scholarly journals Surgical treatment of wounded persons with complicated thoracic damages

2020 ◽  
Vol 87 (11-12) ◽  
pp. 3-9
Author(s):  
Ya. L. Zarutskyi ◽  
S. A. Aslanyan ◽  
O. V. Borzykh ◽  
V. G. Hetman ◽  
V. E. Saphonov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Thoracic Trauma ◽  
Soft Tissues ◽  
Pleural Empyema ◽  
Main Group ◽  
Thoracic Wall ◽  
Vacuum Therapy ◽  
Medical Support ◽  
Gun Shot ◽  
Analysis Of Results

Objective. To improve the results of complex surgical treatment of wounded and injured persons with thoracic trauma, complicated by bronchopleural fistulas, pleural empyema and defects in the thoracic wall soft tissues, basing on introduction of the proposed procedure of vacuum therapy in combination with bronchoscopic obturation of certain bronchus. Materials and methods. Analysis of results of the complex surgical help delivery for 54 wounded persons with defects of the thoracic wall soft tissues, broncho-pleural fistulas and pleural empyema, caused by the combat thoracic trauma, on ІІІ and ІV levels of medical support while conduction of the Antiterrorist operation/Operation of the Joined Forces (the main group) and 73 injured persons with thoracic trauma of the peace period (the comparison group) in the 2014 - 2019 yrs period was conducted. Results. Improvement of complex surgical treatment of the wounded and damaged persons with thoracic trauma and defects of the thoracic wall soft tissues have permitted to reduce the complications frequency by 6.7%, and lethality - by 9.2% in the main group. Conclusion. There was proposed a procedure of vacuum therapy, ultrasound cavitation together with bronchoscopic bronchial obturation for its fistula, which have proved its efficacy in complex surgical treatment of severely wounded persons with the gun-shot thoracic damages and presence of combination of pleural empyema, bronchial fistula and defects of soft tissues.

SURGICAL TACTICS FOR PURULENT-SEPTIC COMPLICATIONS OF COMBAT BELLY INJURIES

2021 ◽  
pp. 103-108
Author(s):  
O. S. Gerasimenko ◽  
Y. I. Gaida ◽  
A. V. Okolets ◽  
K. R. Muradian
Keyword(s):  
Surgical Treatment ◽  
Soft Tissues ◽  
Clinical Manifestations ◽  
Gunshot Wounds ◽  
Treatment Method ◽  
Combat Trauma ◽  
Comprehensive Treatment ◽  
Vacuum Therapy ◽  
Septic Complications ◽  
Severity Of Injury

Summary. Combat injury of the abdomen, according to the ATO / OOS is from 6.7 to 9 %. The specificity of gunshot wounds to the abdomen causes the development of functional disorders and complications (51–81 %) and, as a consequence, a high mortality rate (12–31 %). Objective: To improve the effectiveness of surgical treatment of purulent-septic complications in the wounded with combat trauma to the abdomen (BTC). Materials and methods. The Military Medical Clinical Center of the Southern Region (VMKC PR) analyzed the treatment of 86 wounded who were hospitalized with purulent-septic complications of BTZ from 2014 to 2020, taking into account the location, clinical manifestations and severity of injury, used modern treatment methods , namely: puncture and drainage interventions under the control of ultrasonography and installation of NPWT systems. Comprehensive treatment was supplemented with antibacterial therapy and oxygen barotherapy. First of all, the wounded underwent puncture and drainage interventions under ultrasonic navigation and gradual rehabilitation for diagnostic and therapeutic purposes. NPWT therapy was used in 11 patients with extensive wounds and purulent-septic complications of the soft tissues of the anterior abdominal wall. Thus, the use of interventional sonography, as the primary diagnostic and treatment method for the treatment of purulent-inflammatory complications of combat trauma to the abdomen, has improved the quality of diagnosis and reduced traumatic interventions, which has reduced postoperative complications and inpatient treatment. Results and discussion. Eleven (14.2 %) cases of puncture and drainage interventions were ineffective, in connection with which we had to resort to traditional methods of treatment — opening and drainage of purulent-inflammatory foci and the use of NPWT-therapy. Vacuum therapy is an effective method of treatment of purulent-septic complications of gunshot wounds of the soft tissues of the abdomen, which in combination with puncture-drainage interventions, can reduce by 2.5 times the number of repeated operations (mainly multi-stage surgical treatments), thereby reducing 1.8 times the length of stay of patients in the hospital. Conclusions. Thanks to the use of modern methods it was possible to improve the results of surgical treatment of purulent-septic complications in the wounded with purulent-septic complications of combat trauma to the abdomen. The use of the latest techniques has helped reduce the number of invasive treatments, accelerate recovery, reduce bed rest, reduce intoxication, and increase the rate of return of servicemen.

