Pub Date : 2020-09-02DOI: 10.25199/2408-9613-2019-6-3-6-23
M. I. Bobrov, O. P. Zhivtsov, D. Samoilov, A. Shatalin, N. Orlinskaya, M. Volovik, R. S. Korolev, T. A. Podatelyova
Objective: to develop technology for high amputations of the lower extremities.Materials and methods.We analyzed the materials of the Nizhny Novgorod branch of the Federal State Unitary Enterprise “Moscow Orthopedic and Orthopedic Enterprise” Ministry of Labor of Russia for the period 2004–2018, the operation logs of the purulent surgery department of PIMU (1971–2018), and the electronic medical history “Program 1C” (2006–2012) and “Medialogue” (2013–2018) in all departments of PIMU, where high amputations of the lower extremities are possible performed.Results.Between 2006 and 2018, 391 lower limbs were cut off in 289 patients (above the knee – 128, below the knee – 263). With diabetic foot syndrome, 135 (34.5 %) amputations were performed, due to burns and frostbite, 73 (18.7 %) operations were made, while arterial atherosclerosis – 57 (14.6 %) operations, and the rest – about the consequences of injuries, tumors, malformations and vicious stumps. The number of amputations on the shin is 2 times more than on the hip. A technology has been developed for the formation of a new support and movement organ, including amputation of the lower leg, anesthesia, intensive care, and rehabilitation treatment.Conclusion. An analysis of the initial applications for prosthetics showed that the most frequent high amputations of the lower extremities are performed due to gangrene in arterial atherosclerosis (53.9 %) and diabetes mellitus (24.9 %). High amputations of the lower extremities at the hip level are performed in 60.4 % of patients and only in 30.1 % of patients – at the shin level. Malformations and diseases of the stumps of the thigh and lower leg are detected in 15.4 % of patients. The gold standard should be recognized as myoplastic amputation at the border of the upper and middle third of the shin with excision of the soleus muscle. Preservation of the knee joint creates the conditions for optimal prosthetics and timely social adaptation of patients.
{"title":"High amputation of the lower extremities","authors":"M. I. Bobrov, O. P. Zhivtsov, D. Samoilov, A. Shatalin, N. Orlinskaya, M. Volovik, R. S. Korolev, T. A. Podatelyova","doi":"10.25199/2408-9613-2019-6-3-6-23","DOIUrl":"https://doi.org/10.25199/2408-9613-2019-6-3-6-23","url":null,"abstract":"Objective: to develop technology for high amputations of the lower extremities.Materials and methods.We analyzed the materials of the Nizhny Novgorod branch of the Federal State Unitary Enterprise “Moscow Orthopedic and Orthopedic Enterprise” Ministry of Labor of Russia for the period 2004–2018, the operation logs of the purulent surgery department of PIMU (1971–2018), and the electronic medical history “Program 1C” (2006–2012) and “Medialogue” (2013–2018) in all departments of PIMU, where high amputations of the lower extremities are possible performed.Results.Between 2006 and 2018, 391 lower limbs were cut off in 289 patients (above the knee – 128, below the knee – 263). With diabetic foot syndrome, 135 (34.5 %) amputations were performed, due to burns and frostbite, 73 (18.7 %) operations were made, while arterial atherosclerosis – 57 (14.6 %) operations, and the rest – about the consequences of injuries, tumors, malformations and vicious stumps. The number of amputations on the shin is 2 times more than on the hip. A technology has been developed for the formation of a new support and movement organ, including amputation of the lower leg, anesthesia, intensive care, and rehabilitation treatment.Conclusion. An analysis of the initial applications for prosthetics showed that the most frequent high amputations of the lower extremities are performed due to gangrene in arterial atherosclerosis (53.9 %) and diabetes mellitus (24.9 %). High amputations of the lower extremities at the hip level are performed in 60.4 % of patients and only in 30.1 % of patients – at the shin level. Malformations and diseases of the stumps of the thigh and lower leg are detected in 15.4 % of patients. The gold standard should be recognized as myoplastic amputation at the border of the upper and middle third of the shin with excision of the soleus muscle. Preservation of the knee joint creates the conditions for optimal prosthetics and timely social adaptation of patients. ","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125389729","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 : 2020-09-02DOI: 10.25199/2408-9613-2019-6-3-34-43
S. A. Orudzheva, L. A. Blatun, S. Sokologorskiy, M. A. Sheina, T. G. Turova, Yu. S. Paskhalova
