scholarly journals Prevention of large and giant postoperative ventral hernia prosthetic hernioplasty postoperative complications

2013 ◽  
Vol 94 (3) ◽  
pp. 417-420
Author(s):  
O T Alishev ◽  
R S Shaimardanov ◽  
Y R Makhmutova

Aim. To evaluate the effectiveness of regional prolonged irrigation with ropivacaine ozonated solution at large and giant postoperative ventral hernia prosthetic hernioplasty. Methods. 77 patients who underwent a planned surgery for large and giant postoperative ventral hernia from 2010 to 2012 were examined. All patients were distributed to two groups. The main group included 26 patients in whom a polyvinyl chloride catheter was installed in periprosthetic tissue for the wound irrigation using anesthetic (ropivacaine) ozonated solution for regional prolonged anesthesia and wound complications prevention as well as for preoperative preparation and intra-abdominal pressure monitoring for abdominal compression syndrome prevention using the technique developed by authors. The comparison group consisted of 51 patients in whom prevention of wound complications was carried out conventionally, and who received narcotic analgesics. Ultrasonography of postoperative wound area was used for local inflammation intensity assessment. Pain was assessed using numeric visual analogue scale in both groups. Results. 4 (15.4%) patients of the main group developed subcutaneous tissue seroma at the 5-6th day. In comparison group wound complications were registered in 15 (29.4%) patients, including 11 cases of seromas, 2 cases of suppurative inflammation, 1 case of ischemic necrosis of the wound edges, and also an isolated case of limphorrhea which occurred on the first day. The observations showed that the average pain level among patients of the main group was 3.8±0.4 points, compared to the control group - 5.3±0.4 points. Conclusion. Periprosthetic irrigation with ropivacaine ozonated solution provides adequate anesthesia, reduces the number of wound complications and promotes early rehabilitation.

2016 ◽  
Vol 97 (2) ◽  
pp. 204-207 ◽  
Author(s):  
A G Izmaylov ◽  
S V Dobrokvashin ◽  
D E Volkov ◽  
V A Pyrkov ◽  
R F Zakirov ◽  
...  

AIM. To improve treatment results of patients with ligature fistulas of the anterior abdominal wall by the development of pyo-inflammatory wound complications diagnosis and prevention methods.METHODS. During the period from the beginning of 2001 to June, 2015, 34 patients with a ligature fistulas of the anterior abdominal wall were admitted to the Department of Surgery of Hospital for War Veterans, Kazan. Terms of ligature fistula occurrence ranged from 3 months to 5.5 years after surgery. 7 (20.6%) patients previously underwent herniotomy, 20 (58.8%) - laparotomy for various acute surgical diseases of the abdominal cavity, 2 (5.9%) - appendectomy, 5 (14.7%) - pelvic organs surgery. The patients mean age was 59±4.5 years. Patients were divided into two groups: the first - the comparison group, 23 (67.6%) patients. In this group suturing was performed with polypropylene or absorbable suture filaments, wound debridement was performed by the conventional technique using different antiseptics types: 0.5% chlorhexidine (chlorhexidine bigluconate) and 3% hydrogen peroxide solutions. The second group - the main one, included 11 (32.4%) patients. In this group polyglycolide-co-lactide (purple), USP 2/0 (3 Matric) 75 cm with the atraumatic tip suture materials were used and the wound debridement was performed with 10% aqueous hydroxyethyldimethyldihydropyrimidin (xymedon) solution using a device developed by us.RESULTS. The postoperative pyo-inflammatory complications rate in the control group was 17.4% (4 cases), in the main group - 9.1% (1 case); thereby infiltrates were registered in 3 patients of comparison group and in 1 patient of main group, seroma - in 1 patient of comparison group. Monoculture was isolated in microbiological assay of material from the surgical wounds in 86% of patients. Staphylococci, enterobacteria and non-fermentative Gram-negative bacteria were detected most often. Our results of microbiological assays point to the need for perioperative antibiotic prophylaxis.CONCLUSION. The infectious wound complications rate when using conventional methods of anterior abdominal wall ligature fistulas prevention and treatment is 17.4%, which makes it relevant to search for new methods of treatment and wound surface debridement; the author’s technique offered by us allowed to significantly reduce the wound complications rate.


