Determination of clinical efficiency of deproteinized dialysate from blood of milk-fed calves after endoprosthetics in patients with ventral hernias

2020 ◽  
Vol 28 (3) ◽  
pp. 323-333
Author(s):  
Sergej V. Ivanov ◽  
Ilya S. Ivanov ◽  
Evgenij G. Obyedkov ◽  
Liliya P. Popova

Aim. To study the influence of deproteinized dialysate from blood of milk-fed calves on the type of exudative discharge and dynamics of inflammatory reaction after hernia repair with plastics of the anterior abdominal wall with hernioendoprosthesis of polypropylene. Materials and Methods. The study involved 59 patients being on stationary treatment in the surgical department of Kursk Regional Clinical Hospital. Patients were hospitalized for the herniation of small or medium dimension. The patients were divided to two groups: the main (n=30) and control (n=29) groups. After endoprosthetics, the patients of the control group were given complex conservative treatment. The patients of the main group, besides standard treatment, were administered deproteinized dialysate from blood of milk-fed calves intravenously in drips 10 ml + 200 ml of 0.9% sodium chloride solution within 7 days. For cytological examination and determination of the type of cytograms, the traumatic discharge was collected and analyzed using the method of M.F. Kamaev and M.A. Palthsev. Results. Cytomorphometric examination was conducted on the third, fifth and seventh day after endoprosthetics with the aim of studying dynamic changes. Determination of cell composition and also of its changes characteristic of each studied period, was necessary for obtaining further information characterizing inflammatory process in the region of placement of the endoprosthesis. After endoprosthetics in patients who were administered hemodialysate, the inflammatory reaction was less pronounced than in patients who did not receive the preparation. This was associated with a more dynamic change of stages of the inflammatory process. In patients of the main group who received deproteinized dialysate, regenerative type of inflammation first appeared on the fifth day and made 6.9%; by the seventh day the share of patients with the regenerative type rose to 17.5%, while in the patients of the control group no regeneration stage was observed in both periods. Conclusion. Analysis of the efficiency of influence of hemodialysate on the inflammatory reaction in plastics of the anterior abdominal wall with polypropylene endoprosthesis evidences faster course of all stages of inflammation and reduction of its intensity by 10%.

2021 ◽  
Vol 6 (3) ◽  
pp. 175-181
Author(s):  
R. B. Lysenko ◽  
◽  
V. I. Lіakhovskyi ◽  
V. R. Lysenko

The purpose of the study was to investigate the changes in the mechanical properties of the anterior abdominal wall at maximum functional loads. Materials and methods. The study was conducted on 112 volunteers aged 18 to 49 years old who were examined and treated in the surgical department of the Medical Diagnostic and Treatment Center "Medion" Poltava for the period from June 2020 to May 2021. There were 60 women (53.6 %), and 52 (46.4%) men. Volunteers were divided into 2 groups: the main group (n=58), which underwent the analysis of movement and deformation changes of the anterior abdominal wall during maximal abdominal inflation during the examination, and the control group (n=54), which were operated laparoscopically due to the schedule. Results and discussion. The results of the study showed the following changes in the mechanical properties of the tissues of the anterior abdominal wall: the average deformation in the longitudinal direction was 6% in the main group and 12% in the control one; deformations in the transverse direction were 3% in the main group and 8% in the control group; deformation in the longitudinal direction exceeded the deformation in the transverse by 38-54% (on average by 46%); the area of the anterior abdominal wall in the main group increased by 10%, and in the control one – by 22% (on average by 16%). During the studies, the anterior abdominal wall underwent greater stresses in the transverse orientation than in the longitudinal one (anisotropy coefficient ~2). The Young's modulus of anterior abdominal wall in the sagittal plane is defined as 23.5±2.6 kPa, while in the transverse – 42.5±7.0 kPa. The mechanical properties of human anterior abdominal wall tissues differed along and across the white line of the abdomen: the modulus of elasticity of anterior abdominal wall tissues, with the same force of impact, in the longitudinal direction is less than the transverse average of 44% (p >0.05). That is, the longitudinal stiffness of the anterior abdominal wall is lower than the transverse one. The maximum strength of the anterior abdominal wall is across the white line of the abdomen, and the greatest elasticity – along. The anterior abdominal wall in women showed increased elasticity compared to men, while the stiffness of the anterior abdominal wall tissue in men in both directions was statistically significantly higher than in women (p >0.05). Conclusion. Reconstruction of the spatial distribution of the mechanical properties of anterior abdominal wall tissues according to the nature of their deformation at maximum functional loads provides an additional opportunity to assess the biomechanics of anterior abdominal wall. The mechanical properties of the musculo-aponeurotic structures of anterior abdominal wall in humans differ in the longitudinal and transverse directions. They have the greatest elasticity in the longitudinal direction, and the maximum rigidity and strength in the transverse direction. The strength of the anterior abdominal wall tissue in men is higher, and the elasticity is less than in women. Changes in the mechanical anisotropic characteristics of anterior abdominal wall tissues at maximum functional loads should be taken into account when performing the anterior abdominal wall alloplasty technique


