scholarly journals PREVENTION OF SECONDARY INFECTION OF WOUNDS IN PATIENTS WITH HEMODIALYSIS

2019 ◽  
Vol 18 (4) ◽  
pp. 90-93
Author(s):  
O. Ya. Popadyuk

According to the literature, postoperative complications and associated purulent-inflammatory processes occur in 35-60 % of patients, which increases the rates of postoperative mortality to 25 %. The main purpose of our work was to evaluate the effectiveness of the application of the polymeric film «biodep-nano» in the prevention of secondary infection of wounds in patients with hemodialysis. Methods. The results of treatment of 36 patients divided into two groups were analyzed: the main group (18 patients) with applied traditional gauze dressings and the experimental group (18 patients) with additionally applied biodep-nano polymer films (Pat. No. 110594 Ukraine, MPK 2016.01, biodegradable polymer film «biodep-nano» is produced as «Hygienic and prophylactic. Biodegradable polymer film «Biodep-nano» of 50 g according to TU U 20.4-2950221612-001: 2017». Statistical data processing was performed using Student's t-test, 5 % (p≤0.05). Results. The results obtained showed that the temperature of the study area in the main group came to normal on the 3rd day (2.8±0.2 days), and in the group where traditional methods were used – on the 5-7th (5.9±0.4) day, (p<0.05). Reduction of tissue edema by an average of 3.8±1.2 days, and in the control group by an average of 6.1±1.7 days, (p<0.05). With regard to hyperemia, it gradually decreased and in the main group was up to 3.9±2.1 days on an average, and in the control group by 6.0±1.9 days (p<0.05). In the main group, the appearance of purulent discharge was observed in 1 patient, in the control group in 4 cases. The statistical calculations showed a significant statistical difference in the reduction of inflammatory process in both groups. Conclusions. The use of new methods and means of preventing secondary infections after surgery in patients with hemodialysis will enable to carry out dialysis of patients, shorten their stay in the clinic and save lives.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e17515-e17515
Author(s):  
Olga G. Rodionova ◽  
Marina A. Gusareva ◽  
Elena A. Sheiko ◽  
Vitaliy I. Voshedskiy ◽  
Pavel G. Sakun ◽  
...  

e17515 Background: The purpose of the study was to evaluate advantages of combination ozone therapy as an effective factor of radiomodification and radioprotection in the treatment of patients with cervical cancer. Methods: The study included 20 patients with stage IIIb cervical cancer T3бNхM0, the mean age 52 years. Controls (n = 10) received standard chemoradiation therapy; the main group (n = 10) received combination ozone therapy in addition to chemoradiation therapy. Systemic ozone therapy involved intravenous administration of 250 ml ozonized solution of 0.9% sodium chloride, 15 sessions during external beam radiotherapy. Local ozone therapy involved 15-minute instillations into the vagina during brachytherapy. All patients received standard chemoradiation therapy, total irradiation dose to the primary focus 80 Gy, plus weekly cisplatin 40 mg/m2. Results: In the main group, pain and discomfort in the lower abdomen were managed in 20% patients by the 5th session of ozone therapy; 30% - on the 10th day; in 50% - on the 14th day. In the control group, such symptoms in 40% of patients were reduced after 20 days. The main group showed a more rapid regression of tumor infiltration, disappearance of purulent discharge, relief of intoxication syndrome. Manifestations of gastrointestinal toxicity were observed in 10% of the main group and in 100% controls; leukopenia developed in 7 patients in the control group and was not registered in the main group. MRI showed complete clinical regression in 90% in the main group and in 65% in the control group. The treatment was completed within 7 weeks in the main group and 8.5 weeks in the control group. Conclusions: Combination ozone therapy causes a more pronounced antitumor effect, and its radioprotective effects significantly reduce the severity of chemotherapy-induced disorders. It does not aggravate concomitant pathology and shortens the treatment period.


