Some aspects of surgical treatment of erysipelas

Keywords: surgical forms of erysipelas; procalcitonin.

Abstract

Objective. To study the incidence and to determine the main trends of treatment of the erysipelas surgical forms.

Materials and methods. There were retrospectively and prospectively analyzed 114 histories of the patients’ cases, who were treated in stationary in the centre of purulent-septic surgery of the Municipal Hospital No 3 of Zaporizhzhya in 2019 - 2020 yrs.

Results. Mostly often the affection site was localized on the lower extremities. In bullous and phlegmonous forms of erysipelas the most frequent clinical signs of intoxication were general weakness, hyperthermia, muscular pain. In necrotic form of erysipelas the signs of severe intoxication with nausea, regurgitation and confusion were observed. In complex treatment of erysipelas the main principles are antibioticotherapy and early surgical processing of the pathological process zone. Determination of indices of the procalcitonin content in the blood serum gives possibility to estimate progression and generalization of the process and constitutes a sensitive test for efficacy of the treatment conducted.

Conclusion. Radical surgical intervention and timely targeted antibioticotherapy constitutes basic elements of successful treatment for surgical forms of erysipelas, and this position must not be revised. Procalcitonin content in the blood serum constitutes a diagnostic marker, permitting to prognosticate the sepsis development timely.

Author Biographies

L. A. Vasylevska, Zaporizhzhya Medical Academy of Postgraduate Education

Vasylevska L.A., MD, PhD(Med), Associate professor
Associate professor of outpatient, purulent-septic surgery and ultrasound diagnostics,
Zaporizhia Medical Academy of Postgraduate Education
Wintera blvd., Zaporizhia, Ukraine, 69096,
+38 (061) 213-15-42,
larisavasilevskaya1970@gmail.com
http://orcid.org/0000-0002-0607-5279

S. D. Shapoval, Zaporizhzhya Medical Academy of Postgraduate Education

Shapoval Serhii D., MD, DSci(Med), Professor.
Director of the Institute of sepsis
Zaporizhia Medical Academy of Postgraduate Education
Wintera blvd., Zaporizhia, Ukraine, 69096,
+38 (061) 213-15-42,
shapoval.s.d@gmail.com
http: // orcid.org/ 0000-0001-8516-9494

References

Gopatsa GV, Ermakova LA. Erysipelas: current state of the problem. Scientific Almanac. 2016;(1-2):364-6. [In Russia].

Gostishchev VK, Lipatov KV, Komarova EA. Streptococcal infection in surgery. Pirogov Russian Journal of Surgery. 2015;(12):14-7. [In Russia].

RatnikovaLI, Ship SA, Bespalova MK, Garifanova AR. Comorbidity of erysipelas and endocrine diseases. Scientific Almanac. 2016;(5-3):341-6. [In Russia]. doi: 10.17117/na.2016.05.03.341.

Cherkasov VL, Matkovsky VS, Ivanov AI. Erysipelas. Leningrad: Medicine; 1986. 200 p. [In Russia].

de Jong E, van Oers JA, Beishuizen A, Vos P, Vermeijden WJ, Haas LE, et al. Efficacy and safety of procalcitonin guidance in reducing the duration of antibiotic treatment in critically ill patients: a randomised, controlled, open-label trial. Lancet Infect Dis. 2016 Jul;16(7):819-27. doi: 10.1016/S1473-3099(16)00053-0. Epub 2016 Mar 2. PMID: 26947523.

Polyakova AS, Bakradze MG, Tatochenko VK, Gadlia DD. Diagnostic value of determining the level of procalcitonin in the practice of an infectious disease specialist. Current Pediatrics. 2017;16(4):334-41. [In Russian]. doi: 10.15690/vsp.v16i4.1781 [In Russia].

Falcone M, Concia E, Giusti M, Mazzone A, Santini C, Stefani S, et al. Acute bacterial skin and skin structure infections in internal medicine wards: old and new drugs. Intern Emerg Med. 2016 Aug;11(5):637-48. doi: 10.1007/s11739-016-1450-6. Epub 2016 Apr 15. PMID: 27084183.

Bruun T, Oppegaard O, Hufthammer KO, Langeland N, Skrede S. Early Response in Cellulitis: A Prospective Study of Dynamics and Predictors. Clin Infect Dis. 2016 Oct 15;63(8):1034-41. doi: 10.1093/cid/ciw463. Epub 2016 Jul 11. PMID: 27402819; PMCID: PMC5036916.

Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016 Feb 23;315(8):801-10. doi: 10.1001/jama.2016.0287. PMID: 26903338; PMCID: PMC4968574.

Rudnov VA, Kulabukhov VV. Sepsis-3: updated main definitions, potential problems and next practical steps. Messenger of anesthesiology and resuscitation. 2016;13(4):4-11. [In Russian]. doi: 10.21292/2078-5658-2016-13-4-4-11.

Milcent K, Faesch S, Gras-Le Guen C, Dubos F, Poulalhon C, Badier I, et al. Use of Procalcitonin Assays to Predict Serious Bacterial Infection in Young Febrile Infants. JAMA Pediatr. 2016 Jan;170(1):62-9. doi: 10.1001/jamapediatrics.2015.3210. Erratum in: JAMA Pediatr. 2016 Jun 1;170(6):624. PMID: 26595253.

Published
2020-10-29
How to Cite
Vasylevska, L. A., & Shapoval, S. D. (2020). Some aspects of surgical treatment of erysipelas. Klinicheskaia Khirurgiia, 87(9-10), 59-62. https://doi.org/10.26779/2522-1396.2020.9-10.59
Section
General Problems of Surgery

Most read articles by the same author(s)