Aim. This research was designed to conduct a morphological analysis of the purulent wound exudate in the complex treatment of patients with odontogenic phlegmon of maxillofacial area (MA) by the antioxidant “Rexod” and antihypoxant “Mafusol”.Materials and methods. The objects of the study were 62 patients (aged 18 to 50 years) with odontogenic phlegmon who were divided into 3 groups. Group I (n=20) – the traditional treatment was supplemented by the intravenous drip injection of the antioxidant "Rexod"; group II (n=21) – the traditional treatment was combined with the intravenous injection of the antioxidant "Rexod" and antihypoxicant "Mafusol"; Group III (n=21) had the traditional treatment. The debridement of the purulent wound included a treatment with 0.06% sodium hypochlorite solution in all groups of patients in the first phase of the wound process; in the second phase the patients in all main groups were treated with the "Soderm" ointment dressings; in the comparison group were used the bandages with methyluracil ointment. In the third phase the gel "Kontraktubeks" was used to prevent the formation of rough scar tissue. There was carried out a morphological examination of smearsimprints of the wound exudate.Results. The microscopic analysis of the cellular landscape of the exudate revealed a significant number of polynuclears which are probably the segmented neutrophilic leukocytes and typical eosinophils; the number of mononuclear cells represented by typical lymphocytes was 4 times less; a single presence of macrophages, plasmocytes, fibroblast-like and epithelioid cells. The signs of degeneration were identified in the cells of histiogenic origin.Conclusion. As a result, there was revealed a gradual increase of overall amount of cells in the wound exudate in all study groups during the treatment, however, this process was pronounced to a greater extent in the patients of group I and II. The obtained result indicates the direct dependence of the activation of reparative processes in the wound from the applied medicines.

Background. The incidence of invasive mycoses is reported to increase among patients with a history of new coronavirus infection COVID-19. Adhesion and damage of endothelial cells by zygomycetes lead to fungus angioinvasion, release of a large number of fungal proteases, lipases and mycotoxins, as well as vascular thrombosis, subsequent necrosis of tissues.Objectives. Improvement of the diagnosis and treatment for COVID-19 associated invasive mycosis.Methods. Examination and treatment of 143 patients with invasive mycosis of the maxillofacial area in the period from August 2021 to May 2022 at the Maxillofacial Unit of Regional Clinical Hospital of Emergency Medical Care, Krasnodar Krai, Russia. The diagnosis was confi rmed by cytological, culture-based methods, as well as pathomorphological study of surgical specimen. Follow-up monitoring was carried out in 1, 3, 6 months, with repeated CT and MRI investigations. The group under follow-up monitoring included 91 patients. The incidence of signs was determined via descriptive statistics methods in proportion of the total number of observations and expressed as a percentage. Statistika 12.5 and Excel 2010 (Windows 10) were used in the study, the graphical representation of the material was made in the same programs.Results. Manifestation of invasive mycoses of the maxillofacial area occurred during the early convalescent period of coronavirus infection in specialized infectious hospitals or within two weeks after discharge from the hospital. A typical clinical picture includes rhinocerebral zygomycosis with the development of fungal osteomyelitis of the upper jaw, nasal bones, zygomatic bone, ethmoidal labyrinth bones, sphenoid bone, frontal bone. 17 cases (11.9%) had a lethal outcome as a result of disseminated form of fungal infection caused by Mucorales (14 patients), Aspergillus (3 patients) with damage to the brain, lungs, kidneys and fatal massive necrotic lesions of the craniofacial area. An integrated approach embraced early antifungal therapy (Amphotericin B) as well as surgical debridement of the lesions and provided a positive effect in treatment.Conclusion. Invasive fungal infections require prompt diagnosis and early prescription of antifungal therapy (prior to histological confi rmation of diagnosis) to minimize consequences and prevent fatal outcome. Due to the nonspecifi c nature of clinical symptoms and diffi culties of early diagnosis of invasive zygomycosis and aspergillosis, it is necessary to be alert to potential invasive aggressive mycoses in immunocompromised patients who have a history of a new coronavirus infection COVID-19.

Aim. To assess the effect of cytoflavin on the dynamics of the blood and oral fluid prooxidant-antioxidant system in patients with maxillofacial area phlegmons.Materials and methods. 55 patients were included in the study. The patients were divided into three groups: control group (group 1, n = 20); comparison group (group 2, n = 15); patients with phlegmons of the maxillofacial area (group 3, n = 20). As part of therapy, the patients in group 3 were additionally receiving cytoflavin (10 ml cytoflavin in 200 ml saline solution, 1 time per day, for 6 days). The treatment and monitoring was performed over the period of 6 days, during which the blood and oral fluid indicators were estimated 4 times (day 1, 2, 4 and 6).Results. Cytoflavin had a positive effect on the state of the prooxidant-antioxidant balance in patients with maxillofacial area phlegmons. In comparison with the control group, patients in group 3 demonstrated a lower content of oxidative modifi cation products and a higher antioxidant activity of blood plasma. Cytoflavin therapy also led to an increase in the activity of glutathione peroxidase and reductase, as well as an increase in the concentration of glutathione at the last stage of the therapy.Conclusion. The obtained data indicate the potential of cytoflavin as part of complex metabolic therapy for patients with purulent inflammatory processes of the maxillofacial area.