2020 ◽  
Vol 21 (2) ◽  
pp. 20-25
Author(s):  
J. Sh. Inoyatov ◽  
O. V. Snurnitsyna ◽  
M. V. Lobanov ◽  
O. Yu. Malinina ◽  
Yu. L. Demidko ◽  
...  

Introduction. Urethral transposition remains the most popular operation for postcoital cystitis, however, traumatism and complications, especially such as pudendal neuropathies, dyspareunia and anorgasmia, make us continue to search for effective, but safer techniques.The study objective is to evaluate the efficacy and safety of the proposed treatment of postcoital cystitis, including removal of urethrogymenal adhesions and subsequent paraurethral filler implantation, in comparison with isolated hymenoplasty.Materials and methods. Since 2013, 75 patients with postcoital cystitis have been treated. Patients were divided into two groups: main group – hymenoplasty (removal of urethral adhesions) with paraurethral filler implantation (n = 45), control group – hymenoplasty (n = 30). The gel was injected paraurethrically, fan-shaped, in the volume of 1–2 ml, from a point on the 6-hour conditional dial, creating a gel cushion and thus raising the meautus and distal urethra. To assess the quality of treatment, profile questionnaires were used.Results. In the main group of patient, the quality of life improved in 35 (78 %); in 5 patients, due to the process of biodegradation of the gel during 1 year, the cystitis recidivated, which required the filler reimplantation. In 5 patients, the operation was not effective. In the control group the efficiency of isolated hymenoplasty was noted in 3 (10 %) patients, relapse of cystitis occurred in 27 (90 %) patients, which later required the implantation of a filler. No complications were observed.Conclusions. The suggested combined technique allows to improve the results of treatment of patients with postcoital cystitis. The operation does not carry the risk of damage to the sprigs of the genital nerve, can serve as an alternative to traditional urethral transposition. The main disadvantage is the natural biodegradation of the gel, which may create the need for its reintroduction.


Author(s):  
Z. A. Azizzoda ◽  
K. M. Kurbonov ◽  
K. R. Ruziboyzoda ◽  
S. G. Ali-Zade

Aim. Improving outcomes of diagnosis and treatment of patients with liver echinococcosis and its complications. Materials and methods. A comparative analysis of the results of surgical treatment of liver echinococcosis and its complications with traditional laparotomy access surgery (control group) and minimally invasive interventions (main group) was performed.Results. The study included 300 patients (170 in the control and 130 in the main group). In the main group, 37 (28.4%) cases performed open echinococcectomy from various mini-accesses, and 27 (20.7%) performed twostage operations using minimally invasive technology. Laparoscopic echinococcectomy was performed in 23 (17.7%) patients, laparoscopic pericystectomy 12 (9.2%) and laparoscopic liver resection in 10 (7.7%) patients. The frequency of postoperative complications in the main group was 17.7%, in the control 51.8%, postoperative mortality decreased from 2.3% to 0.8%.Conclusion. Minimally invasive technologies in the surgical treatment of liver echinococcosis show the better immediate results compared to traditional open surgical methods.


2017 ◽  
Vol 4 (2) ◽  
pp. 8-12
Author(s):  
R. M. Solh ◽  
M. I. Andrukhin ◽  
O. V. Makarov ◽  
V. V. Fedchenkov

