Pub Date : 2022-01-12DOI: 10.26779/2522-1396.2021.11-12.40
B. Selskyi, S. Kostiv, P. Nikulnikov, I. Venher, P. Selskyi
Objective. To propose the prognostication method for the complications occurrence after operative interventions, basing on application of multiparametric neuro-web clasterisation with subsequent elaboration of scale for their development risk stratification. Materials and methods. The indices of examination were analyzed in 411 patients, suffering obliterating atherosclerosis of main arteries of the lower extremities. The neuro-web clasterization, using a software raising NeuroXL Classifier, was conducted for more deep analysis of concomitant changes in the indices investigated for the risk prognostication optimization of the morbidity development in postoperative period. Results. The scale of the risk stratification for development of postoperative complications after interventions on the main arteries of the lower extremities proposed, takes into account multifactor character of clinic-anamnestic and laboratory-instrumental investigations. Taking into account the concomitant factors presence, which characterize the organs and systems state, they impact the choice of method of reconstructive operative intervention. Conclusion. Basing on data of the neuro-web clasterization, it is possible to prognosticate the complcations after operative intervention on the main arteries of the lower extremities. There were delineated four levels of the complications development risk in postoperative period: very high – 31-40 points, high – 21-30 points, moderate – 11-20 points, and low – 1-10 points.
{"title":"The complications risk prognostication after operative interventions on the main arteries of the lower extremities on background of application of multiparametric neuro-web clasterization.","authors":"B. Selskyi, S. Kostiv, P. Nikulnikov, I. Venher, P. Selskyi","doi":"10.26779/2522-1396.2021.11-12.40","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.11-12.40","url":null,"abstract":"Objective. To propose the prognostication method for the complications occurrence after operative interventions, basing on application of multiparametric neuro-web clasterisation with subsequent elaboration of scale for their development risk stratification. \u0000Materials and methods. The indices of examination were analyzed in 411 patients, suffering obliterating atherosclerosis of main arteries of the lower extremities. The neuro-web clasterization, using a software raising NeuroXL Classifier, was conducted for more deep analysis of concomitant changes in the indices investigated for the risk prognostication optimization of the morbidity development in postoperative period. \u0000Results. The scale of the risk stratification for development of postoperative complications after interventions on the main arteries of the lower extremities proposed, takes into account multifactor character of clinic-anamnestic and laboratory-instrumental investigations. Taking into account the concomitant factors presence, which characterize the organs and systems state, they impact the choice of method of reconstructive operative intervention. \u0000Conclusion. Basing on data of the neuro-web clasterization, it is possible to prognosticate the complcations after operative intervention on the main arteries of the lower extremities. There were delineated four levels of the complications development risk in postoperative period: very high – 31-40 points, high – 21-30 points, moderate – 11-20 points, and low – 1-10 points.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87629957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-12DOI: 10.26779/2522-1396.2021.11-12.75
І. Duzhyi, V. Shimko, G. І. Pyatikop, M. Kononenko, G. P. Oleshchenko, D. A. Al Yamani Navras
Objective. Studying of impact of regional lymphotropic antibacterial therapy on various abdominal organs and application of the results in a combat abdominal trauma. Materials and methods. In the experiment accumulation of ceftriaxone in various abdominal organs was investigated, and detected by dimensions of the development zone delay in laboratory culture of E. coli in 1 – 2 h regional lymphotropic introduction of the preparation in a daily dose. Laboratory animals (rabbits) were withdrawn from the experiment, using overdosing of ketamine. After obtaining of specimen from certain organs, of them homogenate was processed and it was introduced into agar-agar, on which E. coli was cultivated. Separately, pure antibiotic (control) was introduced into the bacterial development zone as well. In a day the dimensions of the development zone delay in a test-culture was calculated, in accordance to which the level of accumulation of antibiotic was revealed. Results. The biggest dimensions of the development zone delay of E.coli were registered after antibiotic introduction into paravertebral and iliac zones, what have witnessed its maximal accumulation, accordingly, in gastric and pancreatic gland, the small bowel, coecum, sigmoid colon and the small omentum, and peritoneal specimen. After intramuscular injection of the antibiotic the dimensions of the development zone delay of E.coli have appeared minimal, witnessing practically absent accumulation of the preparation in specimen of the organs investigated. Conclusion. Accumulation of ceftriaxone in various organs in different inhibitory dose, concerning development of E. coli, witnesses the necessity to use the regional paths of lymphotropic introduction of antibiotic into certain abdominal zone of purulent-inflammatory process. Intramuscular introduction of antibiotic is not expedient in such inflammatory processes.
