scholarly journals Morphological evaluation of anal canal wound healing after combined operations for combined anorectal pathology

2021 ◽  
Vol 27 (4) ◽  
pp. 13-21
Author(s):  
V.V. Balytskyy
Keyword(s):  
Wound Healing ◽  
Connective Tissue ◽  
Anal Canal ◽  
Postoperative Period ◽  
High Frequency ◽  
Inpatient Treatment ◽  
Study Groups ◽  
Postoperative Wound ◽  
Combined Operations ◽  
Morphological Assessment

The urgency of the problem of postoperative wound healing after combined operations for combined pathology of the anal canal and rectum is quite high and contributes to the introduction into the practice of coloproctologists of new modern surgical technologies for the treatment of this pathology. The aim of the study was to conduct a comparative morphological assessment of postoperative wound healing in patients with combined pathology of the anal canal and rectum after combined operations using modern high-frequency electrosurgical and radiosurgical technologies. The results of surgical treatment of 689 patients with combined pathology of the anal canal and rectum using high-frequency electrosurgery and radiowave surgery with morphological assessment of wound healing on 3, 5, 7, 14, 21 days of the postoperative period, which were divided into 4 study groups. Using of “Surgitron” and “KLS Martin” devices for the treatment of patients with combined pathology of the anal canal and rectum was accompanied by the formation of the thinnest layers of coagulation necrosis in tissues with a depth of 0.189±0.085 mm and 0.194±0.090 mm respectively and as result patients of the first and fourth study groups had the shortest duration of inpatient treatment, which was 3-5 days and the average time of wound healing, which was 14-15 days. Patients in these study groups had the lowest inflammatory neutrophil reaction in postoperative wounds on day 3, which rapidly disappeared by day 5, on days 7-14 they had active reparative processes with the appearance of fibroblasts and connective tissue fibers, and on 21 day squamous epithelial cells, which indicated the processes of active epithelialization of wounds. The effect on the tissues of the devices “EFA” and “ERBE ICC 200” was deeper than in the above groups, forming a layer of coagulation tissue necrosis with a depth of 0.208±0.097 mm and 0.302±0.107 mm respectively, which was accompanied by patients of the third and second study groups with longer terms of inpatient treatment, which amounted to 5-7 days and increase the duration of wound healing, which amounted to 16-19 days. Patients in the 2nd and 3rd study groups showed a more pronounced inflammatory neutrophilic reaction in postoperative wounds on the 3rd day, which did not disappear until the 5th day and in half of the cases the presence of a significant number of segmental neutrophils and bacterial accumulations persisted. On days 7-14 they had weak reparative processes with the appearance of single fibroblasts and a small number of connective tissue fibers and on the 21st day single squamous epithelial cells, which indicated slow processes of wound epithelization. Using of radio-wave surgery and high-frequency electrosurgery devices promotes active epithelialization of tissues preventing scar strictures of the anal canal and improves the rehabilitation of patients in the postoperative period.

scholarly journals Clinical and morphological assessment of the effectiveness of using the radiowave surgery device «surgitron» and high – frequency electrosurgical device «kls martin» for treatment of patients with combined pathology of anal canal and rectum

2019 ◽  
Vol 1 (7) ◽  
pp. 25-32
Author(s):  
V.V. Balytskyy ◽  
O.G. Kuryk ◽  
M.P. Zakharash
Keyword(s):  
Blood Loss ◽  
Anal Canal ◽  
Radio Wave ◽  
Postoperative Period ◽  
High Frequency ◽  
Inpatient Treatment ◽  
Surgical Techniques ◽  
Morphological Examination ◽  
Narcotic Analgesics ◽  
Surgical Interventions