Objective: to demonstrate the successful complex treatment of a shin circular wound in a patient with intense pain due to critical limb ischemia and wound infection, which became possible against the background of prolonged peripheral blockade. Materials and methods. A 72-year-old patient with critical ischemia of the right lower extremity was treated for a circular purulent-necrotic wound of the shin leg from November 2016 to April 2017 at the Wounds and Wound Infections Department of FSBI “A. V. Vishnevsky NRC of Surgery” Ministry of Health of Russia. An examination revealed the impossibility of right lower limb arterial insufficiency surgical correction. The patient refused amputation of the lower limb. For the relief of pain, a long-term blockage of the sciatic nerve was used (infusion of ropivacaine 6.0–8.0 mg / hr into the perineural catheter, additional 100 mg ropivacaine boluses were used before performing traumatic daily dressings). The intensity of pain was evaluated on a visual analogue scale (VAS), sought to achieve a pain intensity of not more than 3 points at rest and not more than 4 points on – when moving. Results. Blockade of the sciatic nerve reduced the intensity of pain from 8–10 to 0–3 points, which made it possible to continue treatment. In total, the duration of sciatic nerve catheterization at the stages of treatment was 115 days (18 + 41 + 23 + 32), the maximum duration of one of the peripheral nerve catheterizations was 41 days. Complications associated with nerve catheterization were not observed in the patient. The pain syndrome is stopped, the area of the wound defect is reduced in size. Discharged for outpatient treatment. Conclusion. Long-term peripheral analgesia made it possible to gain time necessary for cleansing the wound surface from necrotic tissues, therapy with drugs that improve arterial blood supply to the limbs, as well as for performing reconstructive and reconstructive operations after the wound process has passed to the reparative stage. Long-term peripheral blockade is a prerequisite for the successful treatment of extensive wounds of the lower extremities caused by insufficient arterial blood supply at the stage of critical limb ischemia, accompanied by intense pain.
{"title":"Prolonged regional analgesia in the complex treatment of extensive purulent-necrotic wounds on the background of decompensated arterial and venous insufficiency (case report","authors":"S. A. Orudzheva, L. A. Blatun, S. Sokologorskiy, M. A. Sheina, T. G. Turova, Yu. S. Paskhalova","doi":"10.25199/2408-9613-2019-6-3-34-43","DOIUrl":"https://doi.org/10.25199/2408-9613-2019-6-3-34-43","url":null,"abstract":"Objective: to demonstrate the successful complex treatment of a shin circular wound in a patient with intense pain due to critical limb ischemia and wound infection, which became possible against the background of prolonged peripheral blockade. Materials and methods. A 72-year-old patient with critical ischemia of the right lower extremity was treated for a circular purulent-necrotic wound of the shin leg from November 2016 to April 2017 at the Wounds and Wound Infections Department of FSBI “A. V. Vishnevsky NRC of Surgery” Ministry of Health of Russia. An examination revealed the impossibility of right lower limb arterial insufficiency surgical correction. The patient refused amputation of the lower limb. For the relief of pain, a long-term blockage of the sciatic nerve was used (infusion of ropivacaine 6.0–8.0 mg / hr into the perineural catheter, additional 100 mg ropivacaine boluses were used before performing traumatic daily dressings). The intensity of pain was evaluated on a visual analogue scale (VAS), sought to achieve a pain intensity of not more than 3 points at rest and not more than 4 points on – when moving. Results. Blockade of the sciatic nerve reduced the intensity of pain from 8–10 to 0–3 points, which made it possible to continue treatment. In total, the duration of sciatic nerve catheterization at the stages of treatment was 115 days (18 + 41 + 23 + 32), the maximum duration of one of the peripheral nerve catheterizations was 41 days. Complications associated with nerve catheterization were not observed in the patient. The pain syndrome is stopped, the area of the wound defect is reduced in size. Discharged for outpatient treatment. Conclusion. Long-term peripheral analgesia made it possible to gain time necessary for cleansing the wound surface from necrotic tissues, therapy with drugs that improve arterial blood supply to the limbs, as well as for performing reconstructive and reconstructive operations after the wound process has passed to the reparative stage. Long-term peripheral blockade is a prerequisite for the successful treatment of extensive wounds of the lower extremities caused by insufficient arterial blood supply at the stage of critical limb ischemia, accompanied by intense pain. ","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125984906","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 : 2020-09-02DOI: 10.25199/2408-9613-2019-6-3-30-33
A. I. Anikin, O. A. Dedenkov, D. Vasilkov, Yu. N. Shestakov, V. Knyazev, A. M. Skvortsov, B. A. Chaparyan
The article presents the clinical case of successful treatment of a patient with heel plantar trophic ulcer. The results of plastics a neuropathy heel ulcer by medial plantar island flap are demonstrated.