{"title":"Peculiarities of lymphotropic antibioticotherapy in a combat trauma of abdominal organs (clinic-experimental investigation)","authors":"І. Duzhyi, V. Shimko, G. І. Pyatikop, M. Kononenko, G. P. Oleshchenko, D. A. Al Yamani Navras","doi":"10.26779/2522-1396.2021.11-12.75","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.11-12.75","url":null,"abstract":"Objective. Studying of impact of regional lymphotropic antibacterial therapy on various abdominal organs and application of the results in a combat abdominal trauma. \u0000Materials and methods. In the experiment accumulation of ceftriaxone in various abdominal organs was investigated, and detected by dimensions of the development zone delay in laboratory culture of E. coli in 1 – 2 h regional lymphotropic introduction of the preparation in a daily dose. Laboratory animals (rabbits) were withdrawn from the experiment, using overdosing of ketamine. After obtaining of specimen from certain organs, of them homogenate was processed and it was introduced into agar-agar, on which E. coli was cultivated. Separately, pure antibiotic (control) was introduced into the bacterial development zone as well. In a day the dimensions of the development zone delay in a test-culture was calculated, in accordance to which the level of accumulation of antibiotic was revealed. \u0000Results. The biggest dimensions of the development zone delay of E.coli were registered after antibiotic introduction into paravertebral and iliac zones, what have witnessed its maximal accumulation, accordingly, in gastric and pancreatic gland, the small bowel, coecum, sigmoid colon and the small omentum, and peritoneal specimen. After intramuscular injection of the antibiotic the dimensions of the development zone delay of E.coli have appeared minimal, witnessing practically absent accumulation of the preparation in specimen of the organs investigated. \u0000Conclusion. Accumulation of ceftriaxone in various organs in different inhibitory dose, concerning development of E. coli, witnesses the necessity to use the regional paths of lymphotropic introduction of antibiotic into certain abdominal zone of purulent-inflammatory process. Intramuscular introduction of antibiotic is not expedient in such inflammatory processes.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76692621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-12DOI: 10.26779/2522-1396.2021.11-12.29
M. Opanasenko, B. Konik, О. Tereshkovych
Objective. To share own experience for surgical treatment of pulmonary carcinoid tumours. Materials and methods. During last 13 yrs in Department of Thoracic Surgery and Invasive Methods of Diagnosis of Yanovskyi National Institute of Phthisiatry and Pulmonology were treated 45 patients, suffering pulmonary carcinoid. Average age of the patients have constituted 45 yrs old. Among the patients the women prevailed – 31 (68.9%). Concomitant pathology have had 15.6% patients. In 38 (84.4%) patients the disease was diagnosed accidentally in elective roentgenological examination. Pronounced clinical features of the disease were observed in 3 (6.7%) patients only. Additional 4 (8.9%) patients complained about insignificant worsening in general well-being: moderate dyspnea, dry periodical cough, frequent bronchitis. Results. There were 44 (97.8%) patients operated. The most frequent operation performed in patients with pulmonary carcinoid was lobectomy in various modifications: a classic one – in 16 (36.4%), video-assisted – 13 (29.5%), and bronchoplastic – 5 (11.4%). Operative interventions were performed in accordance to rules for thoracic surgery and for oncological surgery in particular. In a central localization of the process the diagnosis was verified preoperatively in all the patients, while in peripheral carcinoids only - in 2 (25.0%) patients, in whom transthoracic biopsy with histological investigation of biopsies was performed. In other 6 (75.0%) patients, suffering peripheral carcinoid, intraoperative histological or cytological investigations with determination of further surgical tactics were conducted. Conclusion. Pulmonary carcinoid is characterised by slow course and absence of pronounced clinical signs, what causes its late diagnosis. To select an optimal method of surgical treatment histological verification of the diagnosis is mandatory. In treatment of pulmonary carcinoid tumours, surgical method is choosed.