scholarly journals Methods of improving treatment results for patients with postoperative ventral hernia

2014 ◽  
Vol 95 (4) ◽  
pp. 543-548 ◽  
Author(s):  
I S Malkov ◽  
Z M Mukhtarov ◽  
M I Malkova
Keyword(s):  
Cardiovascular Risk ◽  
Surgical Treatment ◽  
Ventral Hernia ◽  
Heart Surgery ◽  
High Efficiency ◽  
Risk Identification ◽  
Main Group ◽  
Wound Complications ◽  
Vacuum Therapy ◽  
Ventral Hernias

Aim. To improve the results of surgical treatment for patients with postoperative ventral hernia by improving complex preoperative physical examination and better prevention of wound complications. Methods. Results of surgical treatment of 160 patients [mean age - 64 years, females - 120 (75%), males - 40 (25%)] with postoperative ventral hernia treated from 2003 to 2012 were analyzed. The surgeries were performed routinely. All patients were distributed to 2 groups depending on postoperative wound complications prevention. The main group included 60 patients who underwent a vacuum therapy (authors’ technology) during postoperative period for preventing wound complications. Perioperative management of patients with large and huge hernias in this group was performed according to recommendations of the European Society of Cardiologists and All-Russian Scientific Cardiologic Society for cardiovascular risk assessment at surgeries excluding heart surgery. Comparison group included 100 patients who underwent surgery for postoperative ventral hernias using a conventional vacuum drainage and common methods of patient examination according to recommended standards. Results. Using vacuum therapy in patients of the main group limited the number of Redon-drainage procedures, reduced the rate of local pyoinflammatory complications by 4.2 times (p 0.05). Cardiovascular risk identification and proper preoperative preparation allowed avoiding unfavorable outcomes associated with cardiovascular complications in patients with high cardiovascular risk. Conclusion. High efficiency of a complex approach in preventing postoperative complications after ventral hernias surgical treatment allows to recommend its use in clinical practice.

scholarly journals Tactics of surgical treatment of deep intermuscular gluteal region phlegmons

2021 ◽  
Author(s):  
E.N. Byakova ◽  
V.K. Tatyanchenko ◽  
V.L. Bogdanov ◽  
Y.V. Sukhaya ◽  
Y.V. Krasenkov
Keyword(s):  
Surgical Treatment ◽  
Soft Tissues ◽  
New Technologies ◽  
Main Group ◽  
Gluteal Region ◽  
Control Group ◽  
Tissue Pressure ◽  
Results Of Treatment ◽  
Purulent Wound

Purpose. The purpose is to improve the results of treatment of patients with phlegmon of the gluteal region soft tissues by diagnosing the stage of tissue hypertension and determining the tactics of surgical treatment depending on this indicator. Materials and methods. Clinical studies were performed on 74 patients suffering from phlegmon of the gluteal region. All the patients were divided into 2 groups: in the main group (as opposed to the control group), acute tissue hypertension syndrome was diagnosed and decompressive fasciotomy was performed in tissue hypertension (30–35 mm Hg) (patent). The authors performed ultrasound cavitation and ozone therapy of a purulent wound. Results. With phlegmon of the gluteal region of soft tissues, an increase in tissue pressure by 25% above the norm is an indication for fasciotomy in the area of fascial nodes. The time of purulent wound cleaning against the background of normal tissue pressure (8–10 mm Hg) of the surgery in patients of the main group was reduced to 5 days (8 days in the control). In the long-term (0.5–1 years), good results were obtained in 92.8% of patients in the main group (64.7% in the control group). Conclusion. The developed tactics of treatment of patients with phlegmon of the soft tissues of the gluteal region are highly effective due to the development and application of new technologies for the diagnosis and treatment of tissue hypertension.

