STRUCTURAL FEATURES OF PURULENT INFLAMMATORY DISEASES OF THE MAXILLOFACIAL REGION IN RESIDENTS OF THE POLTAVA REGION
Authors: Steblovskyi D.V. , Skikevich M.G. , Bondarenko V.V. 
Published: December 2020

The problem of surgical infections is an urgent problem of medicine today. Despite the improvement of the quality of medical care, improvement of known and discovery of new methods of treatment, the number of patients with this pathology has a clear temporary tendency to increase. Features of the anatomical structure of the maxillofacial area determine the clinical originality of purulent inflammatory diseases, which are characterized by rapidly progressing course and spread with the generalization of the process. As etiological factors for purulent inflammatory diseases of the maxillofacial area can be diseases of the skin of the face and neck, lymph nodes, ENT diseases. The leading role in purulent inflammatory diseases of the maxillofacial area is occupied by odontogenic cause.

The aim of the study. Investigate the structure and frequency of purulent inflammatory diseases in residents of Poltava region.

Material and methods. The Department of Maxillofacial Surgery is located on the basis of Poltava Regional Clinical Hospital, provides specialized and high-tech assistance to residents of Poltava region. During the period 2015-2019, a total of 3927 patients were treated, of which purulent inflammatory diseases of the face and neck occurred in 1281 (30.1%): phlegmon - in 582 (44.4%), abscesses - in 699 (55, 5%). Sepsis was complicated by surgical infection in 9 patients (0.9%).

All patients underwent a clinical examination to clarify complaints, medical history, studied the data of objective examination of the general condition, careful assessment of local status (localization of the process, discoloration, skin temperature, edema, tissue infiltration, checked the amplitude of mouth opening, studied dental formula). All patients underwent a general clinical examination, the results of microbiological monitoring of bacterial cultures were studied. Additional instrumental methods of examination were performed: CT of soft tissues in 35 (3.89%), ultrasound of soft tissues of the neck - in 123 (13.76%), orthopantomography - in 640 (52.38%), radiography of the neck - in 43 (5.1%).

Among the diseases that form a severe premorbid background, the most significant role is played by HIV and diabetes. Microbiological monitoring has identified as the most common microflora of Staphylococcus aureus, Streptococcus constellatus and Streptococcus mitis. Adequately performed surgery in combination with active complex therapy in the postoperative period, including in addition to traditional therapy “Biocerulin”, allows to reduce the duration of inpatient treatment to 7.3 + 0.3 (in the control group when using traditional dressings - 11 , 5 + 0,5) and ensures the absence of fatalities.

Conclusions. Purulent inflammatory diseases of the maxillofacial area are an urgent problem of surgery, accounting for 9.8% of those hospitalized in the department of maxillofacial surgery.

A significant predominance of the most able-bodied age group (41.0%) puts the problem of the disease in the category of socially significant.

The leading role of odontogenic causes of purulent inflammatory diseases indicates the lateness of patients in dental clinics, the neglect of oral hygiene and the timeliness of remedial measures.

Early surgery in combination with antibacterial therapy in accordance with microbiological monitoring and the use of “Biocerulin”, allows to achieve satisfactory immediate results of treatment.