scholarly journals COMPREHENSIVE PREOPERATIVE APPROACH AND ENDOVENOUS ELECTRIC WELDING IN THE TREATMENT OF CHRONIC VENOUS INSUFFICIENCY C6 CLINICAL CLASS

2021 ◽  
pp. 76-81
Author(s):  
S. I. Savolyuk ◽  
A. R. Dembitsky
Keyword(s):  
Negative Pressure ◽  
Comparison Group ◽  
Platelet Rich Plasma ◽  
Healing Time ◽  
Main Group ◽  
Preoperative Preparation ◽  
Plasma Therapy ◽  
Moisture Balance ◽  
Lateral Posterior ◽  
And Control

The evaluation was done in the sphere of preoperative preparation trophic ulcer in patients with CVI using the proposed tactics of mechanochemical debridement and elimination of vertical venous reflux EVEZ method, in comparison with standard preoperative management tactics and EVLT of saphenous veins. It is established that the proposed tactics of preoperative preparation are more effective than classical approaches. Purpose. The use of the EVEZ method in combination with the proposed preoperative preparation of trophic ulcers in the treatment of CVI was determined to be effective. Materials and methods. An analysis of the treatment of 68 patients with CVI C6 clinical class was performed. The patient of the main group received the EVEZ treatment tributaries and perforating veins with preoperative trophic preparation ulcers, which includes: active mechanochemical debridement and control moisture balance in the wound, installation of negative pressure wound therapy system, platelet rich plasma therapy, application drugs based on diosmin and hesperidin. The proposed scheme of preoperative preparation has the following algorithm: Taking a smear from the sore to determine the bacterial spectrum and subsequent rational antibacterial therapy following the results of the antibioticogram; Active mechanochemical debridement with solutions of 0.1% polyaminopropyl biguanide + 0.1% surfactant, povidone-iodine + ethanol + glycerin + laureate 9 and control of moisture balance in the wound with modern hydrogel sore dressings; Installation of VAC system with a constant negative pressure of 120 mm Hg for 3 days for the first 3 performances of the system. Subsequently, VAC therapy was performed in a constant mode with a pressure of 80-120 mm Hg. in patients with insufficient wound cleanliness; After active cleaning, PRP therapy was performed, which involves the introduction of platelet-enriched plasma along the edge of the wound to a depth of 3 to 5 mm. The amount of PRP used depended on the size of the defect and ranged from 1 to 2 ml. All patients of the main group underwent correction of concomitant pathology with systemic use of capillary stabilizing drugs based on diosmin / hesperidin. Patients in the comparison group received standard preoperative preparation and EVLT. Patients of both groups were outpatient for 6 months. 39 of them (57.35%) were women and 29 (42.65%) were men aged 36 to 78 years. The duration of ulcers ranged from 3 months to 7 years. The following localization of venous trophic ulcers was observed: in the area of the medial bone - in 49 (72%) patients, 10 (14.7%) - on the anterior surface, 9 (13.3%) - on the lateral, posterior, anterior medial or anterolateral surface of the tibia. Results. Tactics of preoperative preparation that is offered allowed to achieve: reduction of redness and swelling in the main group on 7.3 ± 0.8 days (comparison group 10.2 ± 0.7 days); complete cleaning of the wound from fibrin and necrotic tissues at 9.1 ± 0.5 days (15.0 ± 1.1); the appearance of granulation tissues at day 12.6 ± 0.9 (18 ± 0.7); the appearance of marginal epithelialization at 15.3 ±0.7 days (20 ± 1.1). Conclusions. The proposed tactics can reduce the term by 1.7 times the preparation of the ulcer for surgery and 1.6 times the healing time of ulcers. The EVEZ method allows performing ablation efficiently and safely trunk great saphenous vein. The use of phlebotonic drugs, which is called Normoven, allows you to accelerate the healing of ulcers and prevent their recurrence.