{"title":"Pulmonary carcinoid: own experience of surgical treatment","authors":"M. Opanasenko, B. Konik, О. Tereshkovych","doi":"10.26779/2522-1396.2021.11-12.29","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.11-12.29","url":null,"abstract":"Objective. To share own experience for surgical treatment of pulmonary carcinoid tumours. \u0000Materials and methods. During last 13 yrs in Department of Thoracic Surgery and Invasive Methods of Diagnosis of Yanovskyi National Institute of Phthisiatry and Pulmonology were treated 45 patients, suffering pulmonary carcinoid. Average age of the patients have constituted 45 yrs old. Among the patients the women prevailed – 31 (68.9%). Concomitant pathology have had 15.6% patients. In 38 (84.4%) patients the disease was diagnosed accidentally in elective roentgenological examination. Pronounced clinical features of the disease were observed in 3 (6.7%) patients only. Additional 4 (8.9%) patients complained about insignificant worsening in general well-being: moderate dyspnea, dry periodical cough, frequent bronchitis. \u0000Results. There were 44 (97.8%) patients operated. The most frequent operation performed in patients with pulmonary carcinoid was lobectomy in various modifications: a classic one – in 16 (36.4%), video-assisted – 13 (29.5%), and bronchoplastic – 5 (11.4%). Operative interventions were performed in accordance to rules for thoracic surgery and for oncological surgery in particular. In a central localization of the process the diagnosis was verified preoperatively in all the patients, while in peripheral carcinoids only - in 2 (25.0%) patients, in whom transthoracic biopsy with histological investigation of biopsies was performed. In other 6 (75.0%) patients, suffering peripheral carcinoid, intraoperative histological or cytological investigations with determination of further surgical tactics were conducted. \u0000Conclusion. Pulmonary carcinoid is characterised by slow course and absence of pronounced clinical signs, what causes its late diagnosis. To select an optimal method of surgical treatment histological verification of the diagnosis is mandatory. In treatment of pulmonary carcinoid tumours, surgical method is choosed.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85276786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-12DOI: 10.26779/2522-1396.2021.11-12.63
M. Danylyuk, S. M. Zavgorodniy, A. Rylov, M. A. Кubrak, N. O. Yareshko, A. V. Bachurin
Objective. Estimation of the changes efficacy in preoperative preparation of elderly and senile patients as a guarantee for improvement of treatment in perioperative period. Materials and methods. Into the investigation were included 153 patients, suffering an acute cholecystitis on background of biliary calculous disease. Into the control group 89 (58.2 %) patients were included, who were treated in accordance to the standards and clinical protocols, while into the main one - 64 (41.8%) patients, in whom preoperative preparation was modified in accordance to algorithm. Results. The patients’ state in admittance to the hospital in a control group was scored in (30.8 ± 5.2) points, and in the main - in (31.6 ± 5.7) points (U = 2684.00, p =0.5437). All the patients were operated in an urgent order. Application of algorithm of preoperative preparation in elderly and senile patients was followed by improvement in their general state in early postoperative period, estimated in accordance to the P-POSSUM scale: in the main group this index have constituted (28.2 ± 4.6) points, and in a control one - (31.1 ± 7.8) points (U = 2219.00, p = 0.0201). As well, the reduction of duration of the artificial pulmonary ventilation was guaranteed: in a control group - 80.00 (70.00; 120.00) min, while in the main one – 63.00 (52.50; 75.00) min (U = 1316, p < 0.0001). Conclusion. Modified preoperative preparation, more frequent performance of miniinvasive operative interventions and eale activisation of the patients have shortened in them a stationary stay: to (10.9 ± 2.5) days in a control group, while (8.3± 2.3) days – in the main one (U = 1745.50, p < 0.0001).