2021 ◽  
Vol 4 (4) ◽  
pp. 01-05
Author(s):  
Ahmed Mohamed Abd El-Hay

Background: Surgical site infections (SSIs) pose considerable morbidity and account for up to 20% of all nosocomial infections in surgical patients Aim of the Work: to determine the efficacy & safety of irrigation of subcutaneous tissue by Gentamicin for caesarean section Incision in reducing the risk of post-caesarean wound complications among obese women compared with placebo. Patients and Methods: This prospective randomized clinical trial study was conducted on total 132 obese patients who underwent elective cesarean section at Ain Shams University Maternity hospitals. This study was conducted on obese women undergoing caesarean section at Ain Shams University Maternity Hospital with the following inclusion and exclusion criteria. Patients were distributed randomly into 2 groups using a computer based program: Group (A) N = 66: CS with Irrigation of subcutaneous tissue by placebo (200 ml of saline 0.9 %). Group (B) N = 66: CS with irrigation of subcutaneous tissue by Gentamicin solution (1mg/kg gentamicin in 200 ml of saline 0.9%). Results: The results of this study revealed that the rate of SSI was less in gentamycin (3%) (n=2/66) than control group (4.5%) (n=3/66) with no statistical significance between them. Postoperative hospital stay and readmission rate due to SSI for the gentamycin group were also shorter but not statistically different in compared to the control group. Applying local gentamycin antibiotic irrigation during wound closure after cesarean section in obese patients is not recommended. NO role of local gentamycin irrigation in subcutaneous tissue in prevention of wound surgical site infection. Conclusion: as evident from the current study, in obese women undergoing elective CS, wound irrigation with Gentamicin is not superior to wound irrigation with placebo (saline 0.9) regarding efficacy & safety.


2021 ◽  
Vol 4 (3) ◽  
pp. 01-05
Author(s):  
Aliaa M. Maaty ◽  
Amr H. Yehia ◽  
Mohamed M. Abdelaleem ◽  
Mohammed A. Abd El-Fattah

Background: Surgical site infections (SSIs) pose considerable morbidity and account for up to 20% of all nosocomial infections in surgical patients Aim of the Work: to determine the efficacy & safety of irrigation of subcutaneous tissue by Gentamicin for caesarean section Incision in reducing the risk of post-caesarean wound complications among obese women compared with placebo. Patients and Methods: This prospective randomized clinical trial study was conducted on total 132 obese patients who underwent elective cesarean section at Ain Shams University Maternity hospitals. This study was conducted on obese women undergoing caesarean section at Ain Shams University Maternity Hospital with the following inclusion and exclusion criteria. Patients were distributed randomly into 2 groups using a computer based program: Group (A) N = 66: CS with Irrigation of subcutaneous tissue by placebo (200 ml of saline 0.9 %). Group (B) N = 66: CS with irrigation of subcutaneous tissue by Gentamicin solution ( 1mg/kg gentamicin in 200 ml of saline 0.9%). Results: The results of this study revealed that the rate of SSI was less in gentamycin (3%) (n=2/66) than control group (4.5%) (n=3/66) with no statistical significance between them . postoperative hospital stay and readmission rate due to SSI for the gentamycin group were also shorter but not statistically different in compared to the control group. Applying local gentamycin antibiotic irrigation during wound closure after cesarean section in obese patients is not recommended. NO role of local gentamycin irrigation in subcutaneous tissue in prevention of wound surgical site infection. Conclusion: as evident from the current study, In obese women undergoing elective CS , wound irrigation with Gentamicin is not superior to wound irrigation with placebo (saline 0.9) regarding efficacy & safety.


2017 ◽  
pp. 19-24
Author(s):  
O.V. Grishchenko ◽  
◽  
V.V. Bobrytska ◽  

The objective: To evaluate the clinical efficacy and safety of Enoxaparin-Pharmex for the prevention of thrombotic complications (pulmonary embolism) in the postoperative period in patients with moderate risk of these complications. Patients and methods. The study included 50 women after a caesarean section had an average degree of risk of pulmonary embolism. Patients were divided into the main group (n=25) and control group (n=25) in accordance with the treatment: patients of the main group received postoperative Еnoxaparin- Pharmex, group comparisons enoxaparin sodium (brand foreign manufacturer’s). Patients in both groups received the drug at a dose of 20 mg for 5 days, 1 time per day subcutaneously. Results. The research data analysis showed identity results of hemostasiogram of patients in the main group and the comparison group, no side effects after treatment in both groups. Conclusion. The clinical studies suggest the drug Enoxaparin-Pharmex is effective, safe LMWH, which can be used to prevent troboembolic complications, including post-operative treatment in obstetric practice. Spectrum of Enoxaparin-Pharmex can be extended to the prevention and treatment of thromboembolic conditions of varying severity with appropriate doses of the drug. Key words: Enoxaparin-Pharmex, prevention of pulmonary embolism.


