VACUUM DRAINAGE DURING THE TREATMENT OF POSTOPERATIVE STERNOMEDIASTINITIS AFTER CARDIAC SURGERY
Median sternotomy is the main access to the heart for a long time. Currently, with the development of minimally invasive, endovascular, and hybrid techniques, the number of patients operated on using median sternotomy is not reduced. Thus, the problem of infectious complications of post-notomous wounds does not lose its relevance. To improve the efficiency of treatment of patients with infectious complications, a comparative clinical and morphological analysis of the regeneration processes of infected post-motone wounds was carried out. The study included 57 cardiac surgical patients who underwent sternotomy, the postoperative period in which was complicated by the development of sternomediastinitis. Patients received treatment in these centers in the period 2012-2018. The patients were divided into the following clinical groups: 1) variable vacuum vacuum (13 people), 2) permanent vacuum vacuum (14 people), and 3) open management (30 people). It was found that the best indicators of the processes of regeneration of postoperative wounds and shortening the terms of treatment of patients were observed in the group using variable VAC therapy. In all observation groups, longer wound healing periods were observed in patients with concomitant type 2 diabetes. The results obtained depend on the method of treatment and the most adequate ratios of indicators for successfully accelerating regeneration correspond to the application of the method of variable vacuum vacuum.