目标。评估中老年患者术前准备的变化效果，为围手术期改善治疗提供保障。材料和方法。153例以胆道结石为背景的急性胆囊炎患者纳入调查。对照组89例(58.2%)患者按照标准和临床方案进行治疗，对照组64例(41.8%)患者按照算法修改术前准备。结果。对照组患者入院状态评分为(30.8±5.2)分，主入院状态评分为(31.6±5.7)分(U = 2684.00, p =0.5437)。所有的病人都做了紧急手术。应用术前准备算法后，老年患者术后早期总体状态改善，按照p - possum量表进行评估:主组该指标为(28.2±4.6)分，对照组为(31.1±7.8)分(U = 2219.00, p = 0.0201)。同时，也保证了人工肺通气持续时间的缩短:对照组- 80.00 (70.00;主通道- 63.00 (52.50;75.00) min (U = 1316, p < 0.0001)。结论。改良的术前准备、更频繁的微创手术干预和eale激活使患者的平稳住院时间缩短:对照组为(10.9±2.5)天，而主要组为(8.3±2.3)天(U = 1745.50, p < 0.0001)。
{"title":"Modification of preoperative preparation as a guarantee of improvement of perioperative treatment in elderly and senile patients","authors":"M. Danylyuk, S. M. Zavgorodniy, A. Rylov, M. A. Кubrak, N. O. Yareshko, A. V. Bachurin","doi":"10.26779/2522-1396.2021.11-12.63","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.11-12.63","url":null,"abstract":"Objective. Estimation of the changes efficacy in preoperative preparation of elderly and senile patients as a guarantee for improvement of treatment in perioperative period. \u0000Materials and methods. Into the investigation were included 153 patients, suffering an acute cholecystitis on background of biliary calculous disease. Into the control group 89 (58.2 %) patients were included, who were treated in accordance to the standards and clinical protocols, while into the main one - 64 (41.8%) patients, in whom preoperative preparation was modified in accordance to algorithm. \u0000Results. The patients’ state in admittance to the hospital in a control group was scored in (30.8 ± 5.2) points, and in the main - in (31.6 ± 5.7) points (U = 2684.00, p =0.5437). All the patients were operated in an urgent order. Application of algorithm of preoperative preparation in elderly and senile patients was followed by improvement in their general state in early postoperative period, estimated in accordance to the P-POSSUM scale: in the main group this index have constituted (28.2 ± 4.6) points, and in a control one - (31.1 ± 7.8) points (U = 2219.00, p = 0.0201). As well, the reduction of duration of the artificial pulmonary ventilation was guaranteed: in a control group - 80.00 (70.00; 120.00) min, while in the main one – 63.00 (52.50; 75.00) min (U = 1316, p < 0.0001). \u0000Conclusion. Modified preoperative preparation, more frequent performance of miniinvasive operative interventions and eale activisation of the patients have shortened in them a stationary stay: to (10.9 ± 2.5) days in a control group, while (8.3± 2.3) days – in the main one (U = 1745.50, p < 0.0001).","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90316446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-12DOI: 10.26779/2522-1396.2021.11-12.11
R. Nikitenko, K. Vorotyntseva, S. P. Degtyarenko, O. M. Stepanovichus
Objective. To study іntra- and postoperative complications in transanal endoscopic resection in patients, suffering cancer recti and to reduce this quantity. Materials and methods. Through the period 2009 - 2021 yrs on the base of Odessa Regional Clinical Hospital 184 patients, suffering cancer recti, were operated, using transanal endoscopic resection. The patients’ age was from 42 to 86 yrs old. The patients were distributed into two groups. In 90 patients of the first group the cancer recti diagnosis of stage I (T1-2N0M0) was established. In 94 patients of the second group the diagnosis of cancer recti stage ІІ (T3N0M0) was established. Results. Purulent-septic, thromboembolic and urological complications were absent in all 184 patients, as well as severe intraoperative complications and mortality. The average stationary stay of the patients have constitited (3.4 ± 1.7) days (from 2 to 6 days). The average lower edge of the tumour was situated at a distance (9.5 ± 4.2) cm (from 5 to 16 cm) from the anal channell, and the average dimensions of tumour - (2.8 ± 1.7) cm (from 1.5 to 4 cm). While studying of the histological investigations results there was noted, that in all the patients the tumour was excised in the healthy tissues borders in accordance to oncological technique. Period of follow-up have constituted from 12 to 60 mo. Cancer recti recurrence was revealed in 12 (13.3%) patients of the first group. Cancer recurrence have had occur in patients, who have rejected from conduction of chemo- and radiotherapy. The patients with recurrences were reoperated, using classic low anterior rectal resection with total mesorectumectomy. Conclusion. While conduction of preoperative neoadjuvant chemo- and radiotherapy the tumour dimensions are reduced significantly, as well as quantity of іntra- and postoperative complications in performance of transanal endoscopic resection. The disease prognosis for cancer recti depends directly on presence of metastases in regional «sentinel» lymphatic nodes.
