Semenov D. Improving a treatment quality of patients with maxillofacial fractures using a complex, surgical and psychological treatment model

The research aims at upgrading the treatment of patients with fractures of the maxillofacial area by developing a comprehensive therapeutic model for functional algic disorders and psychosocial maladaptation through modifying surgical interventions and developing a system of medical and psychological support. Object of research: patients with fractures of the maxillofacial persons with fractures area. Research methods: clinical, radiological, immunoenzyme, pathopsychological, follow-up, statistical. The scientific novelty of the obtained results is due to the perfection of the surgical intervention procedure in people with maxillofacial injuries owing to the development and integration of a two-stage model of therapy of functional and algic disorders in the structure of traumatic maxillofacial fractures. The model presumes to implant autofibrin films as a "case" for the vascular-nervous bundle in the fracture area. The idea of co-administration of platelet-rich plasma (PRP) injections and low-intensity pulsed ultrasound in maxillofacial surgery has been expanded. It is for the first time that the levels of MMP8, OK and FGF23 in the oral fluid were monitored by enzyme-linked immunosorbent assay against the background of the combined use of PRP injections and low-intensity pulsed ultrasound. It is for the first time that the types of psychosocial maladaptation states were identified and systematized based on the analysis of the characteristics of clinical and psychological disorders in people with fractures of the MFA. The system of medical and psychological support aimed at correcting the conditions of psychosocial maladaptation of people with bone fractures in the postoperative period of reconstructive surgery has been improved and integrated. The practical significance of the obtained results is due to the introduction of a comprehensive model for the treatment of functional and algic disorders in maxillofacial fractures, which allowed to reduce the level of relevant disorders and the duration of their manifestations at the inpatient stage of postoperative reconstructive surgery. Introduction of a system of medical and psychological support for people with maxillofacial bone fractures, which is focused on trauma-dependent and post-traumatic injury-dependent states of psychosocial maladaptation, allowed to reduce the level of psychogenic manifestations in people with maxillofacial bone fractures in the postoperative period. To define the characteristics of clinical and psychological disorders in patients with injuries of the maxillofacial area in the postoperative period of reconstructive surgery, a set of clinical and psychological studies were conducted in the study groups. Based on the analysis of the characteristics of clinical and psychological disorders in patients with injuries of the maxillofacial area, it was found that there were 2 types of psychosocial maladaptation manifestations. Based on the analysis of psychological and behavioural disorders in trauma-dependent and post-traumatic injury-dependent states of psychosocial maladaptation, a system of medical and psychological support of surgery has been developed. It is established that the efficiency of the system of medical and psychological support for type A conditions reaches 91.7%, for type B conditions reaches 90.0%.