{"title":"The experience of plantar wound and ulcers treatment","authors":"A. I. Anikin, O. A. Dedenkov, D. Vasilkov, Yu. N. Shestakov, V. Knyazev, A. M. Skvortsov, B. A. Chaparyan","doi":"10.25199/2408-9613-2019-6-3-30-33","DOIUrl":"https://doi.org/10.25199/2408-9613-2019-6-3-30-33","url":null,"abstract":"The article presents the clinical case of successful treatment of a patient with heel plantar trophic ulcer. The results of plastics a neuropathy heel ulcer by medial plantar island flap are demonstrated.","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132241652","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 : 2020-09-02DOI: 10.25199/2408-9613-2019-6-3-24-29
V. Shiryaev, O. I. Bugrovskaya, F. Shvetskiy, F. M. Khosrovyan, V. Derbenev, R. D. Mustafaev, A. Radzhabov, S. G. Gorin, A. Huseynov, A. Gadzhiev
Objective: to analyze the effectiveness of purulent-necrotic wounds management using intravenous laser irradiation of blood (405nm). Materials and methods. Object of study – patients with purulent-necrotic wounds. Clinical studies and analysis of the intravenous laser blood irradiation (405 nm) effect on the wound healing process and on the healing speed of purulent soft tissues wounds in patients with type 2 diabetes mellitus were carried out. Results. It was found that the use of intravenous laser blood irradiation (405 nm) is a highly effective method for the treatment of purulent soft tissues wounds, which allows to reduce the number of complications and shorten the time for complete epithelization of purulent wounds by 7–10 days compared with traditional treatment.
{"title":"Patients with purulent necrotic wounds treatment using by intravenous laser blood irradiation (405 nm)","authors":"V. Shiryaev, O. I. Bugrovskaya, F. Shvetskiy, F. M. Khosrovyan, V. Derbenev, R. D. Mustafaev, A. Radzhabov, S. G. Gorin, A. Huseynov, A. Gadzhiev","doi":"10.25199/2408-9613-2019-6-3-24-29","DOIUrl":"https://doi.org/10.25199/2408-9613-2019-6-3-24-29","url":null,"abstract":"Objective: to analyze the effectiveness of purulent-necrotic wounds management using intravenous laser irradiation of blood (405nm). Materials and methods. Object of study – patients with purulent-necrotic wounds. Clinical studies and analysis of the intravenous laser blood irradiation (405 nm) effect on the wound healing process and on the healing speed of purulent soft tissues wounds in patients with type 2 diabetes mellitus were carried out. Results. It was found that the use of intravenous laser blood irradiation (405 nm) is a highly effective method for the treatment of purulent soft tissues wounds, which allows to reduce the number of complications and shorten the time for complete epithelization of purulent wounds by 7–10 days compared with traditional treatment. ","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134340789","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 : 2020-09-02DOI: 10.25199/2408-9613-2019-6-4-14-21
A. Bezhin, V. Lipatov, L. A. Blatun, É. Fronchek, A. Grigoryan, M. D. Naimzada
One of the urgent problems of modern surgery continues to be the increasing number of patients with purulent-inflammatory and purulentnecrotic processes of soft tissues – about 60.0 % of patients in the structure of specialized hospitals of a surgical profile. This is due to the adaptation of microorganisms – pathogens of wound infection to existing means for treating wounds. In addition, the number of patients with diabetes mellitus increases annually, and as a result, the number of people suffering from diabetic foot syndrome. Thus, the relevance of developing new modern tools for the local treatment of purulent-necrotic processes of the skin and soft tissues is not reduced.Materials and methods.The material for the study was a highly porous biodegradable sponge (chitosan-collagen) in the ratio of chitosan: collagen 2: 1 with the inclusion of colloidal particles of metallic silver and chymotrypsin. The experiment was performed on 50 Wistar rats that simulated a purulent necrotic wound. During the treatment, the state of the wounds was visually evaluated, the morphological features of the course of the wound process were evaluated after animals were withdrawn from the experiment and the wound material was taken on days 1, 5, 10, 15 and 21, the sections were stained with hematoxylin-eosin and/or according to Van Gieson.Results.By visual assessment, by the 10th day it was noted that necrotic tissues underwent lysis, the wound defect was covered with a scab, swelling of the surrounding tissues was not noted, and on the 21st day of treatment the wound defect was covered with epithelium and had an area of about 3 mm2 with the initial - in 250 mm2. When describing micropreparations, it was noted that on the 10th day the exudation phase passed its peak and the activity of proliferation processes increased from the center of the wound to its periphery and from the granulation surface in depth. On the 15th day, the proliferative phase of inflammation was at its height, and on the 21st day, the proliferation phase was completed and the processes of remodeling of dense fibrous connective tissue began.Conclusion.Based on a visual assessment of the state of wounds and a morphological study, the effectiveness of a chitosan-collagen complex with silver nanoparticles and chymotrypsin was shown to be applied locally to a purulent necrotic wound in an experiment.
