Sliesarenko K. Localized deep defects surgical treatment of the lower extremity covering tissue

The thesis is devoted to actual problems of localised deep defects surgical treatment of the lower extremity covering tissue. A comparative analysis of basic and modified methods of loco-regional tissue complex transposition on the permanent supplying pedicle which included one or few perforative vessels were made. Criteria for success assessment of a surgical technique included both clinical performance, overall performance, and determining the dynamics of patients quality of life. Use of CT-angiography with contrast by the modified protocol as a part of the preoperative examination program allowed decreasing the number of postoperative critical complications of transposed tissues from 44,8 ± 9,2 % % to 16 ± 7,3 %, and, as a result, the number of reoperations for patients, and number of uncritical complications from 68,9 ± 8,6 % to 40 ± 9,8 %, reduce the duration of hospital stay from 39,4 [32;46,8] days to 23 [17;29] days. Application of vacuum perimetric draining of under-flap space during surgeries with perforant-based pedicled flap transposition allowed to reduce risk of uncritical complicationts from 58,8 ± 8,4 % до 30 ± 10,2%, and thus, frequency of reoperations from 44,1 ± 9,2 % to 15,0 ± 5,6 %, both in basic and modified diagnostic programs groups. Loco-regional tissue complex transposition on the supplying pedicle which few perforative vessels allowed to reduce amount of both critical (0 %) and uncritical (13,8 ± 5,7 %) postoperative complications. Supplementary medical procedures during postoperative period were needed in 8,3 ± 4,6 % cases. Reoperations were not required. There have been noted more rapid patients' recovery and returning to habitual quality of life according to their age and medical status even during stationary treatment.