scholarly journals External stabilization of the thorax in complex treatment of children with severe chest injuries: Description of clinical cases

2018 ◽  
Vol 6 (2) ◽  
pp. 73-78
Author(s):  
Mustakhim N. Satyvaldayev ◽  
Mikhail A. Akselrov
Keyword(s):  
Original Method ◽  
Duration Of Treatment ◽  
Septic Complications ◽  
Chest Injuries ◽  
Minimally Invasive Stabilization ◽  
Early Transfer ◽  
External Stabilization ◽  
Clotted Hemothorax ◽  
Conditions Of Work ◽  
Clinical Cases

Aim. To describe a proposed method of treating children with a traumatic disorder of the thorax. Material and methods. Under the conditions of work in the Tyumen “Center of Medicine of Catastrophes”, doctors of all specialties of the Tyumen region interact with thoracic surgeons. Special attention is given to children with polytrauma. In the Tyumen region for the period 2016–2017, two travels to treat children with multiple floating fractures of the ribs on one side were made. The patients were treated by using an original method of external chest stabilization. We present the advantages of the method in the descriptions of the clinical cases. Results. The chest structure was stabilized by using a V-shaped model of the Cramer tire to increase the area of contact with the chest. The tire was fixed with Kapron thread No 5 by using a large cutting needle, which was wound under the ribs after marking the floating section of the chest. The ribs were stitched for stable areas along the edges and for an unstable fragment of the thorax. Later, the V-shaped model of the Cramer tire was applied and fixed by threads to the chest. This method is simple and acceptable in any hospital and allows early spontaneous breathing with no purulent-septic complications. Conclusions. This method of restoring the skeletal function of the thorax with the help of external fixation of the V-shaped model of the Cramer tire allows reliable minimally invasive stabilization of the chest wall. External stabilization of the thorax allows early transfer of the victims to independent breathing and shortens the duration of treatment in the intensive care unit. The availability and simplicity of the design makes it possible to perform this procedure everywhere. Video thoracoscopic support is needed only if there is a suspicion of a clotted hemothorax.

scholarly journals Surgical Treatment for Septic Complications in Patients with Duodenal Perforation Following Endoscopic Retrograde Transpapillary Interventions

2019 ◽  
Vol 14 (2) ◽  
pp. 13-20
Author(s):  
V. L. Korobka ◽  
S. V. Tolstopyatov ◽  
A. M. Shapovalov
Keyword(s):  
Surgical Treatment ◽  
Abdominal Cavity ◽  
Abdominal Sepsis ◽  
Original Method ◽  
Duodenal Perforation ◽  
Symptomatic Therapy ◽  
Primary Reconstruction ◽  
Two Stage ◽  
Septic Complications ◽  
Primary Surgery

Background The most severe clinical cases following transpapillary endoscopic interventions are duodenal perforation with damage to the common bile duct and pancreatic duct, entrance into the abdominal cavity and retroperitoneum the aggressive contents of intestine and the infections. They usually lead to higher mortality. Aim Evaluation of the optimal management for duodenal perforation in patients who have undergone transpapillary endoscopic interventions. Material and Methods A retrospective analysis of surgical treatment in thirty-two patients with duodenal perforation after transpapillary endoscopic interventions from the year 2007 to 2018 in one center was carried out. Nineteen cases (59.4%) were diagnosed less than 24 hours, 13 (40.6%) – more than 24 hours after injury. Twenty patients had the primary reconstruction of duodenum with various drainage options of injury area. In 19 cases there were a two-stage surgical procedure according the original method: 12 had a primary surgery, 7 were reoperated. Results After primary reconstruction of duodenum 11 patients (55.0%) had complications, seven (63.6%) – were re-operated, in four we have applied efferent treatments and symptomatic therapy. Three patients (15.8%) died. After two-stage surgery procedure 7 patients (36.8%) had surgical complications, five (26.3%) – were re-operated. Three patients (15.8%) – were died. Conclusion Primary duodenum reconstruction can be performed if the injury occurred less than 24 hours before surgery. Two-staged surgery is justified in cases with purulent inflammation in abdominum and reproperitoneal cavity because procedure allows reducing mortality from abdominal sepsis