{"title":"Complications of transanal endoscopic resection in cancer recti","authors":"R. Nikitenko, K. Vorotyntseva, S. P. Degtyarenko, O. M. Stepanovichus","doi":"10.26779/2522-1396.2021.11-12.11","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.11-12.11","url":null,"abstract":"Objective. To study іntra- and postoperative complications in transanal endoscopic resection in patients, suffering cancer recti and to reduce this quantity. \u0000Materials and methods. Through the period 2009 - 2021 yrs on the base of Odessa Regional Clinical Hospital 184 patients, suffering cancer recti, were operated, using transanal endoscopic resection. The patients’ age was from 42 to 86 yrs old. The patients were distributed into two groups. In 90 patients of the first group the cancer recti diagnosis of stage I (T1-2N0M0) was established. In 94 patients of the second group the diagnosis of cancer recti stage ІІ (T3N0M0) was established. \u0000Results. Purulent-septic, thromboembolic and urological complications were absent in all 184 patients, as well as severe intraoperative complications and mortality. The average stationary stay of the patients have constitited (3.4 ± 1.7) days (from 2 to 6 days). The average lower edge of the tumour was situated at a distance (9.5 ± 4.2) cm (from 5 to 16 cm) from the anal channell, and the average dimensions of tumour - (2.8 ± 1.7) cm (from 1.5 to 4 cm). While studying of the histological investigations results there was noted, that in all the patients the tumour was excised in the healthy tissues borders in accordance to oncological technique. Period of follow-up have constituted from 12 to 60 mo. Cancer recti recurrence was revealed in 12 (13.3%) patients of the first group. Cancer recurrence have had occur in patients, who have rejected from conduction of chemo- and radiotherapy. The patients with recurrences were reoperated, using classic low anterior rectal resection with total mesorectumectomy. \u0000Conclusion. While conduction of preoperative neoadjuvant chemo- and radiotherapy the tumour dimensions are reduced significantly, as well as quantity of іntra- and postoperative complications in performance of transanal endoscopic resection. The disease prognosis for cancer recti depends directly on presence of metastases in regional «sentinel» lymphatic nodes.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90162961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-12DOI: 10.26779/2522-1396.2021.11-12.68
S. Gramatiuk, Y. Ivanova, I. A. Кryvoruchko, M. Goloborodko, K. Miasoiedov, D. V. Mіnukhin, O. Shevchenko
Objective. Determination of efficacy of the cellular therapy modified method in chronic wounds on background of diabetes mellitus, comparing with standard and new methods of treatment in experiment. Materials and methods. Experimental investigations were conducted on 30 adult male rats of a Wistar line, in which diabetes mellitus was experimentally simulated. Full-thickness square wound was used as experimental pattern. In the animals of group A (control) the wounds were processed with 0.05% solution of chlorhexidine bigluconate and the hydrohel bandages put on (standard of treatment). To the group B animals photodynamic therapy was conducted, and processes of regeneration were stimulated with the help of the mesenchymal stem cells application. To the group C animals the wounds bottom and edges were infiltrated with suspension of autologous mesenchymal stem cells for active regeneration after conduction of photodynamic therapy. Results. Best healing of the wounds while application of photodynamic therapy and injections of mesenchymal stem cells was noted: on the 5th day from the treatment beginning the wounds square reduction have appeared the most – 71.9%, while application of mesenchymal stem cells this index have constituted 61.6%, and while standard treatment – 36.0%. Conclusion. Treatment of chronic wounds on background of diabetes mellitus, using photodynamic therapy and injections of mesenchymal stem cells, have demonstrated essentially better results, than after standard method. Application of mesenchymal stem cells into the wound, the results of which were compared with results of their injectional introduction, may be recommended as alternative, if immediate injections of mesenchymal stem cells into the tissues over the wound are impossible.