2021 ◽  
Vol 7 (3) ◽  
pp. 83-91
Author(s):  
Viktor A. Lazarenko ◽  
Sergey V. Ivanov ◽  
Tatyana A. Pankrusheva ◽  
Ilya S. Ivanov ◽  
Evgeny G. Ob’edkov ◽  
...  

Introduction: Applying a coating on hernia endoprosthesis prevents recurrent anterior abdominal wall hernias, reduces inflammatory response and stimulates reparative processes in the area of its implantation. The aim of investigation was to study the effect of Solcoseryl and Vitamin C in a collagen-stimulating coating of hernioendoprosthesis on a morphological picture in anterior abdominal wall plastic surgery. Materials and methods: The study was performed on 180 laboratory mice divided into three groups of 60 animals each: the first group animals were implanted with polypropylene endoprostheses without a collagen-stimulating coating, the second group animals – polypropylene endoprostheses with a collagen-stimulating coating with Vitamin C, and the third group animals – polypropylene endoprostheses with a collagen-stimulating coating with Solcoseryl. The laboratory animals were withdrawn from the experiment on the 10th, 30th, 60th, and 90th days. The excised sections of the abdominal wall were stained with G+E to determine the nature of inflammation and the number of cell elements. Results and discussion: When using endoprostheses with a collagen-stimulating coating, the stages of inflammatory process proceeded more quickly, which was confirmed by a reliable (р ≤ 0.05) decrease in the number of neutrophils, macrophages and lymphocytes at all stages of the study. By the 90th day of the experiment, the number of fibroblasts in the control group was by 22.64% less than in the study groups with a coating. Conclusion: A cytological and histological analysis in the control group determined a consistent decrease in an exudative phase of inflammatory reaction. When using endoprosthesis with coatings, its acceleration and lower intensity was noted throughout the study. In the group with Solcoseryl, the formation of a dense connective capsule around the endoprosthesis indicates its quality and better adaptation of the endoprosthesis in body tissues.


2021 ◽  
Vol 74 (7) ◽  
pp. 1605-1611
Author(s):  
Orest V. Panchuk ◽  
Yaroslav M. Susak ◽  
Ievgen G. Donets ◽  
Pavlo l. Byck ◽  
Olena F. Panchuk ◽  
...  

The aim: Of work is to determine changes in blood flow in the vessels of the anterior abdominal wall that occur after plastic surgeries in order to improve the results of operations and to develop new methods for the prevention of complications. Materials and methods: The study was conducted in 132 patients. Patients were divided into 2 groups: main group 64 and control group 68 patients. Main group has patients who underwent abdominoplasty in combination with liposuction; control group has patients who underwent abdominoplasty without liposuction. In both groups we make different simultaneous operations. Laser Doppler Flowmetry and Ultrasonic Doppler Flowmetry were performed to determine the blood flow indices in the flaps. Results: Liposuction volumes averaged 3.57 ± 0.74 liters of lipoaspirate. In the main group there were totaly 4 complications, in the control group complications developed in 9 patients. Comparing daily indicators between the two groups, no statistically significant difference in the dynamics of MI changes was found during the entire study period (p = 0.767). Increase in caliber of vessels, on average, from 1.55 ± 0.8 mm in the preoperative period to 1.68 ± 0.75 mm on the 14th day of the postoperative period was statistically significant (p < 0.05). Conclusions: The combination of abdominoplasty with liposuction and simultaneous operations does not lead to greater development of complications and allows to achieve good aesthetic results.


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 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.