scholarly journals Historical aspects of asepsis and antiseptics

2021 ◽  
Author(s):  
A. M. Morozov ◽  
A. N. Sergeev ◽  
S. V. Zhukov ◽  
A. M. Varpetyan ◽  
T. S. Ryzhova ◽  
...  
Keyword(s):  
19Th Century ◽  
Scientific Discovery ◽  
Antibacterial Properties ◽  
The Body ◽  
Duration Of Treatment ◽  
Septic Complications ◽  
Surgical Practice ◽  
Wide Range ◽  
History Of ◽  
The 19Th Century

Relevance. For many centuries, infectious complications have been one of the most pressing problems of surgical practice. In modern medicine, a wide range of aseptic and antiseptic methods is presented, which, without harm to the body, can destroy pathogenic microorganisms and prevent the development of purulent complications that significantly aggravate the patient's condition and increase the duration of treatment. However, this was not always the case. In the era of the formation of surgery, interventions in a significant majority of cases ended with the development of purulent and septic complications, which inevitably led to death.The purpose of this study was to study the main points that play a key role in the history of the formation of modern asepsis and antiseptics.Material and methods. In the course of the study, an analysis of domestic and foreign literature on the history of the development of aseptics and antiseptics was carried out. When compiling the work, the biographical method of historical research was used. Articles and historical sketches of the period of the described events were also used as materials.Results. The formation of the principles of asepsis and antisepsis is a long historical process in which many of the greatest minds of mankind have been involved. At the same time, like the development of any scientific worldview, the development of asepsis and antiseptics was based on previous knowledge, as well as on knowledge obtained, mainly empirically. From time immemorial, physicians have already had an idea of the antibacterial properties of a number of compounds. The first mentions of attempts to prevent contamination of wounds and their disinfection date back to the time of Hippocrates. In the Middle Ages, for the purpose of disinfecting wounds, cauterization with a red-hot iron and boiling oil was widely used. From the middle of the 18th century, the first antiseptics entered the practice of surgeons. From the middle of the 19th century, a significant contribution to the development of asepsis and antiseptics was made by the Russian surgeon N.I. Pirogov, and his follower N.V. Sklifosovsky. A breakthrough in the development of asepsis and antiseptics in the late 19th – early 20th centuries was the scientific discovery of the French scientist Louis Pasteur, who proved that the processes of fermentation and decay are caused by microorganisms. This discovery formed the basis of J. Lister's antiseptic method. At the end of the 19th century, E. von Bergmann developed the aseptic method. One of the last significant events in the history of antiseptics was A. Fleming antibiotics.Conclusions. Thanks to the work of great scientists and doctors, there are many lifethreatening postoperative complications that claimed the lives of many people, if they did not remain in the past, then their incidence and intensity of manifestations have noticeably decreased, and asepsis and antiseptics have become an integral component of surgical practice.

scholarly journals Aspiration drainage in the prevention of postoperative septic complications in rectum sphincter-sparing abdominoperitoneal resection

2015 ◽  
Vol 96 (6) ◽  
pp. 935-939
Author(s):  
F Sh Akhmetzyanov ◽  
N T Shaykhutdinov ◽  
N A Valiev ◽  
Z N Shemeunova ◽  
V I Egorov
Keyword(s):  
Original Method ◽  
Drainage Tube ◽  
Fistula Formation ◽  
Pelvic Cavity ◽  
Published Data ◽  
Septic Complications ◽  
Operative Care ◽  
Intestinal Stoma ◽  
One Step ◽  
Original Construction