{"title":"Experimental assessment and comparative analysis of efficacy for modified method of cellular therapy in chronic wounds on background of diabetes mellitus","authors":"S. Gramatiuk, Y. Ivanova, I. A. Кryvoruchko, M. Goloborodko, K. Miasoiedov, D. V. Mіnukhin, O. Shevchenko","doi":"10.26779/2522-1396.2021.11-12.68","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.11-12.68","url":null,"abstract":"Objective. Determination of efficacy of the cellular therapy modified method in chronic wounds on background of diabetes mellitus, comparing with standard and new methods of treatment in experiment. \u0000Materials and methods. Experimental investigations were conducted on 30 adult male rats of a Wistar line, in which diabetes mellitus was experimentally simulated. Full-thickness square wound was used as experimental pattern. In the animals of group A (control) the wounds were processed with 0.05% solution of chlorhexidine bigluconate and the hydrohel bandages put on (standard of treatment). To the group B animals photodynamic therapy was conducted, and processes of regeneration were stimulated with the help of the mesenchymal stem cells application. To the group C animals the wounds bottom and edges were infiltrated with suspension of autologous mesenchymal stem cells for active regeneration after conduction of photodynamic therapy. \u0000Results. Best healing of the wounds while application of photodynamic therapy and injections of mesenchymal stem cells was noted: on the 5th day from the treatment beginning the wounds square reduction have appeared the most – 71.9%, while application of mesenchymal stem cells this index have constituted 61.6%, and while standard treatment – 36.0%. \u0000Conclusion. Treatment of chronic wounds on background of diabetes mellitus, using photodynamic therapy and injections of mesenchymal stem cells, have demonstrated essentially better results, than after standard method. Application of mesenchymal stem cells into the wound, the results of which were compared with results of their injectional introduction, may be recommended as alternative, if immediate injections of mesenchymal stem cells into the tissues over the wound are impossible.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88423924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-12DOI: 10.26779/2522-1396.2021.11-12.87
S. І. Panasenco, S. O. Gyryev, M. A. Maximenko, D. M. Lysun, V. Kushnir
Closed adominal trauma in polytrauma Part I. Peculiarities of diagnosis and nonoperative treatment of the parenchymal organs injuries
多发外伤中的闭合性腹外伤第一部分:实质器官损伤的诊断与非手术治疗特点
{"title":"Closed adominal trauma in polytrauma Part I. Peculiarities of diagnosis and nonoperative treatment of the parenchymal organs injuries","authors":"S. І. Panasenco, S. O. Gyryev, M. A. Maximenko, D. M. Lysun, V. Kushnir","doi":"10.26779/2522-1396.2021.11-12.87","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.11-12.87","url":null,"abstract":"Closed adominal trauma in polytrauma Part I. Peculiarities of diagnosis and nonoperative treatment of the parenchymal organs injuries","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88150995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-12DOI: 10.26779/2522-1396.2021.11-12.93
I. Lurin, I. Khomenko, K. Gumeniuk, V. Negoduiko, S. Tertyshnyi, M. M. Grinchuk, V. Maidanyuk, O. Popova
Case report of multimodal approach during reconstruction of gunshot defects the soft tissue of the forearm and wrist
多模式入路重建前臂、手腕软组织枪弹缺损一例报告
{"title":"Case report of multimodal approach during reconstruction of gunshot defects the soft tissue of the forearm and wrist","authors":"I. Lurin, I. Khomenko, K. Gumeniuk, V. Negoduiko, S. Tertyshnyi, M. M. Grinchuk, V. Maidanyuk, O. Popova","doi":"10.26779/2522-1396.2021.11-12.93","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.11-12.93","url":null,"abstract":"Case report of multimodal approach during reconstruction of gunshot defects the soft tissue of the forearm and wrist","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72891424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-12DOI: 10.26779/2522-1396.2021.11-12.22
A. Kot
Objective. Clinical assessment of combined application of the calculated dermolipectomy with improved hernioabdominoplasty in treatment of patients, suffering hernias and external abdominal deformities, who have excessive tissues of abdominal wall. Materials and methods. The investigation is based on data of paraoperative examinations and own results of surgical treatment of 67 patients with hernias and external abdominal deformities. Rational methods of their operating were substantiated on background of morphometric characteristics, determined in accordance to the ventral deformity dimensions, and percentages of adipose-containing, fibrous-cicatricial and pathological components content. Results. The program unit «Statistica 6.1» was applied for statistical elaboration of the results obtained. Algorithm of quantitative investigations of the ventral tissues excessives, which have had predominantly supraaponeurotic localization, was elaborated for the first time. Preoperatively calculated volumes of preventive dermo- and fibrolipectomies, which were performed together with hernio- and abdominoplasties in accordance to new principle «without excesses of parahernial tissues» in various hernias and venral deformities, have reduced essentially the local complications rate - to 2% (р < 0.05) and improved the indices of quality of life and the patients’ health. Conclusion. Practical application of the «tension-free» and «nonrebundant» principles in operating of hernias constitute the base for further elaborations of reconstructive-plastic interventions and a real component of the problem decision in medico-social and esthetic rehabilitation of certain herniological patients.