Author(s):  
T.I. Viun ◽  
L.M. Pasieshvili ◽  
S.V. Viun ◽  
A.S. Marchenko ◽  
O.V. Karaya

The prevalence of comorbidities has been growing for the last decades. Therefore, the detection of biomarkers for diagnostic and prognostic purposes is of great practical importance. The aim of this study was to assess the biomarkers of osteo-defficiency in the course of secondary osteoporosis in patients with comorbid chronic pancreatitis and arterial hypertension. We examined 110 patients with chronic pancreatitis: 70 of them had comorbid hypertension, and 40 patients were found as having no comorbidities. The age of patients ranged from 33.2 ± 2.1 (main group) and 32.9 ± 3.1 years (comparison group); women predominated (72.9% and 70%, respectively). The control group includes 78 healthy individuals of the same age and sex. Diagnostic investigation included studying clinical and anamnestic characteristics of patients (duration of the disease, manifestations of the course, frequency of recrudescence, fractures) and biochemical parameters of bone metabolism: osteocalcin, total bone phosphatase and tartrate-resistant acid phosphatase and the establishment of correlations between these parameters and incidence of complications. It was found that in the isolated course of chronic pancreatitis there is a high (R = 0.60) statistically significant (p <0.01) correlation between the levels of osteocalcin and pancreatic elastase-1. A negative statistically significant (p <0.01) mean correlation (R = -0.49) was found between the content of tartrate-resistant acid phosphatase and age of the patients having comorbidity of chronic pancreatitis and hypertension, as well as there is a moderate correlation between the content of tartrate-resistant acid phosphatase and the duration of hypertension, which is statistically significant (R = 0.36, p <0.01). The levels of total bone phosphatase and tartrate-resistant acid phosphatase in the main group exceeded the reference values in 2.5 and 1.9 times respectively (CMU; U = 866.0; p <0.01), while in the comparison group were 2 times (total bone phosphatase) and 1.3 times higher (tartrate-resistant acid phosphatase) times, respectively (CMU; U = 821.0; p <0.01) that enables to diagnose the development of osteopenic conditions. That is, the combined course of chronic pancreatitis and hypertension should be considered as unfavourable tandem in the development of secondary osteoporosis and requires early osteoporotic screening.


2015 ◽  
Vol 64 (4) ◽  
pp. 4-12 ◽  
Author(s):  
Edvard Karpovich Aylamazyan ◽  
Victoriya Yuryevna Andreeva ◽  
Tatiana Ulyanovna Kuzminykh ◽  
Dmitriy Igorevich Sokolov ◽  
Sergey Alekseevich Selkov ◽  
...  

Development and introduction of materials influenced on reparation process in a myometrium is actual direction of modern obstetrics in connection with the increase of cesarean section rate. One of such preparation is «Collost», it stimulates the processes of neoangio- and myogenesis and excludes the disorderly growth of scars tissue. Aim: To study the influence of bioplastic material «Collost» on the reparation process in myometrium after cesarean section. Objectives: to estimate the morpho-functional state of scar on uterus after cesarean sections depending on implantation of collagen membrane. Material and methods: There were included 13 female rabbits in experimental part of the study. In clinical part of the study there were included 20 pregnant woman with intraoperative application of «Collost» (main group), 30 pregnant woman without «Collost» implantation (comparison group) and 10 pregnant with vaginal delivery (control group). Results: histological, immunohistological and immunological findings of postoperative uterine scars of female rabbits showed significant differences of expressions of miosin, vascular endothelial growth factor and collagen I type. The myometrium was significantly thicker in the area of uterine scar in main group (with collagen membrane implantation) than in comparison group. Conclusions: bioplastic material «Collost» leads to full formation of muscular wall and vascular ture in the area of postoperative uterine scar.