Aim. Explore the effectiveness of the double-barreled drainage tube «tube in tube», mounted by the developed technique after rectum sphincter-sparing abdominoperitoneal resection due to cancer. Methods. The data of 52 patients with rectal tumors who underwent rectum sphincter-sparing abdominoperitoneal resection in two surgical wards over the past 4 years were analyzed. At the surgery, the colon was brought down together with anal channel mucosa excision and bringing down the colon mucosa to the anal channel. Rectum sphincter-sparing abdominoperitoneal resection was finished in all patients by placing a double-barreled drainage tube of the original construction to the retroperitoneal part of the cavity of the true pelvis by an original method via the anterior abdominal wall incision. No one-step intestinal stoma was exteriorized in any of the patients. Results. The average duration of postoperative hospital stay was 17 days; in patients who underwent non-hybrid operation (50 of 52 patients) - 15.3 bed-days. Postoperative complications occurred in a total of 11 (21.1%) patients, and the rate of septic complications was 1.9%, which is lower compared to published data. It is worth noticing that the use of our original method of pelvic cavity draining totally excludes peritoneal fistula formation and facilitates post-operative care. Conclusion. The proposed method of pelvic cavity draining at rectum sphincter-sparing abdominoperitoneal resections might be effective, as is associated with lower chance of purulent and septic complications. It excludes the possibility of perineal fistula formation, facilitates the post-operative period management.

A Phonomotor Approach to Apraxia of Speech Treatment

2020 ◽  
Vol 29 (4) ◽  
pp. 2109-2130
Author(s):  
Lauren Bislick
Keyword(s):  
Phase I ◽  
Treatment Effects ◽  
Single Case ◽  
Motor Planning ◽  
The Other ◽  
Multimodal Approach ◽  
Apraxia Of Speech ◽  
Duration Of Treatment ◽  
Treatment Gains ◽  
Future Work

Purpose This study continued Phase I investigation of a modified Phonomotor Treatment (PMT) Program on motor planning in two individuals with apraxia of speech (AOS) and aphasia and, with support from prior work, refined Phase I methodology for treatment intensity and duration, a measure of communicative participation, and the use of effect size benchmarks specific to AOS. Method A single-case experimental design with multiple baselines across behaviors and participants was used to examine acquisition, generalization, and maintenance of treatment effects 8–10 weeks posttreatment. Treatment was distributed 3 days a week, and duration of treatment was specific to each participant (criterion based). Experimental stimuli consisted of target sounds or clusters embedded nonwords and real words, specific to each participants' deficit. Results Findings show improved repetition accuracy for targets in trained nonwords, generalization to targets in untrained nonwords and real words, and maintenance of treatment effects at 10 weeks posttreatment for one participant and more variable outcomes for the other participant. Conclusions Results indicate that a modified version of PMT can promote generalization and maintenance of treatment gains for trained speech targets via a multimodal approach emphasizing repeated exposure and practice. While these results are promising, the frequent co-occurrence of AOS and aphasia warrants a treatment that addresses both motor planning and linguistic deficits. Thus, the application of traditional PMT with participant-specific modifications for AOS embedded into the treatment program may be a more effective approach. Future work will continue to examine and maximize improvements in motor planning, while also treating anomia in aphasia.

Type V Bekesy Pattern: Interpretation and Clinical Utility

1967 ◽  
Vol 10 (4) ◽  
pp. 733-744 ◽  
Author(s):  
William F. Rintelmann ◽  
Earl R. Harford
Keyword(s):  
Clinical Utility ◽  
The Past ◽  
Type V ◽  
Clinical Cases

Recent studies indicate there is some disagreement concerning the interpretation and clinical utility of the Type V Bekesy pattern. Bekesy tracings obtained over the past six years from a sample of clinical cases were analyzed and a definition was established for the Type V pattern. This definition was applied to Bekesy tracings obtained from normal listeners, hypoacusics, and pseudohypoacusics. The Type V pattern was found frequently among pseudohypoacusics and only rarely among other individuals.