Thromboembolic complications prevention in the obstetric practice

2017 ◽  
pp. 19-24
Author(s):  
O.V. Grishchenko ◽  
◽  
V.V. Bobrytska ◽  
Keyword(s):  
Pulmonary Embolism ◽  
Comparison Group ◽  
Main Group ◽  
Control Group ◽  
Efficacy And Safety ◽  
Thromboembolic Complications ◽  
Moderate Risk ◽  
Obstetric Practice ◽  
Thrombotic Complications ◽  
And Control

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.

scholarly journals REPARATIVE PROCESSES FEATURES IN TROPHIC ULCERS CAUSED BY DIABETES MELLITUS WITH THE USE OF PLATELET-RICH PLASMA

2020 ◽  
Vol 73 (10) ◽  
pp. 2150-2155
Author(s):  
Igor D. Duzhiy ◽  
Andrii S. Nikolaienko ◽  
Vasyl M. Popadynets ◽  
Oleksandr V. Kravets ◽  
Igor Y. Hresko ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Growth Factors ◽  
Comparison Group ◽  
Platelet Rich Plasma ◽  
Main Group ◽  
Lower Limbs ◽  
Before And After ◽  
Autologous Platelet Rich Plasma ◽  
Inflammatory Changes ◽  
Autologous Platelet

The aim: Was following: the improvement of the treatment results of the lower limbs ulcers, caused by the diabetes mellitus by using our technique of the platelet-rich plasma application; the study of the features of the morphological and immunohistochemical changes, and the effect of the growth factors of the platelet-rich plasma on the regeneration and healing of the ulcers. Materials and methods: 38 patients with the trophic ulcers of the lower limbs, caused by diabetes mellitus were involved in the study. To assess the morphological features of the reparative processes before and after the treatment with PRP, the histological and immunohystochemical studies of the biopsy specimen of ulcers were carried out. Results: The total epithelialization of the ulcers in the patients from the main group was achieved on 46.5 day, and in the comparison group – 81.7 day. The light and optical study of the specimen of the main group, using the autologous platelet-rich plasma revealed the elimination of the destructive changes and reduction of the mixed-cellular infiltration compared to the patients from the comparison group. The immunohystochemical study revealed the increase of the growth factors receptors. Conclusions: The usage of the autologous platelet-rich plasma in the treatment of the trophic ulcers results in the rapid regeneration by the decrease of the destructive and inflammatory changes as well as the improvement of the vascularization.

scholarly journals The effect of the phytocomplex Renotineх® on postoperative period after external shock wave lithotripsy in patients with urolithiasis

2021 ◽  
Vol 11 (1) ◽  
pp. 49-54
Author(s):  
Aleksandr I. Neymark ◽  
Boris A. Neymark ◽  
Nikolay A. Nozdrachev ◽  
Michail Y. Gatkin ◽  
Yulia S. Fursa
Keyword(s):  
Shock Wave ◽  
Extracorporeal Shock Wave Lithotripsy ◽  
Shock Wave Lithotripsy ◽  
Comparison Group ◽  
Postoperative Management ◽  
Main Group ◽  
Preoperative Preparation ◽  
Effective Discharge ◽  
Extracorporeal Shock Wave ◽  
Nephroprotective Effect

INTRODUCTION: Phytopreparations are one of the leading medicines used as preoperative preparation and postoperative management in patients with urolithiasis. THE AIM of the study was to evaluate the nephroprotective effect of Renotinex in patients with urolithiasis after extracorporeal shock wave lithotripsy (ESWL). MATERIALS AND METHODS: The study included 86 patients (43 in the main and the comparison group) with urolithiasis with localization of the stone in the renal pelvis without disturbing the outflow of urine. All patients underwent extracorporeal shock wave lithotripsy (ESWL). After ESWL patients in both groups received spasmodic, anti-inflammatory, antibacterial therapy. Patients of the main group additionally received Renotinex 2 capsules 3 times a day for 14 days before and 14 days after surgery. RESULTS: During the observation a more effective discharge of calculus fragments was noted in patients of the main group while taking the phytocomplex Renotinex, as well as less pronounced damage and faster recovery of the renal parenchyma after ESWL according to the level of enzimuria. CONCLUSION: The results of the study indicate the feasibility of prescribing the phytocomplex Renotinex for nephroprotective and lithokinetic therapy in patients after ESWL.

scholarly journals Risk stratification of postoperative complications in jaundiced patients with focal diseases of the biliopancreatoduodenal zone

2021 ◽  
Vol 11 (6) ◽  
pp. 309-319
Author(s):  
P. Muraviov ◽  
B. Zaporozhchenko ◽  
I. Borodaev ◽  
V. Shevchenko ◽  
M. Zaporozhchenko ◽  
...  
Keyword(s):  
Mathematical Modeling ◽  
Risk Stratification ◽  
Genetic Factors ◽  
Comparison Group ◽  
Radical Surgery ◽  
Malignant Tumors ◽  
Main Group ◽  
Decompression Surgery ◽  
Preoperative Preparation ◽  
Comparison Groups

