changing of microbial landscape – only monoculture of S.aureus, P.aeroginosa, P.mirabilis were isolated (V2=10,1, ð=0,0015 in comparison with the results of the 1st group of patients). And one ultrasound debridment procedure wasn’t accompanied with significant differences of the bacterial count and CW microbial landscape.
Conclusions. The use of double ultrasound debridement procedures (the first – during pre-operative conservative preparation, the second – before skin grafting) is more effective approach while preparing patients with CW to SG in comparison with the single ultrasound debridement procedure.

Keywords: chronic wound, ultrasound debridement, skin grafting, bacteriological examination of wounds
p. 70 - 76 of the original issue
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Address for correspondence:
246000, Respublika Belarus, g. Gomel, ul. Lange, d. 5. UO «Gomelskiy gosudarstvennyiy meditsinskiy universitet», kafedra klinicheskoy laboratornoy diagnostiki,
e-mail: artyut@mail.ru,
Yarets Yuliya Igorevna
Information about the authors:
Rubanov L.N Head of the Burn Department of SME "Gomel City Clinical Hospital ¹ 1", the Head of Gomel Regional Center of the Thermal Injury, Wounds, Wound Infections and Reconstructive Surgery.
Yarets Y.I. Candidate of Medical Sciences, Assistant of Clinical Laboratory Diagnostics Chair of EE "Gomel State Medical University."
Dundarov Z.A. Doctor of Medical Sciences, Professor, Head of the Surgical Diseases Chair ¹2 with the Course of Pediatric Surgery of EE "Gomel State Medical University."
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