Purpose. Im proving the results of treatment of patients with ureteral stones and reducing the dam aging effects of contact lithotripsy.Materials and methods. In this study, 48 patients were examined aged 20 to 63 years. All patients admitted to the urology department with diagnoses: urolithiasis, calculus of the ureter. In all cases contact ureterolithotripsy with stenting of the upper urinary tract were performed. The patients were divided into two groups: main and control. 25 patients (52 .1%) were included into the main group, which in the postoperative period, we used low-level laser therapy (L-therapy). 23 patients were included in a control group (47.9%) who did not receive low-laser therapy. Laboratory tests and ultrasound with Doppler renal blood vessels scan were performed on admission, on the first day after the operation and on the 5-th day of hospitalization. Low-intensity laser therapy was performed within 5 days after contact ureterolithotripsy on projection of placement of stone and kidney projection by series for 5 minutes.Results. All patients admitted to the hospital, were spared from ureteral stones. In the main group during the treatment with L-therapy a decrease in the level of beta-2 microglobulin to normal was observed. (4.8 ± 0.1 mg/l on the first day. On the 5th day 2 .3 + 0.1 mg/l). In the control group during the treatment without the use of L-therapy, the average level of beta-2 microglobulin decreased but did not reach normal levels. (5.5 ± 0.1 mg/l on the first day. On the 5th day 3,2 ±0, l mg/l).Resistance index in the study group decreased compared to the control. In the control group, cases of acute pyelonephritis were observed. The average hospital stay for patients of the main group (6 days) was less than in the control group (6 .5 + days).Conclusion. The use of laser therapy in the treatment of patients who did undergo ureterolithotripsy can reduce the length of stay of the patient in the hospital and reduce the risk of acute pyelonephritis in the postoperative period. Also it can reduce the damaging effect of lithotripsy on the renal tissues.


2019 ◽  
Vol 4 (2) ◽  
pp. 122-126
Author(s):  
V. G. Lubyanskiy ◽  
V. V. Seroshtanov

Background. The problem of chronic pancreatitis in recent years is acute, primarily due to the occurrence of complications and pain that forces you to turn to a surgeon. The main cause of deaths is the failure of the pancreatic anastomosis and the occurrence of bleeding into the cavity of the pancreatic intestinal anastomosis (40 %).Aims: to improve the results of duodenum-preserving resections by introducing the technology of sealing the pancreaticintestinal anastomosis.Materials and methods. The clinic operated 225 patients with chronic pancreatitis. All patients before the operation and in the postoperative period were carried out clinical and biochemical studies, the Frey operation was performed. Patients were divided into two groups. The first group, the group of comparison, included 184 (81.8 %) patients with pancreatoenteroanastomosis formed without additional sealing methods. The second group – the main one – consisted of 41 (18.2 %)patients in which the suture of the pancreatic anastomosis was strengthened with an adhesive composite or with the loop of the small intestine.Results. After the surgery, complications in the control group were recorded in 19 (8.4 %) patients: failure – in 6 (3 %), bleeding into the lumen of pancreatoenteroanastomosis – in 9 (4 %), mortality was 1.8 % (4 persons). There were no complications in the main group. The analysis of the amylase content in the drainage fluid revealed high values in the control group on the 3rd day – 916 ± 15 U/l, in comparison with the main group – 437 ± 16 U/l (p < 0.05). The data obtained indicate that the cause of insolvency of the pancreatic-intestinal anastomosis is the penetration of enzymes through the pancreatic-cervical anastomosis zone into the abdominal cavity. When analyzing the results, it turned out that the failure of the pancreatic-intestinal anastomosis was not detected in any case in patients with sealing.Conclusion. The escape of enzymes destroys the tightness of the superimposed fistula and is characterized by an increase in the level of amylase in the drainage fluid. The proposed sealing technologies decrease the number of postoperative complications and improve the results of treatment.


