scholarly journals MORPHOLOGICAL CHARACTERISTICS OF THE WOUND PROCESS IN AN OPTIMIZED SURGICAL TREATMENT OF widespread purulent- INFLAMMATORY PROCESSES OF THE MAXILLOFACIAL AREA

2018 ◽  
Vol 25 (6) ◽  
pp. 110-113
Author(s):  
V. Y. Lukashov ◽  
A. A. Kirpichev ◽  
M. I. Kuzmin ◽  
G. G. Sveshnikov
Keyword(s):  
Surgical Treatment ◽  
Soft Tissues ◽  
Morphological Characteristics ◽  
Leukocyte Infiltration ◽  
Tissue Necrosis ◽  
Surgical Technology ◽  
Inflammatory Focus ◽  
Primary Surgery ◽  
Inflammatory Processes ◽  
Pathological Focus

Aim. The research was conducted to study the processes occurring in soft tissues in the surgical treatment of widespread purulent-inflammatory processes of the maxillofacial area and to confirm the effectiveness of the developed optimal surgical technology.Materials and methods. A surgical treatment of 20 patients with the widespread purulent-inflammatory processes of maxillofacial area was carried out according to the developed surgical technology. In all cases, the tissue was taken from the area of the pathological focus for the pathomorphological examination at all stages of treatment. Results. The morphological study of the drugs obtained during a primary surgery on the purulent-inflammatory focus showed a picture of the serous-purulent inflammation with a severe leukocyte infiltration. Necrobiosis and tissue necrosis prevailed in the center of the purulent-inflammatory focus. After 3 days, the wound began to grow young granulation tissue with a large number of capillary kidneys, a marked decrease in the level of leukocyte infiltration, the appearance of fibroblasts and lymph-histiocytic elements, the formation of fibrous connective tissue. Conclusion. The morphological assessment of the wound process showed a positive dynamics and the effectiveness of the proposed treatment of the patients with purulent-inflammatory processes of the maxillofacial area.

Surgical treatment of extensive perianal hidradenitis

2020 ◽  
Vol 99 (9) ◽  
Keyword(s):  
Surgical Treatment ◽  
Hidradenitis Suppurativa ◽  
Soft Tissues ◽  
Case Reports ◽  
Radical Excision ◽  
Skin Flaps ◽  
Perianal Area ◽  
Apocrine Glands ◽  
Patient Preparation ◽  
Two Stages

Introduction: Perianal hidradenitis suppurativa is a chronic recurrent inflammatory, suppurative, and fistulising disease of apocrine glands, adjacent anal canal and soft tissues. Perianal area is the second most common affected area after axilla. There are three grades of the disease. Hidradenitis suppurativa represents a chronic, recurrent, deep-seated folliculitis resulting in abscesses, followed by the formation of sinus tracts and subsequent scarring. Perianal hidradenitis suppurativa is the last and the most serious grade of the disease and a specific access is needed for patient preparation and surgical treatment alone. The currently preferred method of treatment for patients with extensive perianal hidradentitis is excision and closure with combination of skin flaps, primary suture and skin graft in one or two stages. Case reports: There are three case reports of perianal hidradenitis suppurativa in this article. The local and overall initial treatment of patients followed by a radical excision and closure with a rotation skin flaps and skin grafts is described. The final results were satisfactory, with no recurrence or serious complication.

Analysis of the monitoring study of the antibiotic-resistance of the agents of purulent-inflammatory processes of soft tissue

2018 ◽  
Vol 22 (2) ◽  
pp. 285-288
Author(s):  
A.P. Prevar ◽  
A.V. Kryzshanovskaya ◽  
V.A. Radionov ◽  
V.M. Mrug
Keyword(s):  
Soft Tissues ◽  
High Sensitivity ◽  
Biochemical Properties ◽  
Antimicrobial Drugs ◽  
Strict Adherence ◽  
E Coli ◽  
Monitoring Study ◽  
Treatment Measures ◽  
Inflammatory Processes ◽  
Main Factor