The risk stratification was performed by mathematical modeling taking into account genetic factors and the results of instrumental research as ultrasonic elastography. The results of 272 jaundiced patients’ surgical treatment as pancreaticoduodenal resection (PDR) for malignant tumors of biliopancreatoduodenal area (218 patients) and chronic pseudotumoral pancreatitis (54 patients) were analyzed. In the main group (n=112) the optimized algorithm of preoperative preparation and risk stratification was used and in the comparison group (n=160) preparation for PDR was carried out conservatively according to generally accepted standards. radical surgery is defined as inexpedient and too risky, while shunt decompression surgery is performed as a first step for pancreatoduodenal resection. Thanks to the preoperative preparation according to our algorithm, mental status evaluation in the main group compared to the comparison one was significantly better. By MoCA scale before surgery it was 24.9 ± 3.2 and 22.8 ± 2.4 points, and by the DSST test - 40.2 ± 3.8 and 23.6 ± 2.6 points in the main and comparison groups respectively. The level of bilirubinemia in patients of the main group on the day before PDR was 112.3±2.7 μmol/l, while in the comparison one it was 198.3±3.3 μmol/l (p <0.05). On the eve of the PDR, the activity of alkaline phosphatase was in the main group 104.8 ± 1.3 U / l, and in the comparison group - 270.8 ± 1.9 U / l (p <0.05). Before PDR, γ-glutamiltransferase activity significantly decreased to 529 ± 29 U / l in the comparison group and to 485 ± 33 U / l in the main group (p <0.05).

scholarly journals Clinical significance of 24-hour blood pressure monitoring in prediction of hypertension development in patients with gout

2021 ◽  
Vol 36 (3) ◽  
pp. 104-110
Author(s):  
M. V. Gubanova ◽  
N. N. Kushnarenko ◽  
T. M. Karavaeva
Keyword(s):  
Blood Pressure ◽  
Comparison Group ◽  
Blood Pressure Monitoring ◽  
Main Group ◽  
Control Group ◽  
Pressure Monitoring ◽  
Control Groups ◽  
Comparison Groups ◽  
Hypertension Development ◽  
And Control

Aim. The aim of the study was to develop the model for establishing early diagnosis of hypertension in patients with gout. The model was based on data of 24-hour blood pressure monitoring.Material and Methods. A total of 69 patients with gout were enrolled in a single-stage cross-sectional prospective study. Three study groups were assigned as follows: group 1 (main group) comprised hypertensive men with gout (n = 41); group 2 (comparison group) comprised normotensive men with gout (n = 28); group 3 (control) included relatively healthy men  (n = 30). Daily blood pressure monitoring was performed on an outpatient basis using a BPLab device (Peter Telegin, Russia).Results. The significant intergroup differences were found in the following parameters: lowest, mean, and highest 24-hour systolic blood pressure (SBP) values in patients of main and comparison groups (р < 0.001) and in patients of main and control groups (р < 0.001); mean and maximum 24-hour diastolic blood pressure (DBP) values in patients of main and comparison groups (р < 0.001) and in patients of main and control groups (р < 0.001); lowest, mean, and highest 24-hour pulse blood pressure (PBP) values in patients of main and comparison groups (р < 0.001) and in patients of main and control groups (р < 0.001); mean, and maximum 24-hour PBP values in patients of comparison and control groups (р < 0.001). Median values of the lowest, mean, and highest 24-hour SBP in hypertensive patients with gout were significantly higher than the corresponding values in normotensive patients with gout and healthy men of group 3 (p < 0.001). Median values of mean and maximum 24-hour DBP in main group were higher than the corresponding values in comparison group and control group (p < 0.001). Median values of the lowest, mean, and highest 24-hour PBP in hypertensive patients with gout exceeded the corresponding values of patients of control group (p < 0.001). Median values of the mean and maximum 24-hour PBP in main group exceeded the corresponding values of patients of comparison group (p < 0.001). Based on the binary logistic regression model, the prognostic algorithm for hypertension development in gout patients was created using the parameters of 24-hour blood pressure monitoring as predictors and the cut-off K value. If the value of K was > 0.54, then the hypertension development was predicted in gout patients. The sensitivity of developed diagnostic model was 0.84, and the specificity was 0.95.Conclusion. Тhe proposed model, based on the assessment of average-daily values of the lowest, mean, and highest SBP, allowed to establish early diagnosis of hypertension in patients with gout with the accuracy of up to 90%.