scholarly journals OBTURATIVE BOWEL OBSTRUCTION CAUSED BY GALLSTONES

2015 ◽  
Vol 174 (3) ◽  
pp. 20-23
Author(s):  
A. G. Khasanov ◽  
M. A. Nurtdinov ◽  
A. V. Ibraev
Keyword(s):  
Surgical Treatment ◽  
Bowel Obstruction ◽  
Main Group ◽  
Ultrasonic Tomography ◽  
Modern Methods ◽  
Analysis Of Results ◽  
Made In

The article discussed the results of surgical treatment of obturative bowel obstruction caused by gallstones. An analysis of results was made in two groups of patients. Ultrasonic tomography and laparoscopic diagnostics were used in the main group. An application of modern methods of diagnostics allowed reducing of lethality rate.

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.

Cytological substantiation of application of vacuum therapy in combustiology

2021 ◽  
Vol 179 (6) ◽  
pp. 44-49
Author(s):  
S. B. Bogdanov ◽  
D. N. Marchenko ◽  
K. C. Pavlyk ◽  
O. V. Gospirovish ◽  
E. A. Artemova ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Cytological Study ◽  
Scientific Research Institute ◽  
Vacuum Therapy ◽  
Cytological Analysis ◽  
Burn Wound ◽  
Burn Wounds ◽  
Healing Wounds ◽  
Clinic Hospital

The OBJECTIVE was to perform a comparative cytological analysis of the wound exudate in healing wounds during autodermoplasty on a granulating burn wound with and without vacuum therapy.METHODS AND MATERIALS. The article presents the results of the cytological study substantiated the use of vacuum therapy in combustiology. The comparative analysis was performed in 2 groups of patients. The first group consisted of patients with granulating burn wounds, who underwent surgical treatment with vacuum therapy. The second group consisted of patients who underwent surgical treatment without vacuum therapy. In both groups, the complex of surgical treatment included autodermoplasty on a granulating burn wound. All the patients were treated in the Burn Department of the «Scientific research institute – Ochapovsky regional clinic hospital № 1».RESULTS. The application of vacuum-associated dressings in the surgical treatment of patients in burn hospitals helps to reduce the time of graft retention in the plasty of granulating burn wound, decrease the number of dressings and the amount of dressing material, reduce the time of treatment of patients.CONCLUSION. The obtained cytological results allow us to justify the application of vacuum therapy in the surgical treatment of granulating burn wounds.

Surgical treatment of patients with deep infiltrating endometriosis of the rectovaginal septum

2021 ◽  
Vol 20 (4) ◽  
pp. 5-11
Author(s):  
E.A. Galliamov ◽  
◽  
L.N. Aminova ◽  
V.A. Alimov ◽  
A.G. Kozub ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Comparison Group ◽  
Chronic Pelvic Pain Syndrome ◽  
Main Group ◽  
Pelvic Pain Syndrome ◽  
Deep Infiltrating Endometriosis ◽  
Rectovaginal Septum ◽  
Infiltrating Endometriosis

Objective. To optimize the tactics of surgical treatment of deep infiltrating endometriosis of the rectovaginal septum, including with bowel involvement. Patients and methods. The study included 122 patients diagnosed with deep infiltrating endometriosis of the rectovaginal septum, who underwent surgical interventions of different volumes using laparoscopy. The patients were divided into a main group and a comparison group. The main group consisted of 92 patients with deep infiltrating endometriosis of the rectovaginal septum who underwent surgical treatment using the original technique of systematic approach; the comparison group consisted of 30 patients who were operated using the generally accepted technique. Results. There was a statistically significant decrease in the operation duration, intraoperative blood loss, as well as more effective relief of dysmenorrhea and chronic pelvic pain syndrome, less complications and relapses in the main group compared to the comparison group. In addition, it was found that the combination of three symptoms such as dysmenorrhea, dyspareunia and chronic pelvic pain increase the likelihood of deep infiltrating endometriosis up to 93%. Conclusion. Based on the results obtained, the proposed method of surgical treatment of deep infiltrating endometriosis is more efficient and safer in comparison with the generally accepted technique, which can be considered as a valid reason for its wide introduction into clinical practice. Key words: deep infiltrating endometriosis, bowel endometriosis, surgical treatment of endometriosis, treatment algorithm

scholarly journals Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine

2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Surgical Interventions ◽  
Comparative Group ◽  
Operative Wound

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.