{"title":"Substantiation of application of «nonrebundant» and «tension-free» principles in hernioabdominoplasty in patients, suffering hernias and ventral deformities","authors":"A. Kot","doi":"10.26779/2522-1396.2021.11-12.22","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.11-12.22","url":null,"abstract":"Objective. Clinical assessment of combined application of the calculated dermolipectomy with improved hernioabdominoplasty in treatment of patients, suffering hernias and external abdominal deformities, who have excessive tissues of abdominal wall. \u0000Materials and methods. The investigation is based on data of paraoperative examinations and own results of surgical treatment of 67 patients with hernias and external abdominal deformities. Rational methods of their operating were substantiated on background of morphometric characteristics, determined in accordance to the ventral deformity dimensions, and percentages of adipose-containing, fibrous-cicatricial and pathological components content. \u0000Results. The program unit «Statistica 6.1» was applied for statistical elaboration of the results obtained. Algorithm of quantitative investigations of the ventral tissues excessives, which have had predominantly supraaponeurotic localization, was elaborated for the first time. Preoperatively calculated volumes of preventive dermo- and fibrolipectomies, which were performed together with hernio- and abdominoplasties in accordance to new principle «without excesses of parahernial tissues» in various hernias and venral deformities, have reduced essentially the local complications rate - to 2% (р < 0.05) and improved the indices of quality of life and the patients’ health. \u0000Conclusion. Practical application of the «tension-free» and «nonrebundant» principles in operating of hernias constitute the base for further elaborations of reconstructive-plastic interventions and a real component of the problem decision in medico-social and esthetic rehabilitation of certain herniological patients.","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84316668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-12DOI: 10.26779/2522-1396.2021.11-12.53
Y. Potapchuk, O. O. Budniuk, D. Volodychev
Objective. Improvement of the treatment results in injured persons with skeletal polytrauma. Materials and methods. In the investigation 240 patients, suffering skeletal polytrauma, took part. In the Admittance-Diagnostic Department and the Department of Intensive Therapy various scales of assessment were used for objectivisation of its state of severity in the injured persons. Results. The main risk factors for the venous thromboembolism were established in accordance to results of the investigation conducted: skeletal trauma (sensitivity 85%), durable bed-rest regime (sensitivity 94%), untimely surgical osteosynthesis (sensitivity 96%), severity of state – assessment in accordance to shortened scale of damages of 3 points and higher, in accordance to the injury severity scale of 16 points and higher (sensitivity 88%), non-compliance for the pharmacological thrombo-prophylactic regime (sensitivity 94%). Conclusion. Basing on the results obtained, a clinical route of the medical help delivery for patients, suffering skeletal polytrauma, was introduced into the practice, what have permitted to lower the rate of venous thromboembolism from 25.8 to 15% (χ2 =13.07, p=0.001), and the rate of the fat embolism syndrome - from 19.2 t0 3.3% (χ2 =15.07, p=0.001).
{"title":"Skeletal polytrauma: prognostication and prophylaxis of embolic complications","authors":"Y. Potapchuk, O. O. Budniuk, D. Volodychev","doi":"10.26779/2522-1396.2021.11-12.53","DOIUrl":"https://doi.org/10.26779/2522-1396.2021.11-12.53","url":null,"abstract":"Objective. Improvement of the treatment results in injured persons with skeletal polytrauma. \u0000Materials and methods. In the investigation 240 patients, suffering skeletal polytrauma, took part. In the Admittance-Diagnostic Department and the Department of Intensive Therapy various scales of assessment were used for objectivisation of its state of severity in the injured persons. \u0000Results. The main risk factors for the venous thromboembolism were established in accordance to results of the investigation conducted: skeletal trauma (sensitivity 85%), durable bed-rest regime (sensitivity 94%), untimely surgical osteosynthesis (sensitivity 96%), severity of state – assessment in accordance to shortened scale of damages of 3 points and higher, in accordance to the injury severity scale of 16 points and higher (sensitivity 88%), non-compliance for the pharmacological thrombo-prophylactic regime (sensitivity 94%). \u0000Conclusion. Basing on the results obtained, a clinical route of the medical help delivery for patients, suffering skeletal polytrauma, was introduced into the practice, what have permitted to lower the rate of venous thromboembolism from 25.8 to 15% (χ2 =13.07, p=0.001), and the rate of the fat embolism syndrome - from 19.2 t0 3.3% (χ2 =15.07, p=0.001).","PeriodicalId":17876,"journal":{"name":"Klinicheskaia khirurgiia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76024976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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