Vykhtyuk T. I., Orel Yu. G., Savchenko A. A.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Surgical treatment of critical limb ischemia (CLI) may be complicated by surgical infection. The dynamics of infectious complications can be assessed in the laboratory by the level of certain immunological parameters of serum and wound exudate. The aim of the study was to study the state of individual immune response by determining the dynamics of the studied immunological parameters in the serum of patients with SSI after reconstructive interventions for CLI and exudate obtained during local treatment with VAK therapy. We examined and comprehensively treated 135 people with SSI, among which stage I according to the Szilagyi classification was found in 37.78%, stage II in 33.33% and stage III in 28.89% of patients. Individuals with stage II and III were divided into two groups – 41 patients of the main (VAK-therapy) and 23 persons of the comparison group(conventional treatment regimen). Serum levels of pro-inflammatory (IL-6 and TNF-α), anti-inflammatory (IL-2 and IL-10) cytokines and TNF-α / IL-10 were determined. The effectiveness of topical therapy was observed by detecting changes in these immunological parameters in the wound exudate. As a result of treatment in the serum of patients of both groups there was an increase in anti-inflammatory and a decrease in pro-inflammatory cytokines. However, in the main group the dynamics of indicators significantly (p <0.001) differed from those in the comparison group. Similarly, in exudate from wounds decreased from 1 to 3 sessions of pro-inflammatory cytokines: IL-6 by 39.13% and TNF-α by 39.91% and the ratio of TNF-α / IL-10 by 57.28%, and an increase in anti-inflammatory cytokines: IL-2 – by 42.31% and IL-10 – by 45.28%. Such results may indicate the high effectiveness of the proposed comprehensive treatment of infected wounds.

surgical site infection, critical limb ischemia, immunological parameters, VAC therapy

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«Bulletin of problems biology and medicine» Issue 4 (162), 2021 year, 103-108 pages, index UDK 617.58-005.4-089.844-022]-092.19

10.29254/2077-4214-2021-4-162-99-103-108