PECULIARITIES OF CHANGES IN MICROCIRCULATORY PARAMETERS OF MICROCIRCULATION IN LOCAL FREEZING INJURY OF THE UPPER LIMBS

Shapovalov K.G., Sizonenko V.A., Burdinskii E.N.
Chair of Traumatology, Orthopaedics and Field Surgery,
Chita State Medical Academy,
Chita, Russia

The condition of the microcirculatory bed in frostbitten tissues has the decisive importance in the course of the injury. The objective of the work was to investigate the dynamics of the parameters of microcirculation in patients with an endured local frostbite injury of the upper extremities.

Evaluated were oscillations of the bloodstream by means of laser Doppler flowmetry. The study was carried out in a total of sixty 18-to-45-year-old patients presenting with a degree II-IV local frostbite injury of the upper extremities at various periods of the injury. In the prereactive period, when there are no significant deviations of the blood-flow oscillation parameters, using the occlusion test makes it possible to reveal alterations in the condition of the microcirculatory bed. The early and late reactive periods of a local frostbite injury of the upper limbs are characterized by an increase in the neurogenic and myogenic components of vascular tonicity, as well as the bypass index, thus suggesting a vascular spasm and increased bypass blood flow. Degree II-IV frostbites of the upper extremities in the early and late reactive periods of the injury are accompanied by decreased reactivity of the vascular wall in response to occlusion, decreased potential of the active mechanisms of regulation of vascular tonicity, and maintenance of an adequate tissue blood circulation, with a 1.5-2-fold decrease in the blood flow reserve. The revealed alterations in the parameters of microcirculation and regulation of vascular tonicity explain a lingering course of the wound process in frostbites. Using the method of laser Doppler flowmetry makes it possible to determine the condition of microcirculation and vascular tonicity, to evaluate efficiency of the methods of treatment, and to predict the course of frostbite.

KEY WORDS: microcirculation, fruring injury of the upper limbs.

P. 29-32

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