POSSIBILITIES OF REDUCING BLOOD LOSS DURING TANGENTIAL NECRECTOMY IN BURNED PATIENTS (LITERATURE REVIEW)

Abstract

Early surgical treatment of burn wounds is one of the priority areas of kombustiology. Excision of devitalized tissues before the development of a purulent-inflammatory process in them has a directed pathogenetic justification for the effectiveness of the manipulation. Removal of necrosis in the affected area reduces the intensity of intoxication, as well as accelerates the transition of the wound process from inflammation to the regeneration phase (classification of M.I. Kuzin). One of such techniques is early tangential necrectomy, which is currently not widely used in clinical
practice due to a number of critical shortcomings. The main ones include the lack of an objective method for controlling the selectivity of tissue excision, a high incidence of complications in the early postoperative period, as well as the instability of hemostasis. Studies on this topic have allowed us to establish that the volume of blood loss during early tangential necrectomy depends on the timing, depth and method of excision of the burn scab, the choice of tactics of intraoperative hemostasis and systemic therapy. An in-depth analysis of these areas made it possible to identify the main causes of unsatisfactory results and identify possible ways to improve them.