Summary. The problem of treatment of acute purulent paraproctitis is one of the most urgent problems of modern coloproctology.
Study objective. To evaluate the effectiveness of the use of Dalmaxin rectal suppositories in the complex treatment of acute paraproctitis.
Materials and methods. The effectiveness of use of Dalmaxin rectal suppositories was conducted in 62 patients with acute subcutaneous paraproctitis, assigned to two groups, a main group of 30 patients and a comparison group of 32 patients. All patients underwent radical surgery. Antimicrobial, detoxification and symptomatic therapy was prescribed postoperatively. Local treatment of purulent wounds was carried out using hydrophilic ointments depending on the phase of the wound process; the patients of the main group were additionally administered Dalmaxin rectal suppositories twice a day. The effectiveness of the treatment was evaluated by the severity of the swelling, the nature of the discharge from the wound, the level of microbial contamination, the wound cleansing period, the appearance of granulation tissue and epithelialization, and by cytological examination. Furthermore, general laboratory and biochemical studies were performed. Endogenous intoxication (EI) and its changes in the course of treatment were evaluated by the level of average-mass molecules, leukocyte intoxication index and hematological intoxication index. Statistical processing and comparison of the obtained data was performed using the STATISTICA® 5.5 integrated system (STATSOFT® Inc., USA), license A XX 910A374605FA.
Results. The study showed that in patients with acute paraproctitis, the severity of the postoperative period is due to the severe intoxication and the development of a systemic inflammatory response syndrome that were observed in patients at the time of hospitalization. After surgical intervention, clinical and laboratory parameters did not normalize in the first five days of the postoperative period, and only starting from the fifth day, there was a gradual decrease in the level of EI and laboratory indicators, reaching the normal ones only at the time of discharge from the hospital. EI complicates the course of the postoperative period, primarily by weakening the level of humoral immunity and inhibiting the processes of reparative regeneration. When comparing the results of treatment of acute paraproctitis in patients using Dalmaxin rectal suppositories with traditional methods. The hospitalization period of the patients of the main group was also shorter than in the comparison group, and was (9.2 ± 0.5) and (11.9 ± 0.9) bed days, respectively.
Conclusions. A comparative evaluation of the use of Dalmaxin in the complex treatment of acute purulent paraproctitis showed that the drug, due to its properties, significantly improves the course of the postoperative period, as evidenced by faster reduction of endogenous intoxication, reduction of microbial contamination and wound cleansing from necrotic tissues, faster granulation and epithelialization, as well as wound healing, thus helping to reduce the time of hospitalization.
Endobronchial valve in complex treatment of patients with drug resistant fibrous cavernous pulmonary tuberculosis