Minimally Invasive Repair of Pectus Excavatum (MIRPE) - The Basel Experience

Swiss Surgery ◽  
2003 ◽  
Vol 9 (6) ◽  
pp. 289-295 ◽  
Author(s):  
Haecker ◽  
Bielek ◽  
von Schweinitz
Keyword(s):  
Minimally Invasive ◽  
Pectus Excavatum ◽  
Pulmonary Function Tests ◽  
Preoperative Evaluation ◽  
Skin Incision ◽  
Original Method ◽  
Restrictive Lung Disease ◽  
Cardiac Compression ◽  
Cardiac Evaluation ◽  
Indications For Operation

Purpose: Minimally invasive repair of pectus excavatum (MIRPE) was first reported in 1998 by D. Nuss. This technique has gained wide acceptance during the last 4-5 years. In the meantime, some modifications of the technique have been introduced by different authors. Our retrospective study reports our own experience over the last 36 months and modifications introduced due to a number of complications. Methods: From 3/2000 to 3/2003, 22 patients underwent MIRPE. Patients median age was 15.5 years (10.7 to 20.3 years). Standardised preoperative evaluation included 3D computerised tomography (CT) scan, pulmonary function tests, cardiac evaluation with electrocardiogram and echocardiography, and photo documentation. Indications for operation included at least two of the following: Haller CT index > 3.2, restrictive lung disease, cardiac compression, progression of the deformity and severe psychological alterations. Results: In 22 patients (2 girls, 20 boys) undergoing MIRPE procedure, a single bar was used in 21 patients and two bars in one boy. Lateral stabilisers were fixed with non resorbable sutures on both sides. Overall, postoperative complications occurred in six patients (27.3%). In two patients (9.1%) a redo-procedure was necessary due to bar displacement. An additional median skin incision was performed in two patients to elevate the sternum. Pneumothorax or hematothorax in two patients resulted in routine use of a chest tube on both sides. Long-term favourable results were noted in all patients. Conclusions: The MIRPE procedure is an effective method with elegant cosmetic results. Modifications of the original method help to decrease the complication rate and to accelerate acquirement of expertise.

Gastrocnemius-Fibular Flap. A New Pedicled Vascularized Bone Graft Alternative for Femur Pseudarthrosis. Review of 7 Consecutive Clinical Cases

2014 ◽  
Vol 30 (S 01) ◽  
Author(s):  
Luciano Torres ◽  
Fernanda Bogdanovics ◽  
Paganotti Guilherme ◽  
Pelosini Gaiarsa ◽  
José Queiroz ◽  
...  
Keyword(s):  
Bone Graft ◽  
Vascularized Bone Graft ◽  
Fibular Flap ◽  
Vascularized Bone ◽  
Clinical Cases

Treatment of Delayed Union and Septic Osteomyelitis of Metacarpus III/IV in a Calf Using Gentamicin-impregnated Collagen Sponges and Minimal External Coaptation

1998 ◽  
Vol 11 (01) ◽  
pp. 19-22 ◽  
Author(s):  
A. Steiner ◽  
Gaby Hirsbrunner
Keyword(s):  
Standard Treatment ◽  
Delayed Union ◽  
Surgical Debridement ◽  
Rigid Fixation ◽  
Skin Defect ◽  
Long Time ◽  
Metaphyseal Fracture ◽  
External Stabilization ◽  
Long Acting ◽  
Local Antibiotic

SummaryA newborn calf was admitted for evaluation of a primarily closed comminuted metaphyseal fracture of metacarpus III/IV. Closed reduction and application of transfixation pins and a fibreglass cast were performed. Ten days after pin removal, radiographs revealed that the initially healed fracture had collapsed, and osteomyelitis was diagnosed. Bacteriological culture from the deep draining tract yielded Actinomyces pyogenes and Staphylococcus aureus. Standard treatment of delayed union or nonunion caused by septic osteomyelitis consists of surgical debridement, rigid fixation, and long-time administration of antibiotics. In this case, we used surgical debridement, administration of a new long-acting local antibiotic (gentamicin- impregnated collagen sponges), and minimal external stabilization. At day 27 after initiation of this treatment, the skin defect had healed, and the fracture was stable on manual palpation.Standard treatment of delayed union or nonunion caused by septic osteomyelitis consists of surgical debridement, rigid fixation and prolonged administration of antibiotics. In the case described, we used surgical debridement, administration of a long-acting local antibiotic (gentamicin-impregnated collagen sponges), and minimal external stabilization. The promising outcome of this case and the good results in human surgery warrant further investigation in the use of gentamicin-impregnated collagen sponges in veterinary orthopaedics.

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