scholarly journals The influence of polymorbide states on local immune responses and course wound process in surgical infection of soft tissues

2018 ◽  
Author(s):  
K. N. Korobintseva ◽  
A. A. Gafarova ◽  
N. A. Barkhatova
Keyword(s):  
Immune Responses ◽  
Soft Tissues ◽  
Surgical Infection

Specials clinical symptoms the local and general forms of surgical infection of soft tissues on the children’s age

2013 ◽  
Vol 4 (4) ◽  
pp. 18-22
Author(s):  
Natalia Anatolievna Barhatova
Keyword(s):  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Inflammatory Reaction ◽  
Soft Tissues ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Systemic Inflammatory Response ◽  
Surgical Infection ◽  
Clinical Diagnostic ◽  
Significant Factors

In article include results of analyses specials clinical and laboratories manifestations the local and general forms of infection on the soft tissues at the children in different age. Were revealed the most significant factors of risk development general form of infection in the children´s age. Also were determined clinical specials of systemic inflammatory response syndrome in dependent of the character inflammatory reaction of soft tissues, time of hospitalization and time of surgical intervention. Were revealed the most typical combinations symptoms of systemic inflammatory response syndrome on the child in different age. It´s allow improve early clinical diagnostic of sepsis on the child and shorten time of start equivalent therapy of general forms of infection.

scholarly journals Organizational problems and possible ways of its resolve when providing emergency surgical care to patients with comorbid status in a highly specialized medical institution

2020 ◽  
Vol 7 (2) ◽  
pp. 64-74
Author(s):  
I. M. Khokhlova ◽  
V. B. Kozhevnikov ◽  
K. N. Movchan ◽  
B. S. Artyushin ◽  
E. V. Bartashevich ◽  
...  
Keyword(s):  
Medical Care ◽  
Critical Limb Ischemia ◽  
Soft Tissues ◽  
Surgical Care ◽  
Limb Ischemia ◽  
Medical Organization ◽  
Surgical Infection ◽  
Results Of Treatment ◽  
Medical Institutions ◽  
Main Activity

Purpose of the study. To demonstrate the difficulties of objective interpretation of providing medical care to patients with critical limb ischemia.Materials and methods. The results of treatment of more than 29 thousand patients of one of the highly specialized medical organizations of St. Petersburg were studied, in which the main activity of the staff is the examination of patients with surgical infection of soft tissues (particularly, the critical limb ischemia).Results. It has been ascertained that, despite the unconditional success of providing medical care to patients with critical limb ischemia, a high frequency of unsatisfactory treatment results for this category of patients remains (in 2017, among 685 patients of the specialized department of the highly specialized medical organization, the proportion of cases of performing high amputations of limbs and mortality, respectively, was 11,7% (80) and 2,6% (18)). It has been demonstrated on clinical examples that the pronounced comorbidity of critical limb ischemia patients and the severity of their general condition (combined with organizational difficulties in providing them with providing medical care in conditions of highly specialized medical organization) contribute to the formation of complications (up to lethal outcomes) of not only the underlying, but also concomitant diseases. Difficulties in providing medical care of adequate quality in life-threatening conditions for patients of highly specialized medical organization in cases of critical limb ischemia necessitate a wider interaction between specialists in narrow and multidisciplinary hospitals as part of the emergency surgery service.Conclusion. When creating specialized medical centers outside of multidisciplinary medical institutions, the possibilities should be provided for the regulated involvement of highly professional consultants with a reasonable algorithm for routing patients in cases of the need for their emergency re-hospitalization to other medical institutions.

scholarly journals Rational antimicrobial therapy and wound healing stimulation in patients with surgical infection

2021 ◽  
Vol 18 (2) ◽  
pp. 169-176
Author(s):  
S. D. Fedzianin
Keyword(s):  
Bone Marrow ◽  
Wound Healing ◽  
Soft Tissues ◽  
Autologous Bone Marrow ◽  
Alternative Source ◽  
Red Bone Marrow ◽  
Surgical Infection ◽  
Drug Of Choice ◽  
Purulent Wounds ◽  
Almost All