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 THE EFFECT OF NUTRITIONAL THERAPY ON QUALITY OF LIFE INDICATORS FOR PATIENTS WITH GASTRIC CANCER AT THE STAGE OF SURGICAL TREATMENT

2019 ◽  
Vol 6 (3) ◽  
pp. 108-114 ◽  
Author(s):  
A. D. Sergienko ◽  
V. E. Khoronenko ◽  
E. V. Gameeva ◽  
A. B. Ryabov ◽  
V. M. Khomyakov
Keyword(s):  
Quality Of Life ◽  
Gastric Cancer ◽  
Surgical Treatment ◽  
Nutritional Therapy ◽  
Main Group ◽  
Control Group ◽  
Quality Of Life Indicators ◽  
Eortc Qlq C30 ◽  
Eortc Qlq

Purpose of the study. To determine the effect of nutritional deficiency and nutritional therapy on the quality of life of patients with gastric cancer at the stage of surgical treatment. Patients and methods. In Thoracoabdominal Department of P. Herzen Moscow Oncology Research Institute within 2017– 2019 the quality of life at the stage of surgical treatment of gastric malignant neoplasms was evaluated in 62 patients (36 men and 26 women) aged 34 to 79 years (mean age 61.9 ± 9.55). At the outpatient stage, patients were divided into 2 groups: in the 1st (main) group, patients received nutritive support with specialized mixtures for 10 days before hospitalization, in the 2nd (control) group, patients were asked to follow a high-protein diet without adding specialized mixtures. The quality of life assessment was carried out on the basis of the EORTC-QLQ-C30 Questionnaire, which patients received on the day of hospitalization. Patients repeatedly filled in EORTC-QLQ-C30 Questionnaire before discharge from the hospital, which allowed to assess the dynamics of the quality of life indicators of the studied patients. The study groups were comparable in social and medical indicators. Results. The analysis of the survey results showed that the “general state of health” in the studied groups at the stage of hospitalization is estimated �bove average. Also, in both groups there is a positive dynamics in the values of the above indicator before discharge. Patients of the 1st group who received specialized nutritional mixtures, developed the statistical significance of the differences in the assessment of the quality of life upon admission and before discharge. Thus, it can be argued that nutritional therapy had a significant positive impact on the quality of life in terms of “general health”, in contrast to the control group of patients who did not receive specialized nutritional therapy. There was a general tendency toward an increase in the quality of life indicators at admission and before discharge on all scores of the questionnaire in groups. Thisis a positive assessment by patients of their condition after providing them with medical services. In this case, the discomfort from the symptoms accompanying the disease is reduced, which is confirmed by the scoring results. Statistically significant differences in the assessment of symptoms occur in the study group. Patients having received nutritional therapy noted a decrease in pain, an improvement in the processes of assimilation of food, as well as an improvement in well-being, physical condition, an increase in general tone and energy, a surge of strength and a sense of vitality. In “decreased appetite”score the indices of patients in the main group decreased by more than 3 times, i. e. their appetite improved significantly under treatment. Improving appetite in patients of the main group led to an improvement in the functioning of the gastrointestinal tract as a whole. Patients in this group noted an improvement in digestion and bowel movements. Conclusion The study showed that the quality of life of patients with gastric cancer largely depends on their nutritional deficiency, and nutritional therapy at the stages of surgical treatment, in turn, can significantly improve its results, including in the aspect of their perception by patients. Using the general EORTC QLQ-C30 questionnaire is one of the available methods for assessing the quality of life in patients with gastric cancer.

Sign in / Sign up

Export Citation Format

Share Document