The complexity of the treatment of postoperative wounds in patients with malignant tumors of the nervous system and scalp

Despite modern advances in medicine, the number of patients with malignant neoplasms around the world continues to grow [1]. It is known that every year more than 12 million new cases are detected, of which 6 % are brain tumors. Brain lesions are in third place in terms of growth rates among all neoplasms [2, 3]. Often, patients with malignant processes, including the central nervous system and scalp, have difficulties in healing postoperative wounds. This is due to the presence of the oncological disease itself and the effects of radiation and chemotherapy on the body, which reduce immunity and contribute to the development of wound infection.

PURPOSE OF THE STUDY. To describe the clinical observations of patients with malignant tumors of the central nervous system (CNS) and the skin of the head and the complexity of the treatment of postoperative wounds in them.

MATERIALS AND METHODS. Three patients with malignant tumors of the brain and scalp and an unfavorable course of postoperative wound healing were observed in the neurosurgical department of the St. Petersburg State Budgetary healthcare Institution «Mariinsky City hospital». All of them underwent computed tomography (CT) and magnetic resonance imaging (MRI) with additional study protocols, one also underwent SPECT/CT with 99mTc-MIBI. Two patients underwent complex and combined treatment, one had only surgery. In all cases, against the background of poor healing of postoperative wounds, inflammatory changes in the brain developed with an outcome in an abscess.

RESULTS. A favorable course of the disease was observed in one patient who did not receive chemotherapy and radiation therapy. he was discharged in a satisfactory condition with signs of regression of a brain abscess. Two other patients with long-term, poorly healing, open postoperative wounds had a lethal outcome.

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