The aim – to analyze the results of treatment of patients with combined pathology of the anal canal and rectum using Surgitron radio wave surgery and high-frequency electrosurgery "KLS Martin". Materials and methods. The analysis of surgical treatment of 236 patients with combined anal canal and rectum with Surgitron radio wave surgery, 50 patients using KLS Martin high-frequency electrosurgery and 112 patients who have been traditionally operated using a metal scalpel. After surgical interventions using radio-wave and high-frequency electrosurgery devices, morphological examination of tissues was conducted to study the depth of their necrosis. Results. It has been established that the use of Surgitron, as well as the high-frequency electrosurgical apparatus "KLS Martin", reduces the duration of the surgery to 15 ± 5 minutes, reduces the volume of blood loss to 20 ± 10 ml, the need for narcotic analgesics to 2 ± 1 ml, and terms of inpatient treatment of patients up to 4 ± 1 day. The results of the morphological study indicate that the application of the above-mentioned surgical techniques leads to a negligible depth of tissue necrosis from 0.165 ± 0.11 mm using the Surgitron apparatus to 0.192 ± 0.12 mm when used with the KLS Martin apparatus, ensuring cosmetic operations. Conclusions. The use of the Surgitron radio-wave surgery and the KLS Martin electrosurgical apparatus for the treatment of patients with combined pathology of the anal canal and rectum due to insignificant tissue effects contributes to reducing the duration of the operation, reducing the volume of intraoperative blood loss, significantly reducing the pain in the postoperative period, reduction of the terms of inpatient treatment of patients, which determines their rapid medical and social rehabilitation. Also due to the minimal effect on the tissue, the healing of the postoperative wound is faster, which contributes to the formation of a delicate elastic scar and prevents the formation of scar strictures of the anal canal, as well as insufficiency of the anal sphincter in the postoperative period.

scholarly journals Comparative estimation of a pain syndrome in patients after combined operations for coexistent pathology of anal channel and rectum with application of modern and standard surgical technologies

2021 ◽  
Vol 88 (5-6) ◽  
pp. 36-41
Author(s):  
V. V. Balytskyy
Keyword(s):  
Surgical Treatment ◽  
Thin Layer ◽  
Radio Wave ◽  
Postoperative Period ◽  
High Frequency ◽  
Pain Syndrome ◽  
Coagulation Necrosis ◽  
Control Group ◽  
Combined Operations ◽  
Frequency Apparatus

Objective. Comparative estimation of the pain syndrome in patients with concomitant pathology of anal channel and rectum after performance of combined operations, using modern high-frequency electro-surgical and radio-surgical apparatuses, as well as conventional scalpel. Materials and methods. The results of surgical treatment of 689 patients with concomitant pathology of anal channel and rectum, using apparatuses of a high-frequency electro-surgery and radio-wave surgery, were analyzed, using the pain syndrome estimation on 1-7th postoperative day. The patients were distributed into 4 investigation groups and a control group, consisting of 112 patients, operated on using metallic conventional surgical scalpel. Results. The pain syndrome on the first postoperative day was mostly expressed in patients of control group, for anesthesia they needed (4 ± 1) ml of 2% solution of promedol, while the patients of the first, third and fourth groups investigated, in which, accordingly, apparatus of radio-wave surgery «Surgitron» and high-frequency electro-surgical apparatuses «EFA» and «KLS Martin» were used, needed for anesthesia (2 ± 1) ml of 2% solution of promedol. While application of the electro-surgical high-frequency apparatus «ERBE ICC 200» the necessity for the 2% solution of promedol for anesthesia have constituted (3 ± 1) ml. Conclusion. Combined operations, using modern apparatuses of high-frequency electro-surgery and radio-wave surgery give significantly better results, than application of conventional surgical metallic scalpel, because it produces significantly reduced pain syndrome due to thin layer of coagulation necrosis, promoting formation of delicate elastic cicatrix and preventing development of cicatricial strictures of anal channel in postoperative period.

scholarly journals Modern methods of surgical treatment of anal canal and rectum combined pathology

2021 ◽  
Vol 88 (1-2) ◽  
pp. 14-18
Author(s):  
V. V. Balytskyy ◽  
M. P. Zakharash ◽  
O. G. Kuryk
Keyword(s):  
Surgical Treatment ◽  
Anal Canal ◽  
Radio Wave ◽  
High Frequency ◽  
Narcotic Analgesics ◽  
Surgical Interventions ◽  
Combined Operations ◽  
Modern Methods ◽  
Duration Of Operation ◽  
Anorectal Pathology

