Kitri M. Surgical treatment of scar deformations of various localizations using expanded vascularized tissues with own blood circulation

The dissertation is devoted to the problem of increasing the efficiency of treatment of patients with post-burn cicatricial deformations of different localizations due to the improvement of existing and development of new plastic methods combined by expanded flaps on the basis of key and perforated vessels. The presented work includes the results of experimental studies and treatment of patients with scar tissue deformations. The experimental part aimed at modeling on animals (35 white rats) of traditional and developed methods of surgical interventions to substantiate the obtaining, formation and transfer of combined expanded flaps on the basis of perforated vessels. Clinical stage consisted of the study of traditional and developed new methods of surgical treatment of patients with cicatricial deformations of different localizations by obtaining, formation and transfer of combined expanded flaps on the basis of key and perforated vessels. The study material consisted of 91 patients with post-burn cicatricial deformities and contractions. The developed algorithm allows to determine the sequence and stages of formation of expanded combined flaps on the basis of key and perforated vessels in the treatment of patients with scar deformations of different localizations. Сonducted analysis of proximate and distant results of treatment using combined expanded flaps on the basis of key and perforated vessels in the areas of face, neck, trunk and extremities, and treatment with traditional methods of tissue expansion. Developed and proposed new methods of obtaining expanded combined flaps on the basis of perforated vessels make it possible for patients with post-burn cicatricial deformations to increase the number of good results from 51,3 % to 76,6 % in the immediate postoperative period, to reduce the number of satisfactory results from 41,0 % to 23,4 % and to avoid unsatisfactory results of treatment. In the long-term period, the number of good results increased from 29,7 % to 85,7 %, the number of satisfactory results decreased from 51,8 % to 14,3 %, and also there were no unsatisfactory results.