Author(s):  
O. V. Avdeev ◽  
Y. K. Zmarko ◽  
A. B. Boykiv ◽  
R. O. Drevnitska

The high prevalence of inflammatory processes in the periodontitis of children, the ineffective effectiveness of preventive and curative measures can contribute to the development of generalized periodontitis, therefore it remains urgent to develop pathogenetic effects in the treatment of chronic catarrhal gingivitis.The aim of the study – a comparative assessment of the traditional treatment of chronic catarrhal gingivitis in children aged 6–7 years with therapy using an anti-inflammatory gel with neovitin.Materials and Methods. 61 children aged 6–7 years, suffering from chronic catarrhal gingivitis, were taken under clinical supervision and divided into groups: the main (30 children) and the comparative (31 children). All children underwent conventional therapy in accordance with the protocols for the provision of medical care – basic therapy. In the main group, for a month, pathogenetic agents were used: an anti-inflammatory gel with neovitin, hygiene products were recommended. In the comparative group, 3 % hydrogen peroxide solution was used for local therapy, for rinsing of the mouth (during the first week of treatment) – Rotokan, a therapeutic and prophylactic toothpaste.Examination and control examinations were carried out with the hygienic state of the mouth determined by the hygienic index of Yu. A. Fedorov and V. V. Volodkina, prevalence and intensity of the inflammatory process in the gums with the help of the Schiller-Pisarev test and the PMA index, oral fluid index (lysozyme content, formation of oxydradicals, urease activity, degree of dysbiosis, pH and viscosity).Results and Discussion. After the treatment, elimination of gum inflammation in patients of the main group was accompanied by a decrease in the PMA index by 3.8 times; formation of oxyradicals decreased in children of the main group by 6.35 %; in the comparative group – by 6.15 %. Urease activity decreased in children of the main group by 16.37 % (p<0.05), the viscosity of the oral fluid of children decreased in 2.65 times in the main group and in 2.13 times in the comparative group (p<0.05). The lysozyme content increased in children of the main group by 15.61 % (p<0.05) in the comparison group – by 9.63% (p<0.05). The treatment after 0.5 years caused an increase in the lysozyme content in the oral fluid of the children of the main group to the level of the control group. The degree of dysbiosis decreased in the main group, in the comparison group tended to increase.Conclusions. The use of the proposed therapy with gel with neovitin contributed to the best results of treatment: reducing the degree of inflammation of the gums, the number of visits to the doctor, improving the indices of nonspecific protection in the oral fluid of 6-7 years-old children and, to a greater extent, six months after the treatment.


The work is devoted to the problem of reducing intra- and postoperative complications in patients with surgical gastrointestinal tract pathology. The aim of the study is to comprehensively investigate electrosurgical and ultrasound dissection and coagulation features to prevent intra- and postoperative complications, improve the results of treatment of patients with surgical gastrointestinal tract pathology. The study included experimental and clinical parts. The use of ultrasound scanning in the main group of patients revealed significant advantages of this method compared to MES. This device allowed not only to carry out the dissection of the gastrointestinal tract organs, but also to mobilize them, thereby simplifying and speeding up the operation. Intersection of vessels of both omenta, small and large intestines mesentery vessels was carried out with alternating regimes of coagulation and cutting, while ligating only large blood vessels. The study showed that thanks to the use of ultrasound scanning it was possible to reduce the number of postoperative complications from 16.2% to 6.7%, postoperative mortality decreased from 6.11% to 1.55%, and postoperative bed-day decreased from an average of 17.5+ 3.75 to 12.5 + 2.58, which in the complex allowed to improve the parameters of treatment and rehabilitation of patients.


2021 ◽  
pp. 66-71
Author(s):  
Valentin Sergeevich Rzhevsky

The article presents the results of treatment of patients with acute inflammatory diseases of the maxillofacial region using non-drug methods of treatment. Study material: 60 patients with acute purulent-inflammatory diseases of the maxillofacial region (phlegmons and abscesses), who were divided into 2 groups: the main group — 30 patients who underwent a course of complex application of broadband electromagnetic therapy and low — frequency alternating electrostatic field and the control group — 30 patients who were treated with drug therapy (antibiotics, metronidazole group drugs, antihistamines, multivitamins, detoxification therapy, local treatment of the wound process), which served as the background in the main group. Objective: to develop and scientifically substantiate the complex application of broadband electromagnetic therapy and low-frequency alternating electrostatic field in patients with inflammatory diseases of the maxillofacial region. Results. In a comparative aspect, the dynamics of the indicators of the leukocyte intoxication index (LII) and the main indicators of the morphological picture of the blood before and after treatment in patients with HIA CHLO under the influence of the developed complex was studied. Conclusion. The developed complex, which includes a low-frequency alternating electrostatic field and broadband electromagnetic therapy, contributes to the formation of pronounced anti-inflammatory and detoxifying effects in patients with inflammatory diseases of the maxillofacial region due to a significant reduction in endogenous intoxication, which allows us to recommend it for inclusion in complex therapeutic and rehabilitation programs after surgical interventions to accelerate the time of purulent wound cleansing and reduce the length of hospital stay.


