Complex surgical treatment of patients with necrotic soft tissue infections

Anikin A.I.; Zavyalov B.G.; Larichev S.E.; Shapovolyants S.G.; Nosenko M.M.; Dedenkov O.A.

doi:https://doi.org/10.17116/hirurgia202306134

Anikin A.I.

Moscow City Clinical Hospital No. 17

ORCID: 0009-0004-8539-7090

Zavyalov B.G.

Moscow City Clinical Hospital No. 17;
Pirogov Russian National Research Medical University

Larichev S.E.

Moscow City Clinical Hospital No. 17;
Pirogov Russian National Research Medical University

Shapovolyants S.G.

Pirogov Russian National Research Medical University

Nosenko M.M.

Moscow City Clinical Hospital No. 17

ORCID: 0009-0009-5596-0328

Dedenkov O.A.

Moscow City Clinical Hospital No. 17

Complex surgical treatment of patients with necrotic soft tissue infections

Authors:

Anikin A.I., Zavyalov B.G., Larichev S.E., Shapovolyants S.G., Nosenko M.M., Dedenkov O.A.

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Journal: Pirogov Russian Journal of Surgery. 2023;(6): 34‑41

DOI: 10.17116/hirurgia202306134

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To cite this article:

Anikin AI, Zavyalov BG, Larichev SE, Shapovolyants SG, Nosenko MM, Dedenkov OA. Complex surgical treatment of patients with necrotic soft tissue infections. Pirogov Russian Journal of Surgery. 2023;(6):34‑41. (In Russ.)
https://doi.org/10.17116/hirurgia202306134

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

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Abstract:

OBJECTIVE

To develop an optimal algorithm for complex treatment of patients with necrotic soft tissue infections (NSTI).

MATERIAL AND METHODS

The study included 114 patients with NSTI who were treated between 2016 and 2021. We analyzed treatment outcomes in 2 groups: retrospective (n=43) with traditional approaches to purulent surgery (drainage of necrotic foci, local therapy with iodophores and water-soluble ointments, antibacterial and detoxification therapy, delayed skin grafting) and prospective (n=71) with active surgical treatment and modern algorithm based on a differentiated approach and high-tech methods (vacuum therapy, hydrosurgical treatment of wounds, early skin grafting and extracorporeal hemocorrection).

RESULTS

The main group was characterized by shorter phase I of the wound process by 7.1±2.1 days, earlier relief of symptoms of systemic inflammatory response by 4.2±1.4 days, shorter hospital-stay by 7.7±2.2 days and lower mortality by 15%.

CONCLUSION

Early surgery and integrated approach including active surgical strategy, early skin grafting and intensive care with extracorporeal detoxification are necessary to improve the outcomes in patients with NSTI. These measures are effective to eliminate purulent-necrotic process, reduce mortality and hospital-stay.

Keywords:

necrotic soft tissue infections

treatment of necrotic infections

Authors:

Anikin A.I.

Moscow City Clinical Hospital No. 17

ORCID: 0009-0004-8539-7090

Zavyalov B.G.

Moscow City Clinical Hospital No. 17;
Pirogov Russian National Research Medical University

Larichev S.E.

Moscow City Clinical Hospital No. 17;
Pirogov Russian National Research Medical University

Shapovolyants S.G.

Pirogov Russian National Research Medical University

Nosenko M.M.

Moscow City Clinical Hospital No. 17

ORCID: 0009-0009-5596-0328

Dedenkov O.A.

Moscow City Clinical Hospital No. 17

Received:

13.10.2022

Accepted:

01.12.2023

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