EFFECTIVENESS OF CLINICAL APPLICATION OF COMPREHENSIVE RECONSTRUCTIVE-REGENERATIVE METHOD IN THE TREATMENT OF PATIENTS WITH EXTENSIVE DEFECTS OF SOFT TISSUE OF THE DISTAL SECTIONS OF THE LOWER EXTREMITIES

Background. The issues of treating patients with extensive post-traumatic soft tissue defects of the distal lower extremities are among the current and unresolved problems of modern surgery. Aim. To determine the effectiveness of clinical application of the developed complex reconstructive-regenerative method in the treatment of patients with extensive post-traumatic defects of soft tissues of the distal lower extremities. Material and methods. A prospective comparative analysis of the immediate and remote results of surgical treatment of 30 patients with extensive posttraumatic soft tissue defects of the distal lower extremities was performed. In the main group, soft tissue defect plastic surgery was performed using the developed complex reconstructive and regenerative method. In the comparison group, soft tissue defect plastic closure was performed using a non-free neurovascular sural or safenus flap using the classical technique. Results. In comparison with the use of perforator flaps according to the classical technique, the use of the new method of plastic surgery allows to reduce the level of local postoperative complications by 33.3%; avoid the development and need for repeated surgical interventions; reduce the duration of complete wound healing by 7 days; improve the quality of life of patients one year after surgery by 10 points on the EQ-5D-3L-VAS scale in combination with an excellent final treatment result in 100% of cases; reduce the duration of inpatient treatment by 11 bed-days with a specific savings in inpatient treatment costs per patient in the amount of 792 rubles. Conclusions. The implementation of the developed complex method of treating patients with extensive posttraumatic soft tissue defects of the distal lower extremities, based on the combined use of original technical methods for the formation of a vascularized tissue complex and regenerative surgery technologies, is accompanied by positive clinical, social and economic efficiency.