2021 ◽  
Vol 10 (2) ◽  
pp. 217-226
Author(s):  
Aslamhon M. Sharipov ◽  
Khizmatullah A. Shamszoda ◽  
Rukhshona A. Rahmatova ◽  
Bobokhon Kh. Usupov ◽  
Uldosh T. Dodochonov ◽  
...  

Objective to improve the results of treatment of children with cicatricial narrowing of the esophagus in various dilative ways. The results of treatment of 95 patients aged from 1 year to 18 years with Cicatricial esophageal stenosis in the period from 2014 to 2019 were analyzed. There were 59 boys (62.1%) and 36 girls (37.9%). The patients were divided into two groups. The control group included 47 (49.5%) patients who had esophageal dilatations performed "blind" in 15 children and "thread" in 32 children, the main group 48 (50.5%) patients who had esophageal augmentation performed using conductor screws. Of the 95 patients, 70 (73.7%) were after burning with acetic essence, 20 (21.05%) after burning with alkali, 2 (2.1%) after consuming potassium permanganate crystals, 2 (2.1%) after swallowing a round battery, and another (1.05%) received a burn from an unknown chemical reagent. Diameters and lengths of narrowed sections were taken into account based on endoscopic and radiological data in order to select the appropriate sizes of branches in both groups. 18 (26%) of 70 children with scar stenosis after acetic essence were admitted to the hospital later than a month, with dilation of which in 4 cases (5.7%) there was a complication in the form of esophageal perforation, where two children had short scar stenosis, and the rest had tubular and elongated. The cases of complications in the control group were in three cases (two during blind bugging and one during bugging "for a thread"), and in the main group in one. 20 (21.05%) children had scar stenosis after an alkaline burn, where extended scar stenosis was observed 6 (30%) patients. In the control group, 4 of patients had boujinga complications, and in the main group 2. In 2 (2.1%) patients with Scar stenosis, which occurred after the potassium permanganate crystals were successfully run "along the thread". In two children, scar stenosis was formed after swallowing batteries, where one was reinforced with a "thread" (there was a perforation of the esophagus), and the other with a conducting string. Two children who received scar stenosis from an unknown reagent were reinforced with a conducting string, where in the first case a favorable result was achieved, and the outcome of treatment of the second child due to expanded stenosis was not successful. They were offered gastrostomy surgery to perform "thread" listening, but this offer was not accepted. Conclusions. The obtained results reflect an advantage for bougienage on the conductor string in the treatment of children with cicatricial stenosis of the esophagus compared with other dilatation methods.


2017 ◽  
Vol 176 (1) ◽  
pp. 70-75
Author(s):  
V. I. Pomazkin

The aim of the study was a comparative analysis of results of different approaches to two-stage treatment of malignant colonic obstruction on the stage of recovery of the integrity of intestinal tract. The main group included 260 patients. A double-barreled colostomy was formed at the first stage, than resection of the colon with tumor removing and stoma excision were performed. The control group consisted of 192 patients. An obstructive resection of the colon was made at the first stage with following reconstructive operation. Intraoperative damage of the small intestine was observed in 6,9% patients of the main group and 18,2% patients of the control group. Postoperative mortality consisted of 1,2% in the main group and it was 1,5% in the control group. The early postoperative complications numbered 9,2% and 17,7%, respectively. The main risk factor of complication development was an expressed adhesion process of the abdominal cavity in the control group of patients. CONCLUSIONS. The method, which included the colostomy formation at the first stage with following radical surgery at the second stage, had advantages in case of elimination of malignant colonic obstruction.


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