The objective of the study was to develop the problem of complex treatment of surgical infections of the skin and soft tissues (SISST).The studies were carried out in 201 patients with SISST who were treated at the Department of Purulent Surgery of the Hospital Surgery Clinic of the EE “Vitebsk State Medical University” in 2017–2020. As a result, it was developed: a protocol for a rational use of antibiotics in the patients with SISST, an effective regimen for use of antiseptic drugs, a method for treating purulent wounds with autologous bone marrow aspirates.For 13 years, there have been significant changes in the etiological structure of gram-negative problematic pathogens in patients with purulent wounds. The share of K.pneumoniae increased approximately 8 times (by 12.25 %; p < 0.05), and A.baumannii ‒ 9 times (by 14.69 %; p < 0.05). The share of MRSA remained virtually unchanged. The resistance of problem microorganisms to almost all antibacterial drugs significantly increased. For MRSA-induced SISST, glycopeptides (vancomycin) should be recommended as a drug of choice, and oxazolidinones (linezolid) and glycylcyclines (tigecycline) should be recommended as a reserve; K. pneumoniae ‒ colistat and tigecycline; P. aeruginosа ‒ carbapenems (doripenem) and colistat; A. baumannii ‒ penicillins or cephalosporins with sulbactam (ampicillin + sulbactam) and colistat.It was found that septomyrin and 0.02 % chlorhexidine bigluconate have the greatest activity against the leading representatives of the microflora of purulent wounds. With a combined use of septomirin and chlorhexidine, the bacterial contamination of wounds decreased below the critical level already on the 2nd day after surgical treatment (p < 0.01).To stimulate wound healing, sternocentesis is performed and automyeloaspirate is taken. The curettage of the wound and the aspirate introduction into the wound edges and the application to the wound surface are performed. It has been established that, along with the pelvic bones, the sternum can be an alternative source of red bone marrow. The myeloaspirate volume obtained by sternal puncture varied from 10 to 140 ml. The developed method allows us to reliably reduce the duration of the 2 phase of the wound process by 7 days (р < 0.01).

scholarly journals Necrotizing fasciitis in obstetric practice: review of literature and description of own clinical саse

2019 ◽  
pp. 150-155
Author(s):  
V. M. Husiev ◽  
V. M. Astakhov ◽  
S. A. Dubyna
Keyword(s):  
Early Diagnosis ◽  
Necrotizing Fasciitis ◽  
Soft Tissues ◽  
Clinical Symptoms ◽  
Inflammatory Diseases ◽  
Clinical Manifestations ◽  
Fatty Tissue ◽  
Superficial Fascia ◽  
Surgical Infection ◽  
Surgical Infections

Despite the successes of modern medicine, the problem of purulent surgical infection still remains relevant and is one of the unsolved and most debatable in clinical surgery. In the structure of purulent-inflammatory diseases of soft tissues, there are forms of surgical infections that are characterized by progressive necrosis of fascial formations and particular clinical course. They are accompanied by the development of endotoxemia, which further leads to the development of severe sepsis and multiple organ failure. Among generalized surgical infections, necrotizing fasciitis is of particular interest – one of the varieties of a large group of surgical infections of soft tissues, in the pathomorphological basis of which lies the rotten-necrotic lesion of the superficial fascia and subcutaneous fatty tissue. It has various clinical manifestations, the absence of specific signs that make it difficult for clinicians of various specialties to diagnose in time, the development of serious complications and deaths. The basis for the early diagnosis of necrotizing soft tissue infections, therefore, the key to successful treatment of these seriously ill patients, as before, is the timely analysis of anamnestic data and clinical symptoms. The treatment of necrotizing fasciitis is a difficult and complex task, which is explained by the peculiarity of the pathological process, the success of which is determined by early diagnosis and urgent radical surgical intervention. Rarely rare publications on this issue are the cause of the information vacuum and the lack of awareness of the majority of doctors in this pathology, potential for the development of critical states, once again necessitates the imperative informing of narrow specialists, as well as doctors practicing in the outpatient network and hospital level. Тhe article describes the own clinical observation of the fulminant form of necrotising fasciitis diagnosed by autopsy data.

scholarly journals VARIETY OF DIAGNOSED MICROORGANISMS IN PATIENTS WITH ERYSIPELAS

2021 ◽  
pp. 140-143
Author(s):  
L. A. Vasilevskaya ◽  
S. D. Shapoval
Keyword(s):  
General Population ◽  
Soft Tissues ◽  
Lower Extremities ◽  
Clinical Situation ◽  
Point Of View ◽  
Quantitative Composition ◽  
City Hospital ◽  
Gram Negative ◽  
Non Profit ◽  
Surgical Infection

