EFFECTIVENESS OF PHOTODYNAMIC THERAPY IN THE PREVENTION AND TREATMENT OF POSTTRAUMATIC OSTEOMY ELITIS IN PATIENTS WITH GUNSHOT FRACTURES OF THE JAWS
DOI:
https://doi.org/10.35220/2523-420X/2024.2.7Keywords:
jaw fracture, posttraumatic osteomyelitis, photodynamic therapyAbstract
Purpose of the study. To study the clinical, antibacterial and immunological effects of photodynamic therapy in patients with gunshot fractures of the jaw during the prevention and treatment of posttraumatic osteomyelitis. Research methods. 54 patients (military and civilian) with gunshot fractures of the jaws were divided into two groups. The use of photodynamic therapy by two methods in combination with antibiotic therapy in patients of the second group provides a significant bactericidal effect and improves the state of local immunity. Research results and their discussion. Clinical studies conducted by us at the beginning of treatment did not reveal any differences in the manifestations of symptoms of jaw fractures in patients of groups I and II and corresponded to approximately the same level. During reposition, an accurate comparison of fragments and their reliable fixation was achieved in all victims of groups I and II. In both groups, positive clinical dynamics were observed in the near future after the reposition of fragments. During a clinical examination, 1 month after treatment, in most patients of Group I, the consolidation of lower jaw fragments was complete. So far, only in three cases, we have registered 4 cases of posttraumatic osteomyelitis (16%) on Day 10, callus was not palpated in 20 cases (80 %), and only in 3 (12 %) patients, consolidation occurred with its pronounced formation. Scientific novelty. For the first time, the effectiveness of the combination of photodynamic therapy and traditional antibacterial drugs in patients with gunshot fractures of the jaw was substantiated. Conclusions. The use of photodynamic therapy in the prevention and complex treatment of gunshot fractures of the jaws reduces the risk of developing purulent inflammation in the area of bone integrity disruption in patients with reduced local immunological reactivity, provides a bactericidal effect and improves the state of local immunity, thereby affecting the triggering links in the pathogenesis of purulent inflammation.
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