2021 ◽  
Vol 14 (1) ◽  
pp. 19-24
Author(s):  
Vladislav Sergeevich Rakintsev ◽  
Anatolii Vladimirovich Yurasov

Introduction. The paper focuses on technical features of endoscopic extraperitoneal reconstruction (EER) of the anterior abdominal wall in patients with primary median hernias combined with diastasis of the rectus abdominis muscles, the nuances of the operating room equipment and preparation of patients for intervention.The aim of the study was to analyze the stages and features of the technique for performing endoscopic extraperitoneal reconstruction of the anterior abdominal wall to ensure safe and qualified implementation of the operation in clinical practice.Materials and methods. This research was a prospective study including 45 clinical cases of patients with primary median hernias of the anterior abdominal wall combined with diastasis of the rectus abdominis muscles, who were exposed to endoscopic extraperitoneal reconstruction. The study was performed in the surgical department of the private healthcare facility "Central Clinical Hospital Russian Railways-Medicine" in 2019-2020. The median follow-up was 14 months (8 - 18 months), there were no complications estimated higher than type I according to the Clavien-Dindo classification and relapses.Results and discussion. Successful EER requires thorough preoperative preparation: to connect a second monitor; to distance anesthetic equipment; to ensure the patient is in an extension position in the lumbar segment of the spinal column; to identify principle anatomical landmarks under ultrasound control. The main two stages of EER - mobilization and reconstruction - are performed extraperitoneally in a confined space, and therefore the localization of the ports must be anatomically validated. The major point at the stage of mobilization is to maintain the integrity of the parietal peritoneum, this solves visualization problems and helps to work in the required layer of the anterior abdominal wall. Adherence to the principles of open surgery, namely, orientation of the needle holder at an angle close to 0 to the suture line (white line), and the needles at a right angle; maintaining working angles between the instruments 30-60, - allows effectively performing the reconstructive stage.Conclusion. Thus, a topographic-anatomically based approach to each stage of the operation and adherence to a set of features of the surgical technique allows safely and effectively applying EER for the treatment of patients with primary midline hernias and diastasis of the rectus abdominis muscles.


2018 ◽  
pp. 81-83
Author(s):  
I. Basiuha ◽  

The article focuses on clinical-statistical analyses of microbiocenosis of maternity pathways of women with oligohydramnios, which will enable the usage of etiotropic mediator aimed at reducing of the frequency of fetus and newborn’s infecting. The objective: to learn the biotope of vaginal environment in the process of pregnancy complicated by oligohydramnios. Materials and methods. There were observed 120 pregnant women with oligohydramnios at gestation term of 27–29 weeks (the main group). 30 women with physiological pregnancy process constituted the control group. Oligohydramnios was diagnosed on the basis of complex examination of pregnant women at the term of 27–29 weeks with the help of standard determination of amniotic fluid index. All the women underwent bacterioscopic and bacteriological examination and detection of antigens to: chlamydia, ureaplasma, mycoplasma, virus of genital herpes, cytomegalic virus. Results. In the main group of women there was diagnosed ureaplasmosis, Gardnerella vaginalis, chlamydiosis, trichomoniasis, Candida albicans, more than half of women had increased concentration of pathogenic bacteria (staphylococcus epidermidis, aureus, saprophyticus, enteric bacteria, enterococcus faecalis), genital herpes, cytomegalovirus. Most of the representatives of the main group had bacterial infection of genital tract (69.17%), and complex bacterial-viruses infection (30.83%). Conclusion. Results of the research show that pregnant women with urogenital infections, inflammations of pelvic organs complicated by obstetrical – gynecological anamnesis should be referred to the group of high risk in reference to the development of oligohydramnios. Key words: pregnancy, microbiocenosis of vulva, oligohydramnios, infections.


2021 ◽  
Vol 16 (7-8) ◽  
pp. 60-66
Author(s):  
I.N. Demiter ◽  
S.I. Vorotintsev ◽  
O.S. Dolya

