Abstract:
The number of patients with deep phlegmon in the neck and acute secondary
mediastinitis is increasing from year to year, which entails an increase in
temporary disability, and in severe cases leads to death. Based on the research,
we proposed a medical technology for the use of controlled negative pressure in
the treatment of patients with acute secondary mediastinitis, developing against
the background of a deep phlegmon of the neck. The dynamics of changes in the
concentration of pro- and anti-inflammatory cytokines in the blood serum in
patients with deep phlegmon of the neck and acute secondary mediastinitis with
various methods of treatment was determined. It was found that in the group of
patients in the treatment of which vacuum therapy was used, there is a decrease
in the acute inflammatory process by 37.5% and by 28.6%, respectively, than
with conventional treatment. The use of vacuum therapy in the treatment of
patients with deep phlegmon of the neck reduces the duration of treatment in the
intensive care unit by 20%, inpatient treatment by 15.4%, reduces the number of
repeated surgical interventions and complications by 17.3% and 15.5%,
respectively. At the same time, this method of treating patients with acute
secondary mediastinitis leads to a decrease in the duration of treatment of
patients by 12.2%, the number of complications and repeated surgical
interventions by 21.2% and 34.4%, respectively. When used in the treatment of
patients with deep phlegmon of the neck and acute secondary mediastinitis of
vacuum therapy in the postoperative period on the 5th and 10th days and patients
with acute secondary mediastinitis on the 10th and 14th days, there is a low
concentration of cytokines in the blood serum by an average of 2 times, which
indicates a decrease in the intensity of the acute inflammatory process.
