OBJECTIVE

To show the effectiveness of a new technology for surgical treatment of patients with congenital epidermolysis bullosa with hand deformities based on taking into account the pathogenetic aspects of the development of extrasermal complications in this area.

MATERIAL AND METHODS

In 13 children with VBE, 24 operations were performed to eliminate hand deformities according to the original method without using a scalpel for incisions of the skin and dermis in the area of the fingers, followed by closing the wounds with a waste autoepidermis, which is fundamentally different from the practice of world experience.

RESULTS AND DISCUSSION

In 75% of cases (18 operations), excellent treatment results were obtained. After 5 operations (20%), satisfactory results were observed. In one case (5%), after 6 months, signs of flexion contracture of the fingers appeared.

Epithelization of the wound surface under the waste epidermis occurred after 2—3 weeks. The reduction in wound healing time is due to the fact that the decaying autoepithelium from the cocoon-like membrane and the derivatives of the skin appendages preserved in the dermis are a source of active epithelization after the elimination of syndactyly and deformities of the fingers. This is also facilitated by the use of multi-layer dressings, under which an optimal environment is created for wound healing without the need for frequent bandages and the use of general pain relief.

CONCLUSION

The developed new tactics of surgical elimination of hand deformations allows to increase the efficiency of surgical treatment of patients with incurable dermatological disease based on the use of modern medical technologies.