Background. Postoperative delirium is one of the most common complications after surgery in elderly patients. The aim of the study was to evaluate the impact of different techniques of regional analgesia on the incidence of postoperative delirium and the level of cognitive impairment in elderly patients. Materials and methods. A single-center prospective study consistently included 70 elderly patients who underwent emergency abdominal surgery. Depending on the method of perioperative anesthesia, all patients were divided into two basic groups: control (n = 30) and research (n = 40), where one of the perioperative techniques of regional analgesia was used — blockade of the anterior abdominal wall (subgroup AA, n = 20) or epidural analgesia (subgroup EA, n = 20). Results. The initial cognitive status of patients in subgroup EA did not differ significantly from the same indicator in the control group and amounted to 3.0 [3.0; 4.0] points. Subsequently, it gradually improved, reaching 4.0 [3.0; 5.0] (p = 0.04) points on the fifth postoperative day. The cognitive status of patients in the AA subgroup before surgery was slightly better (4.0 [3.0; 4.5] points), but also did not differ significantly from that either in the control group or the EA subgroup. As it turned out, the patients of both subgroups had even better cognitive functioning on the 5th day than before surgery (p ˂ 0.05). This improvement is mostly due to the cessation of an important factor influencing cognitive status — pain. Conclusions. In elderly patients after emergency surgery with epidural analgesia, the incidence of postoperative delirium is 5 %, and when using the anterior abdominal wall blockade — 10 %. The cognitive function of patients received regional postoperative analgesia is restored on the third day after surgery and improves on the fifth postoperative day (p < 0.05).


2021 ◽  
Vol 5 ◽  
pp. 38-42
Author(s):  
A. Senchuk ◽  
R. Zakordonets ◽  
I. Doskoch ◽  
T. Andriichuk

The objective: a determination of anxiety and depression levels in patients in perimenopausal period with hyperplastic processes of the endometrium and myometrium.Materials and methods. 150 patients in the perimenopausal period were examined. The main group included 100 persons with hyperplastic process, the control group – 50 healthy women in perimenopausal period. We used the PHQ-2 and PHQ-9 questionnaires to study the level of anxiety and depression. In order to objectively assess the degree of anxiety and depressive symptoms, a questionnaire was conducted according to the Hospital Scale of Anxiety and Depression (HADS).Results. The analysis of data on the frequency of major types of extragenital pathology in the examined patients demonstrated that in the structure of extragenital pathology the following diseases dominated: varicose veins of the lower extremities – 61.0±4.9 %, arterial hypertension of 2–3 stages – 46.0±4.98 %; coronary heart disease, stenocardia – 8.0±2.7 %; obesity – 43.0±4.95 %, liver, gallbladder and pancreas pathologies – 42.0±4.93 %. In 78.0 % of patients, somatic pathology was represented by two or more diagnoses. The results of the survey demonstrated that in the main group 23.0 % of women had mild «subclinical» depression; 19.0 % – moderate, and 12.0 % – moderate depression. The women in the main group had the following psychoemotional disorders: the feeling of fatigue and exhaustion – 64.0±4.8 %, sleep disorders – 64.0±4.8 %, appetite problems – 46.0±4.98 %, depressed mood and low interest in ordinary affairs – 54.0±4.98 %, the difficulty concentrating – 33.0±4.7%, hypodynamia – 26.0±4.4 %. Four percent of patients intended to do something with themselves. Analysis of the results obtained using the HADS scale revealed that both anxiety and depressive symptoms in patients in the main group were more pronounced than in the control women.Conclusion. The identified psycho-emotional disorders are the result of adverse effects of somatic diseases and gynecological pathology. The results of the study indicate the need to correct psycho-emotional disorders and take them into account when choosing a method of treatment for such patients.


2021 ◽  
Vol 12 (1) ◽  
pp. 43-50
Author(s):  
Dmitry O. Ivanov ◽  
Galina A. Suslova ◽  
Inga N. Surenkova ◽  
Victoria N. Filippova

The article is devoted to the research of the development of motor skills of premature babies on the background of medical rehabilitation in an outpatient-polyclinic and the determination of the age standard (scale) for the development of motor skills of premature babies. The research includes 137 premature babies with the gestational age from 26 to 37 weeks, birth weight from 800 to 2600 grams. The main group of the research consisted of 117 premature babies who had already took a part in the early and complex rehabilitation, the control group which consisted 20 children who were included in the research because of a history of prematurity and who applied to the rehabilitation department with already established disabilities (the health status of premature babies in the control group was studied retrospectively). Premature babies in the control group began medical rehabilitation after 6 or more months of life and did not receive it in full. The assessment of the motor skills of premature babies was carried out in dynamics on the monthly basis. Of the 117 premature babies of the main group 2.5% had motor disorders that led to disability, the premature babies of the control group reached disability in 100% of cases. The research of motor development of premature babies revealed that with a delay in applying for medical rehabilitation, even for one day, the integrated indicator of the relative deviation of actual skills development from the standard increases by 0.9%.


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