PERI-IMPLANT COMPLICATIONS IN THE CLINIC OF TRAUMATOLOGY AND PURULENT SURGERY: MODERN TACTICS, TREATMENT METHODS

Abstract

The aim of the study was to evaluate the current range of para-implant complications after metal osteosynthesis and joint prosthetics and to study the features of the course of the wound process with various methods of their treatment. Material and methods. The materials of a comparative analysis of 64 clinical cases of paraprosthetic and paraimplant complications are presented, in the treatment of which various modern approaches were used to influence the inflammation focus. The results of cytomorphological studies revealed two types of inflammatory reaction of paraimplant tissues, one of which is dominated by the processes of purulent inflammation, and in the other there are manifestations of the granulomatous nature of the tissue response. Analysis of local immune reactions revealed a direct correlation between the level of phagocytosis activity and the proportion of wound macrophages, lymphocytes, or polynuclear cells, depending on the local management of the wound process. A higher activity of cellular immunity during treatment under vacuum therapy determined a 1.4-2.9-fold reduction in the elimination of pathogens and the transition of the wound process to the stage of regeneration, and was also accompanied by a decrease in the proportion of multinucleated cells and lymphocytes in the granulomatous type of inflammatory reaction. Conclusions. The revealed effects of locally controlled negative pressure exposure open up possibilities for cytoregulation and control of reactions of purulent and granulomatous inflammation and improvement of the results of treatment of paraimplant complications in purulent surgery and traumatology.