DOI: https://doi.org/10.22263/2312-4156.2020.6.92
Stavchikov E.L., Zinovkin I.V., Marochkov A.V.
C-reactive protein as a criterion of treatment efficacy of patients with purulent-necrotic soft tissue infections by means of vacuum therapy
Mogilev Regional Clinical Hospital, Mogilev, Republic of Belarus
Vestnik VGMU. 2020;19(6):92-98.
Abstract.
In recent decades, a method of treating acute and chronic wounds with the use of negative pressure has aroused great interest. Among the biochemical parameters, the dynamics of the C-reactive protein (CRP) content has not been studied sufficiently, and the correlation of the CRP content when using physical methods for treating chronic wounds is unknown.
Objectives. To study the determining of CRP content in the blood serum of patients as an objective laboratory criterion for the effectiveness of treating of patients with purulent-necrotic soft tissue infections of various localizations using vacuum therapy.
Material and methods. A prospective non-randomized observational study involved 24 patients. To achieve the set goal, all patients were divided into groups: group 1 included patients who received vacuum therapy during general treatment (n=13); group 2 was composed of patients who underwent traditional treatment (n=11).
In patients of both groups, blood samples were taken to determine the CRP content before surgery, in 2 days after surgery, and in 5 days after surgery.
Results. At the first stage of the study, the blood serum CRP content in patients was 106.70 (29.12; 184.17) mg/l, at the second stage, a slight decrease in CRP was observed, which made up 41.13 (17.61; 172.46) mg/l (p>0.05). At the third stage, the CRP content decreased compared to the first and the second stages – 39.24 (8.31; 94.32) mg/l (p=0.01).
The level of CRP at the first stage in group 1 equalled 101.09 (30.59; 206.99) mg/l, and in group 2 – 112.3 (22.10; 150.71) mg/l (p>0.05). The CRP content at the second stage amounted to 33.50 (12.51; 132.82) mg/l in group 1 and 107.74 (31.36; 177.75) mg/l in group 2 (p>0.05). At the third stage, the CRP level was 13.88 (05.94; 104.12) mg/l in group 1 and 52.97 (18.28; 97.00) mg/l in group 2 (p<0.05).
Conclusions. The monitoring of the C-reactive protein level in the blood serum is an objective laboratory criterion to evaluate the treatment effectiveness of patients with purulent-necrotic soft tissue infections by means of vacuum therapy.
Key words: C-reactive protein, vacuum therapy, wound infection, efficacy criteria.
References
1. Cherkasov MF, Galashokian KM, Startcev IuM, Cherkasov DM, Pomazkov AA, Melikova SG, i dr. Experience in the treatment of wounds of various etiologies using vacuum therapy. Sci Eur. 2019;(40-1):6-11. (In Russ.)
2. Zemlianoi VP, Singaevskii AB, Kozhevnikov VB. Morphological and functional monitoring of the wound process in assessing the effectiveness of vacuum therapy of wounds. Vestn Nats Med-Khirurg Tsentra im NI Pirogova. 2016;11(4):51-5. (In Russ.)
3. Petukhov VI, Okulich VK, Plotnikov FV, Senkovich SA. Features of the clinical course of the wound process depending on the ability of the pathogen to form a biofilm. Vestn VGMU. 2013;12(4):100-5. (In russ.)
4. Bogomolov MS, Bogomolova VV. The use of digital monitoring of wound size to control the effectiveness of treatment on the example of analyzing the effect of diabetes mellitus on the dynamics of healing of trophic ulcers in patients with venous insufficiency of the lower extremities. Rany Ranevye Infektsii. 2018;5(2):42-51. (In Russ.)
5. Будкевич ЛИ, Зайцева ТВ. Состояние и перспективы проблемы лечения детей с ранами различной этиологии при использовании вакуумной терапии. Дет Хирургия Budkevich LI, Zaitceva TV. State and prospects of the problem of treating children with wounds of various etiology using vacuum therapy. Det Khirurgiia. 2015;19(3):44-7.