2019 ◽  
pp. 156-161
Author(s):  
E. A. Voroshilova

The article presents the results of a comparative randomized study, the purpose of which was to evaluate the effectiveness of the use of aminodihydrophthalasindione sodium (Galavit, LLC SELVIM, Russia) in the treatment of patients undergoing an abortion. Included in the study, 48 women were divided into two groups, 24 patients of the main group in addition to the standard rehabilitation were treated with aminodihydrophthalasindione sodium in the comparison group – 24 patients underwent only standard rehabilitation. In this study, all patients (100%) of the main group who were treated with aminodihydrophthalasindione sodium in addition to the standard therapy marked reduction of the clinical symptoms of the disease and positive dynamics was observed at ultrasound. In the control group, the full clinical effect of treatment was observed only in 10 patients (52.6%). 9 women (47,4%) required repeated therapy. Ultrasound studies in 12 patients (63.2%) showed changes equivalent to endometritis.


2021 ◽  
Vol 106 (2) ◽  
pp. 28-35
Author(s):  
V. Batig ◽  
◽  
O. Tokar ◽  
I. Burdenyuk ◽  
◽  
...  

Goal. Improving the scheme of treatment and prevention of periodontal diseases in workers of the woodworking industry of Chernivtsi region, who in the process of professional activity have long-term contact with unfavorable factors of the production environment. Materials and methods. 70 workers of the woodworking industry with diagnosed chronic generalized periodontitis of the I degree were treated (35 people – the main group (A); 35 people – comparison group (B)), age – from 25 to 45 years. To compare the results of laboratory studies, an additional survey of 25 healthy individuals of the same age with an intact periodontium were conducted. They formed the control group (C). Clinical examination of patients was performed according to standart methods: subjective (complaints, medical history, life history) and objective (examination, periodontal indices, determination of the level of gingival attachment). Laboratory methods of research included determination of urease and lysozyme activity in saliva, degree of dysbiosis of oral cavity. As maintenance therapy, patients of the main group were prescribed the proposed composition DEPE. Results. After the treatment, a significant improvement in the hygienic status of patients in both groups was observed, but difference between groups A and B in the indicators of oral hygiene after treatment was no statistically significant (pA2–B2 > 0.05). There was a significant improvement in periodontal indices after treatment in patients of both groups (PMA index according to C. Parma, bleeding index according to Muhlemann in Cowell I. modification, Russell periodontal index, PSR-test), but the indicators in patients of the main group were significantly better – pA2–B2 < 0.05. In patients of the main group (A) the level of attachment loss decreased by 1.83 times, comparison group (B) – by 1.71 times. The difference in levels of attachment loss after treatment between groups A and B is statistically significant (pA2–B2 < 0.05). The activity of the enzyme urease in patients of the main group (A) and comparison group (B) after treatment was significantly reduced (pA1–A2 < 0.001, pB1–B2 < 0.001), but only in the main group it reached the level in the control group (C) (pA2–C > 0.05). The level of lysozyme after treatment was significantly increased in patients of both observation groups (pA1–A2 < 0.001, pB1–B2 < 0.001), and reached the level of lysozyme in patients of the control group (C) (pA2–C > 0.05, pB2–C > 0.05). The degree of oral dysbiosis in patients of the main group (A) was significantly reduced by 5.43 times (pA1–A2 < 0.001), and its difference from the degree of dysbiosis in patients of the control group (C) is statistically insignificant (pA2–C > 0.05 ). The degree of oral dysbiosis in patients of the comparison group (B) was significantly reduced by 3.04 times (pB1–B2 < 0.001), but still remained significantly different from oral dysbiosis in patients of the control group (C) (pB2–C < 0.05). Conclusion. The proposed pharmacological composition DEPE is an effective antiseptic solution and can be used in the phase of maintenance therapy to improve the treatment and prevention of periodontal disease in workers of woodworking industry. Key words: decamethoxine, propolis, ethonium, generalized periodontitis, woodworking industry.