Purpose. The purpose is to find out the frequency of surgical forms of erysipelas among the general population of the disease. Materials and methods. Traditionally, there is a widespread point of view about streptococcal etiology of erysipelas. However, recently, staphylococcus or microbial associations are increasingly sown from the focus of inflammation in patients. The relevance of studying the course of erysipelas is determined by the tendency to relapse, a significant increase in complications of the disease in recent years and the final phenomena. The existing clinical situation is largely explained by changes in the spectrum of pathogens of purulent surgical infection of soft tissues. Its leading pathogens are mainly staphylococci and streptococci, as well as gram - negative aerobic bacteria. The nature of the clinical course of the disease, including the nature of the local inflammatory focus, depends on the totality of the pathogenic properties of microbes that form the microbial landscape. It was found that most often the local focus was localized on the lower extremities. 114 case histories of patients who were hospitalized in the center of purulent-septic surgery in the Non-profit municipal enterprise “City Hospital № 3” in Zaporizhzhia for the period 2019-2020 were analyzed retrospectively and prospectively. All patients were diagnosed with erysipelas on admission, according to the forms: erythematous - 24 (21.0%), bullous - 28 (24.6%), phlegmonous form - 48 (42.1%), necrotic - 14 (12.3%). %). Disease relapses were noted in 21 patients. In terms of gender: men - 47 (41.2%), women - 67 (58.8%). The patients' age was 62.1 ± 2.6 years. Automated devices "Vitek-2" or "BaCT ALERT" (France) were used to determine the sensitivity of microorganisms in a purulent focus to antibacterial drugs. Statistical analysis was performed using the “Statgraphics Plus for Windows 7.0” software package. Research results and their analysis. It was found that most often the local focus was localized on the lower extremities. A total of 26 types of bacteria were identified from the wound contents of patients with destructive forms of erysipelas. No bacterial growth was found in 3 (4.8%) patients, and mixed flora was isolated in 27 (45.8%) patients. Gram-positive flora accounted for 61.0%, gram-negative flora - 35.6%, anaerobes - were not found, fungi - 3.4%. Conclusions. The number of destructive forms of erysipelas among the general population of the disease is more than 50%. The study of purulent-necrotic foci in patients with destructive forms of erysipelas makes it possible to determine the qualitative and quantitative composition of microflora, sensitivity to antibiotics, and make adjustments to the conduction of antibiotic therapy.

scholarly journals MODERN PHYSICAL METHODS IN MANAGING SUPPURATIVE WOUNDS

2021 ◽  
Vol 21 (3) ◽  
pp. 267-274
Author(s):  
І.І. Niemtchenko ◽  
V.І. Liakhovskyi ◽  
O.N. Liulka ◽  
R.B. Lysenko ◽  
R.M. Riabushko ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Systemic Infection ◽  
Vacuum Treatment ◽  
Hospital Treatment ◽  
Wound Treatment ◽  
Physical Methods ◽  
Surgical Infection ◽  
Depth Analysis ◽  
Rapid Healing ◽  
Inflammatory Processes

Suppurative and inflammatory processes in soft tissues make up a considerable share, 35 – 40%, in the structure of surgical problems in inpatients. Suppurative and inflammatory processes are often characterized as acute, resulting in systemic infection, sepsis, and even fatal outcomes. In the total structure of lethal outcomes in surgical inpatient departments the mortality rate due to acute surgical infection makes up 40 – 60%. Long hospital treatment, insufficient effectiveness of existing treatment methods, additional expenses for recovery and rehabilitation put this issue in the forefront of the most challenging healthcare tasks. This review states out that management of suppurative wounds is still remaining the most pressing for surgeons nowadays. Despite the rich experience and ever-increasing techniques and approaches in treating suppurative wounds, the elaboration of more effective physical methods to stimulate the healing of the wounds seems to be promising. The physical methods can include vacuum treatment, laser and ultrasound wound treatment, ozon therapy, hyperbaric oxygenation, phototherapy, hydropress sanation. The above methods can considerably contribute to the wound treatment thus promote its rapid healing. However, each of the techniques listed has its own disadvantages (technical, biological, economical), and can be applied only at a particular stage of wound healing. In-depth analysis of all advantages and shortcomings, contraindications to each method, enables to improve the treatment outcomes for patients with suppurative wounds thus reducing the time of hospital staying and expenses.