Objective. To evaluate the effectiveness of surgical treatment of anal canal and rectum combined pathology, through combined surgical interventions using modern electro- and radiosurgical technologies. Materials and methods. A comparative evaluation of the results of surgical treatment of 681 patients with combined pathology of the anal canal and rectum, who underwent combined single-stage operations using high-frequency electrosurgery and radio-wave surgery. Results. In case of application the device for radio-wave surgery "Surgitron", and also devices of high-frequency electrosurgery "ERBE ICC 200", "EFA", "KLS Martin" duration of operation is reduced to (15 - 25 ± 3) minutes, volume of blood loss decreases to (15 ± 6) ml, the need for narcotic analgesics decreases up to (2 ± 1) ml, the duration of inpatient treatment was reduced up to (4 ± 1) days. Conclusions. The use of modern radio- and electrosurgical technologies for the treatment of combined anorectal pathology prevents the occurrence of anal canal strictures and scarring of the perianal areas, causing the cosmeticity of combined operations.

Reduction of number of postoperative complications depends on quality of dressing material and wound treatment

2020 ◽  
pp. 61-63
Author(s):  
Larisa Katkasova ◽  
Svetlana Kropotova
Keyword(s):  
At Risk ◽  
Wound Healing ◽  
Postoperative Complications ◽  
Wound Treatment ◽  
Postoperative Wound ◽  
Speed Up ◽  
Modern Technologies

Operated patients suffering from diabetes are at risk of developing postoperative complications. Modern technologies of postoperative wound treatment and modern dressings allow to avoid complications and speed up the process of postoperative wound healing.

Dexamethasone-Chemical Structure and Mechanisms of Action in Prophylaxis of Postoperative Side Effects

2019 ◽  
Vol 70 (3) ◽  
pp. 843-847 ◽  
Author(s):  
Oana Roxana Ciobotaru ◽  
Mary-Nicoleta Lupu ◽  
Laura Rebegea ◽  
Octavian Catalin Ciobotaru ◽  
Oana Monica Duca ◽  
...  
Keyword(s):  
Wound Healing ◽  
Side Effects ◽  
Length Of Stay ◽  
Hospital Admission ◽  
Postoperative Period ◽  
Analgesic Effect ◽  
Chemical Structure ◽  
Mechanisms Of Action ◽  
Good Recovery ◽  
Synthetic Glucocorticoid

Dexamethasone is a synthetic glucocorticoid used for its anti-inflammatory and analgesic effect. In addition to these therapeutic indications, it is also recommended for nausea and vomiting treatment which may occur during the postoperative period, with impact on postoperative evolution, regarding the evolution of wound healing and length of stay (LOS), with a reflection on the costs of hospital admission. Therefore, their prevention is very important for both patients� comfort and a good recovery.

Management of Deep Spinal Wound Infections Following Instrumentation Surgery with Subfascial Negative Pressure Wound Therapy

2021 ◽  
Author(s):  
Marcus Rickert ◽  
Michael Rauschmann ◽  
Nizar Latif-Richter ◽  
Mohammad Arabmotlagh ◽  
Tamin Rahim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Wound Healing ◽  
Wound Infection ◽  
Spinal Fusion ◽  
Negative Pressure Wound Therapy ◽  
Wound Infections ◽  
Wound Therapy ◽  
Postoperative Wound ◽  
Deep Wound ◽  
The Impact

