Shapoval O. Early surgical treatment of the patients with burn disease and peculiarities of wound complication prevention.

Object of the study: Burn disease, deep burns. Purpose of the study: To improve the results of treatment of burn disease by means of improvement the treatment tactics and surgical techniques aimed at prevention of wound complications in patients with deep burns. Methods of the investigation: General clinical, morphological, morphometric, laboratory, instrumental, statistical. Practical significance of the obtained results: Methods of concervative and surgical treatment which allow to reduce WC incidence in patients with burn disease at early surgical interventions were suggested and introduced into practice. To prevent WC in the acute period of the disease, a new method of treatment consisting in management of the paraeccrisis zone which allows to prevent deepening of the wound and to reduce the area at ESI was worked out. Schemes of infusion treatment were worked out. A simple clinical algorithm taking into consideration the structure of the wound structure was worked out. It allows to predict the course of acute period of burn disease. A method of surgical treatment accessible for use in specialized in-patient department which allows to reduce the incidence of wound complications and reduce hospital stay. A method of diagnosis of the disease severity in the acute phase, prognosis of WC, evaluation of the risk of death which can be used both in in-patients departments and during the stages of first aid, was worked out. The use of these methods allows to individualize the treatment tactics and to reduce the incidence of complications and death rate. Novelty: For the first time, a complex program of prevention of wound complications in patients with burn disease based on pathogenetic correction of the disorders developing in an acute period of burn disease was worked out. Controlled (beginning of treatment, colloid index, infusion rate) and uncontrollable (age, accompanying pathology, structure and the area of the wound surface) factors influencing the state of the burn wound were distinguished. A systemfor WC prevention in patients with burn disease was improved by means of development of methods of their prognosis (Patent of Ukraine №60259 А) and choice of treatment tactics (Patent of Ukraine №60260 А). Further development of a scientific concept of WC prevention at EST in patients with burn disease was promoted. This was completed by an improved method for surgical treatment (Patent of Ukraine №37531 А). Degree of introduction: The findings of the research were included into "Scientific proposals of Institutions of AMS of Ukraine" recommended for introduction into the practice of health protection and are used in the work of burn and reanimation departments of Kharkiv City Hospital for First Aid, Regional Clinical Traumatology Hospital and Central District Hospital. Sphere of application: Medicine, surgery.