Some peculiarities of preoperative care of patients with biliopancreatoduodenal area focal diseases complicated by mechanical jaundice

2021 ◽  
Vol 43 (3-4) ◽  
pp. 57-62
Author(s):  
P. T. Muraviov ◽  
◽  
B. S. Zaporozhchenko ◽  
I. E. Borodaev ◽  
M. B. Zaporozhchenko ◽  
...  
Keyword(s):  
Obstructive Jaundice ◽  
Total Bilirubin ◽  
Comparison Group ◽  
Postoperative Mortality ◽  
Perioperative Period ◽  
Main Group ◽  
Preoperative Preparation ◽  
Original Algorithm ◽  
Early Results ◽  
Life Threatening

The aim of the current research was to compare the early results of pancreatoduodenal resection performing in patients with focal diseases of the biliopancreatoduodenal area complicated by obstructive jaundice syndrome, depending on the type of preoperative preparation. The results of surgical treatment of 272 patients who had been underwent pancreatoduodenal resection for focal diseases of the biliopancreatoduodenal zone complicated by the development of obstructive jaundice syndrome were analyzed. Patients, depending on the type of preoperative preparation, were randomized into two groups: the main group included 112 patients, who were prepared for surgery and predicted the course of the perioperative period in accordance with the original algorithm; and a comparison group (160 patients), in which the preparation was carried out only in a conservative way. Due to the original algorithm of detoxification with the use of biliary decompression in patients of the main group, the level of total bilirubin on the eve of pancreatoduodenal resection was 112.3 ± 2.7 μmol / L, while in the comparison group, where the preparation of patients for radical surgery was carried out without biliary drainage – 198.3 ± 3.3 μmol / L. The activity of alkaline phosphatase on the eve of PDR was 104.8 ± 1.3 U / L in the main group, and 270.8 ± 1.9 U / L in the comparison group (p <0.05). On the eve of PDR, the activity of γ-glutamyltransferase decreased insignificantly – to 529 ± 29 U / L in the comparison group and to 485 ± 33 U / L in the main group (p <0.05). The number of cases of life-threatening postoperative complications in the main group was 42 (37.5%), and in the comparison group – 102 (63.8%). Postoperative mortality in the main group was 6.3%, and in the comparison group – 11.9%.

scholarly journals The Effect of CaCl2 Added PRP (Platelet Rich Plasma) to the Healing Time, Tensile Strength and Adhesion Degree of the Ruptured Tendinopathic Achilles Tendon of Rats (Rattus norvegicus)

2019 ◽  
Vol 15 (1) ◽  
pp. 59
Author(s):  
Istan Irmansyah Irsan ◽  
R. Muhammad David Jayanegara
Keyword(s):  
Tensile Strength ◽  
Achilles Tendon ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Intervention Group ◽  
Achilles Tendinopathy ◽  
Healing Time ◽  
Control Group ◽  
And Control

Abstract: Achilles tendinopathy produce morbidity, long-lasting disability in athletes and non-athletes and remain a challenge for clinician. Tendinopathy may lead to reduced tensile strength and a predisposition to rupture.The aim of our study was to evaluate the effects of activated and non-activated PRP on the healing process of ruptured tendinopathic achilles tendon in rat. Tendinopathy achilles condition induced by injecting collagenase bacterial type-1 locally. Right achilles tendon in 48 rats ruptured by transecting it transversely and repaired it by using a Kessler technique. Further, the wound immobilized with PRP and injecting activated PRP (5% CaCl2 added) in  one group, non-activated PRP on the other group and saline on control group. Tendons from each group were collected at the 1st and 2nd week postoperatively also assessed for biomechanical test. Tendons were also evaluated histologically by using hematoxylin-eosin to know adhesion degree based on Tang criteria. The significant differences was found between intervention group and control (p<0.05) at the 1st week but there was not any significant differences at the 2nd week in tensile strength test (p>0.05). Adhesion degree of the intervention group also reduce better rather than the control at the 1st and 2nd week (p<0.05). PRP have a positive effect on healing tendons by improving healing time, mechanical strength and decreasing adhesion degree. Keywords: achilles tendinopathy, PRP, healing time, tensile strength, adhesion

scholarly journals Efficiency of wound dressing made of powder cotton cellulose

2021 ◽  
Vol 102 (1) ◽  
pp. 12-18
Author(s):  
S S Ksembaev ◽  
O V Nesterov ◽  
L N Khafizova
Keyword(s):  
Postoperative Period ◽  
Wound Dressing ◽  
Comparison Group ◽  
Clinical Signs ◽  
Healing Time ◽  
Main Group ◽  
Cotton Cellulose ◽  
Surgical Wound ◽  
Clinical Indicators ◽  
Inflammatory Edema

