Comparative Evaluation of The Effectiveness of Treatment of Deep Phlegmon of the Neck and Acute Secondary Mediastinitis

Abstract

The number of patients with deep phlegmon in the neck and acute secondary mediastinitis is increasing from year to year, which entails an increase in temporary disability, and in severe cases leads to death. Based on the research, we proposed a medical technology for the use of controlled negative pressure in the treatment of patients with acute secondary mediastinitis, developing against the background of a deep phlegmon of the neck. The dynamics of changes in the concentration of pro- and anti-inflammatory cytokines in the blood serum in patients with deep phlegmon of the neck and acute secondary mediastinitis with various methods of treatment was determined. It was found that in the group of patients in the treatment of which vacuum therapy was used, there is a decrease in the acute inflammatory process by 37.5% and by 28.6%, respectively, than with conventional treatment. The use of vacuum therapy in the treatment of patients with deep phlegmon of the neck reduces the duration of treatment in the intensive care unit by 20%, inpatient treatment by 15.4%, reduces the number of repeated surgical interventions and complications by 17.3% and 15.5%, respectively. At the same time, this method of treating patients with acute secondary mediastinitis leads to a decrease in the duration of treatment of patients by 12.2%, the number of complications and repeated surgical interventions by 21.2% and 34.4%, respectively. When used in the treatment of patients with deep phlegmon of the neck and acute secondary mediastinitis of vacuum therapy in the postoperative period on the 5th and 10th days and patients with acute secondary mediastinitis on the 10th and 14th days, there is a low concentration of cytokines in the blood serum by an average of 2 times, which indicates a decrease in the intensity of the acute inflammatory process.