A Cytologic Study of Wound Process Dynamics in Purulent Soft Tissue Diseases with the Use of Programmed Rehabilitation Technologies

Abstract

Purpose of research:to study cytological features of healing processesin patients with soft tissue phlegmons using programmed rehabilitation technologies.

Methods:The study involved167 patients with purulent phlegmonsof soft tissuesat various locations. Patients were randomised in two groups. Conventional postoperative local treatment was provided to patients from the control group (n=79). Inintervention group(n=88),aftersurgical debridementthe wound tube drainages were used, withdrawnthroughseparateincisions;the wound was blindly sutured.Post-surgical periodincludedprogrammedrehabilitation procedurescarried out using the AMP-01device.The dynamics ofreparative processes in purulent woundswas evaluated according to the cytologic pattern of the material taken employing surface or needle biopsy method.

Results:A higher speed ofcell-mediated responses in purulent wounds is noted in the intervention group of patients.By the 9^th day after surgery,the cytologic pattern corresponded to theregenerative type of cytograms. Noteworthy werestatistically significantmore rapid decrease in the number ofdegenerative formsofneutrophils and positive redistribution ofbanded and segmentonuclearneutrophils together withhigh values ofregeneration and degeneration index (p<0.001),indicating that the reversal ofinflammatory process speeds up. In earlier periods, astatistically significant occurrence ofmacrophages and cells ofyoungconnective tissueasfibrocytes, fibroblasts, fibrous fibers(p<0.001) was also observed, what demonstratedactiveregeneration processes in the wound. Low intensity ofcell-mediated responses in the wound, prolonged inflammation phase, long-lastingregeneration phase, and later onset of scar reorganisationphase were found in the control group. With that,by the 9^th day ofpost-surgical period,the cytologic pattern in the control groupcorresponded to theinflammatorytypeof cytograms.

Conclusion:The conductedcytologic study has proved the effectiveness of using programmed rehabilitation technologies, which facilitate shortening of inflammation phase andacceleration ofreparative processes insuppurative focusesofsoft tissue phlegmons.