6. Liu T, Yang F, Li Z, Yi C, Bai X. A prospective pilot study to evaluate wound outcomes and levels of serum C-reactive protein and interleukin-6 in the wound fluid of patients with trauma-related chronic wounds. Ostomy Wound Manage. 2014 Jun;60(6):30-7.
7. Chasnoit ACh, Zhilinskii EV, Serebriakov AE, Leshchenko VT. Mechanisms of action of vacuum wound therapy. Mezhdunar Obzory Klin Praktika Zdorov'e. 2015;(4):25-35. (In Russ.)
8. Kubrakov KM, Petukhov VI, Kornilov AV. Application of vacuum therapy in the surgical treatment of spinal epidural abscesses. Novosti Khirurgii. 2019;27(1):59-65. (In Russ.)
9. Stavchikov EL, Zinovkin IV, Marochkov AV, Makhnach AE, Rosinskaia MN. Dynamics of the C-reactive protein content in patients with radical phlebectomy on the lower limb. Zhurn Grodn Gos Med Un-ta. 2020;18(4):436-40. (In Russ.)
10. Marshall JC, Reinhart K. Biomarkers of sepsis. Crit Care Med. 2009 Jul;37(7):2290-8. doi: http://dx.doi.org/10.1097/CCM.0b013e3181a02afc
11. Tachyla SA, Marochkov AV, Lipnitski AL, Nikiforova YG. The prognostic value of procalcitonin, C-reactive protein and cholesterol in patients with an infection and multiple organ dysfunction. Korean J Anesthesiol. 2017 Jun;70(3):305-310. doi: http://dx.doi.org/10.4097/kjae.2017.70.3.305
12. Abelevich AI, Marochkov AV, Abelevich OM, Dobrianskaia NI. Early rehabilitation method and dynamics of C-reactive protein content in blood serum in patients after knee arthroplasty. Zhurn Grodn Gos Med Un-ta. 2019;17(4):420-5. (In Russ.)
13. Gustafsson R, Johnsson P, Algotsson L, Blomquist S, Ingemansson R. Vacuum-assisted closure therapy guided by C-reactive protein level in patients with deep sternal wound infection. J Thorac Cardiovasc Surg. 2002 May;123(5):895-900. doi: http://dx.doi.org/10.1067/mtc.2002.121306
14. Dzieciuchowicz Ł, Kruszyna Ł, Krasiński Z, Espinosa G. Monitoring of systemic inflammatory response in diabetic patients with deep foot infection treated with negative pressure wound therapy. Foot Ankle Int. 2012 Oct;33(10):832-7. doi: http://dx.doi.org/10.3113/FAI.2012.0832
15. Zaitceva EL, Tokmakova AIu. Vacuum therapy in the treatment of chronic wounds. Sakhar Diabet. 2012;(3):45-9. (In Russ.)
16. Razmakhnin EV, Shangin VA, Kudriavtceva OG, Okhlopkov DIu. Possibilities of vacuum instillation therapy using dimexide and betadine in the treatment of purulent wounds. Acta Biomed Sci. 2017;2(6):153-6. (In Russ.)
Information about authors:
Stavchikov E.L. – surgeon of the department of purulent surgery, Mogilev Regional Clinical Hospital,
ORCID: https://orcid.org/0000-0001-5147-5274
Zinovkin I.V. – head of the department of purulent surgery, Mogilev Regional Clinical Hospital;
Marochkov A.V. – Doctor of Medical Sciences, professor, anesthesiologist-resuscitator, head of the Practical-Scientific Division, Mogilev Regional Clinical Hospital,
ORCID: https://orcid.org/0000-0001-5092-8315
Correspondence address: Republic of Belarus, 212016, Mogilev, 12 Belynitsky-Birula str., Mogilev Regional Clinical Hospital, the department of purulent surgery. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Yevgeny L. Stavchikov.
