Analysis of unsatisfactory consequences of erysipelas treatment

Abstract

The objective of the research was to determine the cause of unsatisfactory treatment results in patients with destructive forms of erysipelas among the overall disease population. Materials and methods. 284 case histories of the patients who underwent an inpatient treatment at the center of purulentseptic surgery of Municipal Non-Profi t Enterprise “City Hospital №3” in Zaporizhzhia for the period of 2016-2022 were analyzed retrospectively and prospectively. Results. The local focus was found to be localized the most often on the upper and lower extremities. The most common clinical manifestations of intoxication in case of bullous and phlegmonous forms of erysipelas included general weakness, hyperthermia, muscle pain. Signs of severe intoxication with nausea, vomiting and confused mental state were observed in patients in case of the necrotic form of erysipelas. Early surgical treatment of the pathological process area and antibiotic therapy (ABT) are the most important in the comprehensive treatment of the patients with erysipelas. Determination of procalcitonin indices in the blood serum provides an opportunity to assess the progression of the process generalization and is a sensitive test for the effectiveness of the conducted treatment. Conclusions. Radical surgery and timely targeted ABT are the main elements of success in the treatment of erysipelas surgical forms and are not subject to revision. The main causes of unsatisfactory consequences in the patients with erysipelas are disease complication by septic shock and multiple organ failure at the time of hospitalization, severe decompensated comorbidities. Procalcitonin is a diagnostic marker that provides an opportunity to predict timely sepsis development.