The main factor in the treatment of suppurative and inflammatory processes is the timely optimization of treatment measures taking into account the nature of the microflora and its susceptibility to antimicrobial drugs. The purpose of the study is to monitor the spectrum of microorganisms – pathogens of purulent-inflammatory processes of soft tissues in surgical patients; study of the sensitivity of isolated strains to antibiotics. The material was collected in accordance with aseptic rules. The identification of a pure culture of bacteria was carried out according to morphological, culture, biochemical properties, and the presence of virulence enzymes. Sensitivity of bacteria to antibiotics was determined by the standard disks method (by Kirby-Bauer’s). 255 patients with purulent-inflammatory processes of soft tissues were examined for the period from 2014 to 2017. 229 strains of isolated bacteria were included to Escherichia coli, Citrobacer freundii, Enterobacter cloacae, E.aerogenes, Proteus vulgaris, Staphylococcus aureus, S.epidermidis, Streptococcus pyogenes, S.viridians, S.agalactiae, Pseudomonas aeruginosa. The main cause of purulent-inflammatory processes of soft tissues is Staphylococci (67,2%). Compared to previous studies, the number of P.aeruginosa isolated cultures increased (7.9%). In monoculture and in association with other microorganisms, E. coli (9.6% of cases), E.cloacae et aerogenes (3.9% of cases), P.vulgaris (3.9% of cases), C.freundi (2.5% of cases), S.agalactiae, S.pyogenes, S.viridans (3.5%). The number of associated sows reaches 12%. Clinical strains of microorganisms remain most sensitive to fluoroquinolones, cephalosporins, and also retains high sensitivity to gentamicin, lincomycin, rifampicin, which is important for empirical antibiotic therapy. To increase the effectiveness of antibacterial therapy, strict adherence to the mode of appointment of antibiotics, justification of indications, a combination of antibiotics of different spectrum of action, mandatory correction after determining the sensitivity of the pathogen.

scholarly journals A CLINICAL CASE OF REMOVING A RESIDUAL FOREIGN BODY FROM THE LEFT SUPRACLAVICULAR REGION

2017 ◽  
Vol 4 (3) ◽  
pp. 120-122
Author(s):  
V.V. Boyko ◽  
V.V. Makarov ◽  
A.L. Sochnieva ◽  
V.V. Kritsak
Keyword(s):  
Surgical Treatment ◽  
Foreign Body ◽  
Soft Tissue ◽  
Clinical Case ◽  
Foreign Bodies ◽  
Soft Tissues ◽  
Life Quality ◽  
The Other ◽  
Practical Case ◽  
The One

Boyko V.V., Makarov V.V., Sochnieva A.L., Kritsak V.V.Residual foreign bodies in soft tissues are one of the main causes of chronical infection lesions and decrease in life quality. Surgical treatment is the most common way to relieve the patient from a foreign body. Often there is a question whether to remove a foreign body? On the one hand, all foreign bodies that are in the human body must be removed. On the other hand, in the absence of symptoms, the risk of surgery performed for the purpose of removal exceeds the risk associated with finding the foreign body. We would like to describe a practical case of removing a foreign body (Kirschner`s wires) from the left supraclavicular region. The young patient lived with a fragment of Kirschner's wire left after the osteosynthesis of the fractured clavicle for 5 years. Surgery to remove the residual foreign body was successful. On the 7th postoperative day the patient was discharged from the hospital under the supervision of surgeons at the place of residence.Key words: foreign body in soft tissue, Kirschner`s wire, surgical treatment. КЛІНІЧНИЙ ВИПАДОК ВИДАЛЕННЯ ЗАЛИШКОВ СТОРОННЬОГО ТІЛА З ЛІВОЇ НАДКЛЮЧИЧНОЇ ОБЛАСТІБойко В.В., Макаров В.В., Сочнева А.Л.,  Крицак В.В.Залишкові чужорідні тіла м'яких тканин залишаються однією з основних причин виникнення вогнища хронічної інфекції та зниження рівня якості життя. Хірургічне лікування основний спосіб позбавити хворого від наявності чужорідного агента. Часто виникає питання чи видаляти чужорідне тіло. З одного боку, усі сторонні тіла, що знаходяться в тілі людини, підлягають видаленню, з іншого боку при відсутності симптомів ризик операції, проводимої з метою видалення, перевищує ризик, пов'язаний з перебуванням чужорідного тіла. Ми хотіли б поділитися випадком видалення залишкового стороннього тіла (спиці Кіршнера) лівої надключичної ділянки із власної практики. Молода пацієнтка прожила з уламком спиці Кіршнера, залишеної після металлоостеосинтезу поламаної ключиці протягом 5 років. Операція з видалення залишкового стороннього тіла пройшла успішно. На 7 післяопераційну добу пацієнтка була виписана зі стаціонару під спостереження хірурги за місцем проживання.Ключові слова: чужорідне тіло м'яких тканин, спиця Кіршнера, хірургічне лікування. кЛИНИЧЕСКИЙ СЛУЧАЙ УДАЛЕНИЯ ОСТАТКОВ ИНОРОДНОГО ТЕЛА ИЗ ЛЕВОЙ ПОДКЛЮЧИЧНОЙ ОБЛАСТИ Бойко В.В., Макаров В.В., Сочнева А.Л.,  Крицак В.В.Остаточные инородные тела мягких тканей остаются одной из основных причин возникновения очага хронической инфекции и снижения уровня качества жизни. Хирургическое лечение основной способ избавить больного от наличия чужеродного агента. Часто возникает вопрос удалять ли инородное тело? С одной стороны, все инородные тела, находящиеся в теле человека, подлежат удалению, с другой стороны при отсутствии симптомов риск операции, производимой с целью удаления, превышает риск, связанный с нахождением инородного тела. Мы хотели бы поделится случаем удаления остаточного инородного тела (спицы Киршнера) левой надключичной области из собственной практики. Молодая пациентка прожила с обломком спицы Киршнера, оставленной после металлоостеосинтеза поломанной ключицы в течении 5 лет. Операция по удалению остаточного инородного тела прошла успешно. На 7 послеоперационные сутки пациентка была выписана из стационара под наблюдение хирурги по месту жительства.Ключевые слова: инородное тело мягких тканей, спица Киршнера, оперативное лечение.

