PATHOMORPHOLOGY OF NON-HEALING BEDSORE ULCERS IN INTENSIVE CARE PATIENTS IN NEUROSURGERY

Bedsores are a serious complication in patients with impaired tissue nutrition not only under the influence of external compression, but also a result of various systemic diseases, as well as disorders of the nervous system. Purpose of research. To study the features of the microscopic structure of non-healing bedsore ulcers in patient who are unconscious for a long time in the intensive care unit. Material and methods. Microscopic examination of non-healing bedsore ulcers in 6 patients (5 men,1 woman),who are in a long unconscious state with the consequences of severe traumatic brain injury at the age 22 to 70 years (average-45).In cases, the bedsore ulcer was localized in the sacrum, in 1 case in in the heel region and 1 on the scalp in the occipital region. Results. It was found that the surface of non-healing bedsore ulcers is represented by granulation tissue, which has a morphologically similar character in all cases, regardless of localization. The main differences between granulations in chronic bedsore and classical granulation tissue are established. It was noted that the granulation tissue of bedsore ulcers has an incomplete structure with a violation of the ratio and reduction of layers, increased collagenization. In the considered cases, only 4 layers were determined: the surface leukocyte-necrotic layer; the surface layer of vascular loops; layer of vertical vessels; maturing layer. Consaltion. Bedsore ulcers in patient who are in a long unconscious state have the character of chronic deep non-healing wounds with the formation of atypical granulation tissue, reflecting the violation of the phases of the wound process.

vegetative state, non-healing bedsore, chronic wound, granulation tissue, pathomorphology