Abstract Background and Study Aims The treatment of infections following a spine surgery continues to be a challenge. Negative pressure wound therapy (NPWT) has been an effective method in the context of infection therapy, and its use has gained popularity in recent decades. This study aims to analyze the impact of known risk factors for postoperative wound infection on the efficiency and length of NPWT therapy until healing. Patients and Methods We analyzed 50 cases of NPWT treatment for deep wound infection after posterior and posteroanterior spinal fusion from March 2010 to July 2014 retrospectively. We included 32 women and 18 men with a mean age of 69 years (range, 36–87 years). Individual risk factors for postoperative infection, such as age, gender, obesity, diabetes, immunosuppression, duration of surgery, intraoperative blood loss, and previous surgeries, as well as type and onset (early vs. late) of the infection were analyzed. We assessed the associations between these risk factors and the number of revisions until wound healing. Results In 42 patients (84%), bacterial pathogens were successfully detected by means of intraoperative swabs and tissue samples during first revision. A total of 19 different pathogens could be identified with a preponderance of Staphylococcus epidermidis (21.4%) and S. aureus (19.0%). Methicillin-resistant S. aureus (MRSA) was recorded in two patients (2.6%). An average of four NPWT revisions was required until the infection was cured. Patients with infections caused by mixed pathogens required a significantly higher number of revisions (5.3 vs. 3.3; p < 0.01) until definitive wound healing. For the risk factors, no significant differences in the number of revisions could be demonstrated when compared with the patients without the respective risk factor. Conclusion NPWT was an effective therapy for the treatment of wound infections after spinal fusion. All patients in the study had their infections successfully cured, and all spinal implants could be retained. The number of revisions was similar to those reported in the published literature. The present study provides insights regarding the effectiveness of NPWT for the treatment of deep wound infection after spinal fusion. Further investigations on the impact of potential risk factors for postoperative wound healing disorders are required. Better knowledge on the impact of specific risk factors will contribute to a higher effectiveness of prophylaxis for postoperative wound infections considering the patient-specific situation.

scholarly journals MRGPR-mediated activation of local mast cells clears cutaneous bacterial infection and protects against reinfection

2019 ◽  
Vol 5 (1) ◽  
pp. eaav0216 ◽  
Author(s):  
Mohammad Arifuzzaman ◽  
Yuvon R. Mobley ◽  
Hae Woong Choi ◽  
Pradeep Bist ◽  
Cristina A. Salinas ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Wound Healing ◽  
Dendritic Cells ◽  
Mast Cells ◽  
Connective Tissue ◽  
Selective Activation ◽  
Adaptive Immune ◽  
Antigen Presenting ◽  
G Protein Coupled ◽  
Draining Lymph Nodes

Mast cells (MCs) are strategically distributed at barrier sites and prestore various immunocyte-recruiting cytokines, making them ideal targets for selective activation to treat peripheral infections. Here, we report that topical treatment with mastoparan, a peptide MC activator (MCA), enhances clearance ofStaphylococcus aureusfrom infected mouse skins and accelerates healing of dermonecrotic lesions. Mastoparan functions by activating connective tissue MCs (CTMCs) via the MRGPRX2 (Mas-related G protein-coupled receptor member X2) receptor. Peripheral CTMC activation, in turn, enhances recruitment of bacteria-clearing neutrophils and wound-healing CD301b+dendritic cells. Consistent with MCs playing a master coordinating role, MC activation also augmented migration of various antigen-presenting dendritic cells to draining lymph nodes, leading to stronger protection against a second infection challenge. MCAs therefore orchestrate both the innate and adaptive immune arms, which could potentially be applied to combat peripheral infections by a broad range of pathogens.

Diode laser technology in the treatment of hemorrhoid disease. Laser HemorrhoidoPlasty (LHP) – description of the method

Nowa Medycyna ◽  
2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Sławomir Glinkowski ◽  
Daria Marcinkowska
Keyword(s):  
Connective Tissue ◽  
Anal Canal ◽  
Diode Laser ◽  
Laser Technology ◽  
Laser Techniques ◽  
American Society

Hemorrhoids is one of the most common proctological diseases of the anal canal. In the guidelines presented in 2018 in „Diseases of the Colon & Rectum”, the American Society of Colon and Rectal Surgeons (ASCRS) hasn’t specified laser techniques as a method of treatment. The first attempts of laser trail in hemorrhoidal treatment were made at the end of the 70s by using laser CO2 instead of scalpel. Nowadays one of the newest devices is Leonardo laser which emits fan-shaped movement of 1470 nm length. It enabled the development of laser hemorrhoidoplasty technique (LHP). The advantage of this procedure is decrease of hemorrhoidal plexus by obliteration of hemorrhoidal vessels leading to their fibrosis. It reclaims almost anatomical architecture of anal canal without a necessity to excise the extended hemorrhoids. Development of the connective tissue fibers guarantees adequate adhesion of mucosa to the underlying tissue which prevents the recurrence of the disease, especially the ones connected with prolapsing of hemorrhoids. The article contains a description of the method recommended by the manufacturer of Leonardo laser with the autors’ modifications developed on the basis of their own experience.

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