scholarly journals MORPHOLOGICAL CHARACTERISTICS OF PERIPHERAL BLOOD OF COWS INFECTED WITH BLV AND THE FREQUENCY OF REGISTRATION OF LEUKEMOID REACTIONS IN COWS WITH LEUKEMIA-AFFECTED HERDS

2020 ◽  
pp. 66-72
Author(s):  
P. N. Smirnov ◽  
S. M. Chudum ◽  
I. V. Trostyansky ◽  
O. S. Kotlyarova
Keyword(s):  
Successful Treatment ◽  
Peripheral Blood ◽  
Serum Proteins ◽  
Morphological Characteristics ◽  
Controlled Experiments ◽  
Individual Analysis ◽  
Morphological Composition ◽  
Inflammatory Processes

In controlled experiments during planned studies of cattle for leukemia, animals that showed leukemoid changes in blood – quantitative redistribution of granulocytes and agranulocytes-were identified. Individual analysis revealed that granulocytosis was detected in animals with inflammatory processes. In addition, the article presents comparative indicators of serum proteins in cows at the hematological stage of the leukemic process, with the manifestation of leukemoid reactions and in clinically healthy cows. Characteristic changes in the synthesis of immunoglobulins in cows with leukemia and leukemoid changes in the morphological composition of blood were established. With successful treatment of inflammatory processes, the hematological status of cows is restored to the initial indicators.

scholarly journals Rational selection of treatment methods in recurrent clubfoot

2021 ◽  
pp. 64-71
Author(s):  
G. V. Divovich
Keyword(s):  
Surgical Treatment ◽  
Bone Growth ◽  
Soft Tissues ◽  
Primary Treatment ◽  
Ponseti Method ◽  
Growth Potential ◽  
Idiopathic Clubfoot ◽  
Rational Selection ◽  
Congenital Clubfoot ◽  
Selection Of

Objective. Based on an analytical assessment of the results of surgical treatment of children with equinovarus foot deformity of various origins (idiopathic clubfoot, syndromic clubfoot), to determine a way of rational selection of surgical techniquesin each specifc case.Materials and methods. The results of the treatment of 78 children with congenital idiopathic clubfoot over the period 2010–2018 were assessed in comparison with the results of the treatment of 41 children with recurrent congenital clubfoot, whose primary treatment had been carried out before 2010. We have gained the experience in treating 30 children with severe clubfoot syndrome (meningomyelocele, CNS lesions, chromosomal diseases and others).Results. In the treatment of congenital clubfoot with the Ponseti method, recurrences occur in 21.79 % of the cases, and in the traditional treatment — in 57.74 %. The Ponseti surgical treatment of recurrences consists in performing release operations on the tendon-ligament apparatus from mini-accesses. Cases of rigid, long-standing deformities require extensive releases on soft tissues, as well as resection and arthrodesis interventions on the joints of the foot. The treatment of clubfoot syndrome requires “surgically aggressive” methods of correction in early childhood.Conclusion. In the idiopathic variants of clubfoot and its relapses, it is possible to correct the vicious position of the feet by minimally invasive operations with minimal damage to the tissues of the circumflex joints and without damage to the flexor tendons and their sheaths in the medial ankle area. Long-standing recurrent rigid variants, as well as syndromic clubfoot, presuppose the performance of extensive releases, osteotomies and arthrodetic resections of the joints of the foot at an early age. A promising direction for clubfoot correction in the process of child development is a surgery with the use of the bone growth potential of the lower leg and foot.