MODERN APPROACHES IN MANAGING WOUND DEFECTS IN CHILDREN WITH SURGICAL INFECTION

2020 ◽  
pp. 169-175
Author(s):  
Kuzmin A.I. ◽  
Munin A.G. ◽  
Zavyalkin V.A. ◽  
Barskaya M.A. ◽  
Terekhina M.I.
Keyword(s):  
Surgical Treatment ◽  
Hospital Stay ◽  
Soft Tissues ◽  
Local Treatment ◽  
Wound Management ◽  
Innovative Technologies ◽  
Surgical Infection ◽  
Results Of Treatment ◽  
Inadequate Antibiotic Therapy ◽  
Good Cosmetic

The results of treatment of 57 children with wound defects of soft tissues that have appeared at the background of surgical infections of various origins have been analyzed. The causes of the wound defects formation were analyzed according to the T.I.M.E. system.[7,8,9]. While treating the wound defects the strategy of creating the conditions close to the ones in an acute wound was followed («Wound bed preparation») [7,8,11]. We used several types of debridement aimed at shortening the phases of the wound process with the following closure of the wound defects by different methods [1,2,5,7]. The assessment of the effectiveness of local treatment was carried out taking into account the nature and severity of the phases of the wound process by the method of clinical observation of the state of the wound (the severity of symptoms of inflammation, the nature and amount of exudate, the presence and appearance of granulations, the presence of signs of wound epithelialization and scarring, the size of the wound), microbiological, cytological and histology and research [10]. The study revealed factors that disrupt wound healing during primary surgical treatment, in the management of foci of surgical infection, in the management of postoperative wounds, in the treatment of pressure ulcers in children with neurological pathology. During the initial surgical treatment of the received wounds, its inadequacy was noted - the abandonment of necrotic, defective tissues, foreign bodies, the presence of an undiagnosed infection, the absence or inadequate antibiotic therapy, constant tension of the skin edges, impaired blood flow and innervation, inadequate sanitation and drainage. The use of modern innovative technologies in wound management reduces hospital stay, reduces the duration of the use of antibiotics and other medications, contributes to a good cosmetic effect. Application of the current innovative technologies in wounds treatment shortens the hospital stay, decreases the duration of the use of antibiotics and other medicines, and contributes to better cosmetics effects [1,4,6]. The current trends in wounds treating with the choice of local treatment according to the phases of the wound process are presented in this article. The methods of active wound defects therapy and different types of debridement considering their pros and cons are analyzed.

scholarly journals Improving effectiveness of microbiological diagnostics in patients with surgical infection of soft tissues.

2020 ◽  
Vol 25 (1) ◽  
pp. 122-127
Author(s):  
O. M. Biesiedin ◽  
L. N. Storubel ◽  
E. V. Yevtushenko ◽  
K. O. Biesiedina
Keyword(s):  
Soft Tissues ◽  
Surgical Infection ◽  
Microbiological Diagnostics

Rapid Critical Point Drying of Tissues in a Parr Bomb

1972 ◽  
Vol 30 ◽  
pp. 400-401
Author(s):  
C.A. Baechler ◽  
W. C. Pitchford ◽  
J. M. Riddle ◽  
C.B. Boyd ◽  
H. Kanagawa ◽  
...  
Keyword(s):  
Critical Point ◽  
Critical Pressure ◽  
Soft Tissues ◽  
Biological Tissues ◽  
Critical Temperatures ◽  
Air Drying ◽  
The Past ◽  
Critical Point Drying ◽  
Great Stress ◽  
Infiltration Techniques

Preservation of the topographic ultrastructure of soft biological tissues for examination by scanning electron microscopy has been accomplished in the past by using lengthy epoxy infiltration techniques, or dehydration in ethanol or acetone followed by air drying. Since the former technique requires several days of preparation and the latter technique subjects the tissues to great stress during the phase change encountered during air-drying, an alternate rapid, economical, and reliable method of surface structure preservation was developed. Turnbill and Philpott had used a fluorocarbon for the critical point drying of soft tissues and indicated the advantages of working with fluids having both moderately low critical pressures as well as low critical temperatures. Freon-116 (duPont) which has a critical temperature of 19. 7 C and a critical pressure of 432 psi was used in this study.

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