Objective: To investigate the microhemodynamics of the skin in the area of damage of the cover tissues of the limbs after trauma using LDF.
Materials and methods: the data of this work was analyzed from 144 patients with defects of the body tissues of the extremities, which were divided into 4 groups depending on the size, depth and degree of damage. To study microhemodynamics, a laser analyzer “LAКK-2” was used.
Results. Patients in group I with a separate area of skin and subcutaneous tissue damage to deep fascia did not find a statistically significant difference between the microcirculation of the damaged area and the corresponding area of the contralateral limb, with a slight increase in the M and σ scores with almost unchanged Kv, indicating an increase in perfusion and activation of mechanisms of control of microhemodynamics. The II group of patients with excessive wound surface and soft tissue damage below deep fascia was characterized by an increase in the level of perfusion M with a decrease in the coefficient of variation. Indicators of neurotonus, myotonia remained unchanged. The III group consisted of patients suffering from DPT that arose together or as a result of damage to the osteo-articular apparatus. There was a significant increase in the mean level of perfusion M and a decrease in Kv, an increase in myogenic tone by more than 50%. Group IV included patients with combined or multiple injuries, accompanied by damage to the major vessels, nerves, partial or complete secretion of the limb. Significant changes in microhemodynamics were observed — an increase in perfusion levels M and σ, a pronounced decrease in Kv, an increase in neurogenic tone (more than 50%).
Conclusions. 1. The choice of the method of reconstructive intervention to restore injured integumentary tissues depended on the size, depth and extent of damage to the limbs, while an objective assessment of microhemodynamics by the LDF method allowed to predict reliably the possibility of postoperative complications of patients.
2. The obtained parameters of perfusion of integumentary tissues by the method of LDF testify to the necessity of a detailed approach to the choice of the volume of surgical correction of the area of injury and allowed to obtain a satisfactory result of surgical interventions in 98.3% of cases.