scholarly journals Organization of stage rehabilitation of servicemen with gunshot defects of soft tissues at the levels of medical care

2021 ◽  
Vol 26 (4) ◽  
pp. 188-195
Author(s):  
K.D. Babov ◽  
I.P. Khomenko ◽  
S.V. Tertyshnyi ◽  
Babova I.K. Babova I.K. ◽  
R.S. Vastianov
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Medical Care ◽  
Soft Tissues ◽  
Lower Extremities ◽  
Gunshot Wounds ◽  
Care Quality ◽  
Rehabilitation Service ◽  
Soft Tissue Defects ◽  
Tissue Defects

Building a modern system of rehabilitation of servicemen in Ukraine is an integral part of providing medical care in armed conflict. Rehabilitation of servicemen after gunshot wounds with soft tissue defects of the lower extremities is a common but difficult problem for surgical and rehabilitation teams. The process of rehabilitation requires the implementation of certain methodological provisions. At present, medical care for servicemen is a four-levels’ one. Rehabilitation service is provided at the third and fourth levels of medical care. The aim of the study was to improve the quality of medical care for servicemen after gunshot wounds with soft tissue defects of the lower extremities by introducing a system of staged rehabilitation. Organizational and methodological bases of the system of staged rehabilitation of wounded servicemen with soft tissue defects at different levels of medical care have been developed. Two models of rehabilitation depending on the severity of the injury and the tactics of surgical treatment are proposed. The division of the stage of early sanatorium rehabilitation for the wounded with severe soft tissue injuries depending on the stage of surgical treatment and the formation of a "skin patch" is justified. The introduction of the proposed models of rehabilitation of wounded with soft tissue defects in the practice of early sanatorium rehabilitation will provide increasing of medical care quality.

Basic principles of surgical treatment of artificial pyoinflammatory diseases of soft tissues

2018 ◽  
pp. 44-46
Author(s):  
A.N. Koval ◽  
N.V. Tashkinov ◽  
G.G. Melkonyan ◽  
A.Y. Marochko ◽  
B.M. Kogut ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Soft Tissues ◽  
Basic Principles

Method of surgical treatment of the saddle nose deformity

2021 ◽  
Vol 20 (4) ◽  
pp. 43-47
Author(s):  
D. S. Pshennikov ◽  
◽  
Z. M. Abdulaev ◽  
◽  
Keyword(s):  
Surgical Treatment ◽  
Local Anesthesia ◽  
Nasal Septum ◽  
Soft Tissues ◽  
Operation Time ◽  
Functional Results ◽  
Nasal Dorsum ◽  
Superficial Musculoaponeurotic System ◽  
Saddle Nose Deformity ◽  
External Nose

Saddle deformity of the external nose, which is a consequence of trauma, is usually combined with a nasal septal deviation and is quite widespread in the population. The problem of surgical treatment of this group of patients lies not only in the technical complexity, trauma of the proposed methods but also in the need to carry out significant interventions under general anesthesia, which limits the use of available techniques by a wide number of ENT surgeons, increases the duration of the operation, recovery time and temporary disability of the patient. The invention aims to improve surgical treatment of patients with saddle nasal deformity by providing stable cosmetic and functional results. Materials and methods: The proposed method of surgical treatment of saddle deformity of nasal dorsum includes several stages. Cartilage autograft taken from nasal septum during septoplasty is milled to 0,5–1,0 mm, mixed with 0,5 ml of latex tissue glue (LTG) having hemostatic and antiseptic properties due to aminocaproic acid and dioxidine content, respectively. This mixture is kept for 5 minutes and delivered to the pocket formed under the SMAS (superficial musculoaponeurotic system) layer in the soft tissues of the dorsum of the external nose, after which the final shape of the nose is simulated and fixed with a plaster splint for a week. Results: Based on the department of otolaryngology of Semashko Ryazan Regional Clinical Hospital, for the period from 2012 to 2019, 17 patients were treated with a diagnosis: saddle deformity of the external nose and nasal septum deviation. All patients underwent rhinoseptoplasty under local anesthesia using LTG as described above. No complications were observed in the postoperative period. During follow-up from 7 to 24 months, patients retain constant functional and cosmetic results. Conclusions. This method is a simple, low-traumatic one of surgical treatment of saddle deformity of the nasal dorsum, which allows reducing the operation time, performing it under local anesthesia and obtaining good cosmetic and functional results. The technical simplicity and accessibility of the method make it possible to use it in hospitals engaged in the surgical treatment of nasal diseases.

Survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma

2020 ◽  
Vol 21 (4) ◽  
pp. 127-130
Author(s):  
V. U. Rayn ◽  
◽  
A. A. Chernov ◽  
S. O. Zabotkin ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Soft Tissues ◽  
Abdominal Cavity ◽  
Survival Rates ◽  
Pancreatic Head ◽  
Ductal Adenocarcinoma ◽  
En Bloc ◽  
Free Survival ◽  
Pancreatic Head Cancer

Aim. To access overall and event-free survival rates in patients after surgical treatment of localized and locally spread pancreatic head cancer. Materials and methods. A single center observational trial was conducted at a low-volume pancreatic surgery center in Khanty-Mansiysk. Data were collected retrospectively from 2007 to 2019. Patients with resectable tumors were included into the study whose final histology showed pancreatic ductal adenocarcinoma and en-bloc resection. According to the technical facilities and actual clinical protocols all patients received surgical treatment only and were then monitored. Data on progression patterns and survival rates were collected and calculated using Kaplan-Meier survival analysis. Results. Median overall survival (OS) after R0 pancreaticoduodenectomy was 16,8 months (IQR 10,9-23,5). Median progression-free survival was 10,6 mo. (IQR 8,0-20,7). OS in jaundiced patients was 4,9 mo. shorter than in patients without jaundice at the diagnosis (р = 0,011). Patients with serum bilirubin level < 100 μmol/l lived on average 7.2 months longer (p = 0.014). Most frequent sites of primary progression were liver and peritoneum, lungs, bones, lymph nodes of the abdominal cavity / retroperitoneal space, less often metastases were found in the skin and soft tissues. In 21.4% of cases metastases were found in several organs simultaneously with most frequent combination of liver and peritoneum, liver and lungs, lungs and bones. The median survival after progression was 7.1 ± 4.8 months Conclusion. Pancreatic duct adenocarcinoma has a high potential for progression and has therefore poor prognosis. To improve long-term outcomes, it is advisable to apply additional therapeutic options perioperatively.

Microanatomy of the dura mater at the craniovertebral junction and spinal region for safe and effective surgical treatment

2020 ◽  
Vol 33 (2) ◽  
pp. 165-171
Author(s):  
Kiyoshi Ito ◽  
Mitsunori Yamada ◽  
Tetsuyoshi Horiuchi ◽  
Kazuhiro Hongo
Keyword(s):  
Surgical Treatment ◽  
Posterior Fossa ◽  
Dura Mater ◽  
Morphological Characteristics ◽  
Craniovertebral Junction ◽  
Venous Sinus ◽  
Microsurgical Anatomy ◽  
Spinal Region ◽  
Vascular Structures ◽  
Minor Muscle

OBJECTIVEFew reports have been published regarding the detailed microsurgical anatomy of the dura mater at the craniovertebral junction (CVJ), although many neurosurgeons have had the opportunity to conduct surgeries in this region, such as in cases of Chiari malformation. The authors aimed to evaluate the detailed and precise microsurgical anatomy of the dura mater at the CVJ for safe and effective surgical treatment at this area.METHODSThis study consisted of dissection of 4 formalin-fixed, continuous, human cadaveric dura maters, extending from the posterior fossa to the C2 level. After removing the occipital bone and C1 laminae, a dural incision was made to harvest the specimen. The following structural and topographical aspects of the dura mater in each region were studied: 1) thickness, 2) morphological characteristics, and 3) vascular structures.RESULTSThe average thicknesses of the dura mater were 313.4 ± 137.0 μm, 3051.5 ± 798.8 μm, and 866.5 ± 359.0 μm in the posterior cranial fossa, CVJ, and spinal region, respectively. The outer layer of the posterior cranial dura mater and the tendon of the rectus capitis posterior minor muscle were connected, forming the “myodural bridge.” The dura mater at the CVJ had a well-developed vascular network. These vascular structures were determined to be veins or the venous sinus, and were mainly located around the interface between the inner layer of the cranial dura mater and the rectus capitis posterior minor muscle layer. Regarding the morphological features, the bulging located in the inner layer of the dura mater at the CVJ was determined to be the marginal sinus, and contained a pacchionian granulation that allowed for CSF circulation. In the spinal region, the dura mater was characterized by a single, thick layer enclosing the collagen fibers with almost the same orientation.CONCLUSIONSThe dura mater at the CVJ displayed dynamic morphological changes within an extremely short segment. Its characteristic anatomical features were not similar to those in the cranial regions. The dural bulging at the CVJ was determined to be the venous sinus. During surgery in the posterior fossa, CVJ, and spinal cord, different procedures should be used because of the specific microsurgical anatomy of each region.

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