Cytological assessment of wound regeneration during vacuum therapy of odontogenic phlegmon of the maxillofacial region

Annually, 0.1–0.3 % of all hospitalized patients in Russia die from purulent-inflammatory diseases of the maxillofacial region. The issues of rationalization of methods of prevention and treatment of purulent processes of the maxillofacial region in connection with the resistance of microorganisms of infectious and inflammatory diseases to antibacterial drugs still remain unresolved. This article is devoted to the study of morphological features due to the use of vacuum therapy in the treatment of odontogenic phlegmon of the maxillofacial region. An applied randomized study was conducted in which 56 people with a diagnosis of «odontogenic phlegmon» of the submandibular region, pterygomandibular, near-pharyngeal, and subasseteral spaces participated, at an average age of 34.8±8.6 years. During the study, the patients were divided into groups: some (the control group) received treatment using the traditional method (opening of a purulent lesion, passive drainage before fixing a drainage vacuum flushing device, removal of the «causal» tooth if present, medical support), while others (the comparison group) had the traditional method supplemented by a local one. vacuum therapy according to the developed method. The drugs received intraoperatively and on the 1st day after surgery in both groups corresponded to cytograms of the necrotic type. On day 3, a few degenerative forms were visualized in the samples of the control group, while in the comparison group a large number of them were detected in combination with monocytes and endothelial cells. By day 5, degenerative-inflammatory types of cytograms dominated in the control group, while inflammatory-regenerative types dominated in the comparison group. The conducted cytological study demonstrates that the inclusion of vacuum therapy according to the developed method in the treatment regimen of patients with odontogenic phlegmon of the maxillofacial region helps to reduce the time for wound cleansing and the formation of granulation tissue, which allows for secondary sutures to be applied at an earlier date.

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