Author(s):  
O. V. Avdeev ◽  
Y. K. Zmarko ◽  
A. B. Boykiv ◽  
R. O. Drevnitska

The high prevalence of inflammatory processes in the periodontitis of children, the ineffective effectiveness of preventive and curative measures can contribute to the development of generalized periodontitis, therefore it remains urgent to develop pathogenetic effects in the treatment of chronic catarrhal gingivitis.The aim of the study – a comparative assessment of the traditional treatment of chronic catarrhal gingivitis in children aged 6–7 years with therapy using an anti-inflammatory gel with neovitin.Materials and Methods. 61 children aged 6–7 years, suffering from chronic catarrhal gingivitis, were taken under clinical supervision and divided into groups: the main (30 children) and the comparative (31 children). All children underwent conventional therapy in accordance with the protocols for the provision of medical care – basic therapy. In the main group, for a month, pathogenetic agents were used: an anti-inflammatory gel with neovitin, hygiene products were recommended. In the comparative group, 3 % hydrogen peroxide solution was used for local therapy, for rinsing of the mouth (during the first week of treatment) – Rotokan, a therapeutic and prophylactic toothpaste.Examination and control examinations were carried out with the hygienic state of the mouth determined by the hygienic index of Yu. A. Fedorov and V. V. Volodkina, prevalence and intensity of the inflammatory process in the gums with the help of the Schiller-Pisarev test and the PMA index, oral fluid index (lysozyme content, formation of oxydradicals, urease activity, degree of dysbiosis, pH and viscosity).Results and Discussion. After the treatment, elimination of gum inflammation in patients of the main group was accompanied by a decrease in the PMA index by 3.8 times; formation of oxyradicals decreased in children of the main group by 6.35 %; in the comparative group – by 6.15 %. Urease activity decreased in children of the main group by 16.37 % (p<0.05), the viscosity of the oral fluid of children decreased in 2.65 times in the main group and in 2.13 times in the comparative group (p<0.05). The lysozyme content increased in children of the main group by 15.61 % (p<0.05) in the comparison group – by 9.63% (p<0.05). The treatment after 0.5 years caused an increase in the lysozyme content in the oral fluid of the children of the main group to the level of the control group. The degree of dysbiosis decreased in the main group, in the comparison group tended to increase.Conclusions. The use of the proposed therapy with gel with neovitin contributed to the best results of treatment: reducing the degree of inflammation of the gums, the number of visits to the doctor, improving the indices of nonspecific protection in the oral fluid of 6-7 years-old children and, to a greater extent, six months after the treatment.


2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 218s-218s
Author(s):  
M. Khanevich ◽  
A. Khazov

Background: Surgical removal of the tumor remains the only 1 radical treatment of patients with soft tissue sarcomas of the extremities. However, the parameters of total and disease-free survival after this type of treatment cannot be considered satisfactory. Currently the active search and introduction into clinical practice of additional impact methods that can improve the immediate and long-term results of treatment of such patients is being conducted. Aim: To evaluate the risk of the wound process complications after surgical treatment of soft tissue sarcomas using endovascular embolization and cryosurgery. Methods: We have assessed the quantity and quality of postoperative complications of wound process in 199 patients with soft tissue sarcomas and their recurrences. The study group consisted of 53 patients, who underwent radical surgery with selective preoperative endovascular embolization and intraoperative cryosurgery. The control group consisted of 146 patients who had radical surgery without any additional methods. Preoperative embolization and cryosurgery on the wound bed after tumor removal was used to prevent local recurrence of soft tissue sarcomas. Preoperative angiography with selective embolization of vessels feeding the tumor was performed 1-1.5 hours before the main surgical treatment. Cryosurgery was carried out by the method of “Olympic rings” with 3 minutes duration. The temperature of exposure was −186°C. In the course of cryosurgery we adhere to the principle of “quick freezing - an independent slow thawing”. All postoperative wounds tightly sutured with silicone drains by Redon, if necessary. Results: Complications of wound healing have been diagnosed in 15 (28.3%) patients of the main group and in 34 (23.3%) control group patients. Inflammatory-suppurative complications were observed in the remaining 8 (15.1%) patients of the main group and in 18 (12.3%) control group patients ( P > 0.05). Long lymphorrhea was observed in 6 (11.3%) patients of the main group and 11 (7.5%) control group patients. Bleeding in the postoperative period was observed in 1 (1.9%) case of main group patients and in 5 (3.4%) cases of control group. Conclusion: The additional using of selective preoperative endovascular embolization and cryosurgery is safe and does not worsen immediate results of surgical treatment of soft tissue sarcomas.


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