Aim. To study the effectiveness of a wound dressing made of powdered cotton cellulose for open surgical wounds in the oral cavity. Methods. The effectiveness of a wound dressing made of powdered cotton cellulose during vestibuloplasty was assessed based on clinical indicators. The study included 197 children aged 812 years (boys 91, girls 106), divided into 2 groups the main group (100 children treated with powdered cotton cellulose wound dressing) and the comparison group (97 children, treated with a surgical gauze dressing). The number of children in clinical groups was determined by the copy-pair method. The dynamics of the postoperative period was assessed according to traditional clinical indicators (the presence of pain, inflammatory edema, hematomas, healing time, etc.). The severity of general and local clinical signs was determined by using the system of its assessment in points developed by us. Differences were considered significant at p 0.05. Results. In the postoperative period, the patients of the main group had no complications in contrast to the patients of the comparison group, who had pronounced edema and hematomas of the soft tissues of the chin, edema and hyperemia of the displaced flap. Changes in clinical signs severity in points also prevailed in the comparison group (p 0.001). The surgical wound showed complete epithelialization after 11.40.7 days in the main group and after 13.50.9 days in the comparison group. The reduction in the duration of treatment was 2.10.8 days. Conclusion. When using a wound dressing made of powdered cotton cellulose, the wound is protected from the aggressive environment of the mouth, including microflora, food debris, etc., which excludes the possibility of its secondary infection; there is no pain, postoperative inflammatory edema and hematomas; the surgical wound healing time is reduced; there are no contraindications, no side and allergic reactions.

PENGGUNAAN SELAPUT AMNION SEGAR PADA INSISI LUKA OPERASI SEKSIO SESAREA

2019 ◽  
Vol 1 (2) ◽  
pp. 47-55
Author(s):  
Syahredi Syaiful Adnani ◽  
Hafni Bachtiar
Keyword(s):  
Wound Healing ◽  
Caesarean Section ◽  
Amniotic Membrane ◽  
Healing Time ◽  
Cost Of Care ◽  
Control Group ◽  
P Value ◽  
Control Groups ◽  
And Control ◽  
Wound Healing Time

In the last few decades, the incidence of caesarean section is increasing in the world, especially in Indonesia. One of the way to treat tissue scar is through biologic and synthetic dressing where nowadays, amnion has been used as biologic dressing frequently. This study was conducted to determine the effect of the use of fresh amniotic membrane on wound incision Caesarean section compared with Caesarean section incision wound covered using regular gauze bandages and fixated with plaster in RS. Dr. Reksodiwiryo Padang. The design of this study is an experimen-tal study with Post test design with control group design. Sampling was done using a formula consecutive sampling two different test samples obtained an average of 72 people for each group. The analysis used include univariate and bivariate analyzes. The average wound healing time the difference was statistically significant (p value <0.05) in the treatment and control groups. There was highly significant difference in the proportion of local infection on day 3 between the treatment and control groups (p value <0.05). There were very significant differences in the proportion of local allergic reactions at day 3, and 5 between the treatment and control group (p <0.05). There are significant differences in terms of the cost of care per day between treatment and control groups (p <0.05). From this study, the average wound healing time has a very significant difference.Keywords: Fresh Amniotic Membrane, Wound Cesarean Section, Wound Healing

Assessment of the impact of factors of the working environment on the health of workers in oil refining based on the analysis of morbidity

2020 ◽  
pp. 600-600 ◽  
Author(s):  
I. V. Ginko ◽  
T. M. Sushinskaya ◽  
A. L. Rybina
Keyword(s):  
Comparison Group ◽  
Main Group ◽  
Working Environment ◽  
Oil Refinery ◽  
Oil Refining ◽  
Production Environment ◽  
The Impact

Studies have been conducted to assess the impact of factors of the production environment on employees of the oil refinery ofJSC «Naftan». Significant differences with the comparison group on the indicators of SVT were revealed. Priority nosological forms of employees of the main group are identified.

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