Surgical care for drug-addicted patients with purulent-septic pathology

• Main Authors: N. A. Brooklich, V. G. Laneev, E. S. Citronov, Н. А. Бруклич, В. Г. Ланеев, E. С. Цитронов
• Format: Article in Journal/Newspaper
• Language: Russian
• Published: Regional non-governmental organization “Surgical society - Wounds and wound infections” 2018
• Subjects: качество медицинской помощи; purulent-septic pathology; diagnosis; surgical treatment; quality of medical care; гнойно-септическая патология; диагностика; хирургическое лечение; Vorkuta
• Online Access: https://www.riri.su/jour/article/view/145; https://doi.org/10.25199/2408-9613-2018-5-2-52-57

Objective: analysis of surgical care for drug-addicted patients with purulent-septic pathology on the example of the Vorkuta emergency hospital.Materials and methods. In 2006–2018 in the Vorkuta emergency hospital, 285 drug-addicted patients between the ages of 23 and 52 were treated. Among them, parenteral hepatitis (B, C) was diagnosed in 257 cases, and in 83 cases – HIV. Patients were treated with postinjection abscesses and phlegmon of the extremities, purulent arthritis of various localizations, less commonly with phlebitis, ileofemoral thrombosis, arrosive bleeding, retroperitoneal phlegmon.Results. Surgical treatment included surgical debridment of a purulent focus, management of wounds by an open method, closed flowaspiration lavage of cavities, and NPWT. In 91 cases (32.0 %), treatment remained incomplete due to the unauthorized departure of patients from the hospital, or due to a violation of the regime and rules of conduct in the hospital, which resulted in a forced discharge. The wounds were closed with either a primary suture over the through drainage, or secondary sutures, or various types of skin plastics. In the department of purulent surgery, 4 (1.4 %) patients died. The cause of death is the development of decompensated multiple organ failure. Conclusions. The number of drug-addicts practically does not correlate with the population and is relatively constant. The quality of medical care directly affects mortality among drug-addicted patients with surgical infection. Drug-addicted patients who use opioid surrogates should be treated as septic when admitted to hospital. Цель: анализ хирургической помощи наркозависимым пациентам с гнойно-септической патологией на примере больницы скорой медицинской помощи города Воркуты.Материалы и методы. В 2006–2018 гг. в Воркутинской больнице скорой медицинской помощи пролечено 285 наркозависимых пациентов в возрасте от 23 до 52 лет. Среди них в 257 случаях диагностированы парентеральные гепатиты (В, С), а в 83 случаях – ВИЧ. Пациенты поступали с ...