{"title":"Morphological evaluation of the effectiveness of the use of chitosan-collagen complex with silver nano-particles and chymotrypsin in the purulent-necrotic process in soft tissues","authors":"A. Bezhin, V. Lipatov, L. A. Blatun, É. Fronchek, A. Grigoryan, M. D. Naimzada","doi":"10.25199/2408-9613-2019-6-4-14-21","DOIUrl":"https://doi.org/10.25199/2408-9613-2019-6-4-14-21","url":null,"abstract":"One of the urgent problems of modern surgery continues to be the increasing number of patients with purulent-inflammatory and purulentnecrotic processes of soft tissues – about 60.0 % of patients in the structure of specialized hospitals of a surgical profile. This is due to the adaptation of microorganisms – pathogens of wound infection to existing means for treating wounds. In addition, the number of patients with diabetes mellitus increases annually, and as a result, the number of people suffering from diabetic foot syndrome. Thus, the relevance of developing new modern tools for the local treatment of purulent-necrotic processes of the skin and soft tissues is not reduced.Materials and methods.The material for the study was a highly porous biodegradable sponge (chitosan-collagen) in the ratio of chitosan: collagen 2: 1 with the inclusion of colloidal particles of metallic silver and chymotrypsin. The experiment was performed on 50 Wistar rats that simulated a purulent necrotic wound. During the treatment, the state of the wounds was visually evaluated, the morphological features of the course of the wound process were evaluated after animals were withdrawn from the experiment and the wound material was taken on days 1, 5, 10, 15 and 21, the sections were stained with hematoxylin-eosin and/or according to Van Gieson.Results.By visual assessment, by the 10th day it was noted that necrotic tissues underwent lysis, the wound defect was covered with a scab, swelling of the surrounding tissues was not noted, and on the 21st day of treatment the wound defect was covered with epithelium and had an area of about 3 mm2 with the initial - in 250 mm2. When describing micropreparations, it was noted that on the 10th day the exudation phase passed its peak and the activity of proliferation processes increased from the center of the wound to its periphery and from the granulation surface in depth. On the 15th day, the proliferative phase of inflammation was at its height, and on the 21st day, the proliferation phase was completed and the processes of remodeling of dense fibrous connective tissue began.Conclusion.Based on a visual assessment of the state of wounds and a morphological study, the effectiveness of a chitosan-collagen complex with silver nanoparticles and chymotrypsin was shown to be applied locally to a purulent necrotic wound in an experiment.","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133876938","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 : 2020-05-31DOI: 10.25199/2408-9613-2018-5-4-14-21
É. Fronchek, A. Grigoryan, L. A. Blatun
Preservation of a consistently high number of domestic, industrial or military injuries, trophic ulcers, pressure sores, chronic wound defects in the morbidity structure makes the problem of effective and physiological healing of wounds extremely urgent. One of the most promising directions for solving this problem is the creation of wound healing and hemostatic agents of high efficiency (in comparison with traditional dressings from cellulose and non-woven textile materials) based on biologically active high-molecular natural and synthetic polymers with the immobilization of drugs with antibacterial, analgesic and necrolytic effects.Object: development of innovative biologically active wound healing and hemostatic agents based on chitosan and collagen.Materials and methods. As materials for determining medical and technical characteristics, new wound products were investigated: - means “Chitocol” performed by “Chitocol-S”, “Chitocol-CS”, “Chitocol-DA”, “Chitocol-CDA”, “Chitocol-SC”, “Chitocol-SCD”, sterile, “Chitocol-CSC”, “Chitocol-CSCD” with immobilized substances of colloidal silver, dioxidine and chymotrypsin; - means “Chitocol-Hemo” performed “Chitocol-Hemo C”, “Chitocol-Hemo CS”, “Chitocol-Hemo”, “Chitocol-Hemo S” with the immobilized substance colloidal silver. A preliminary preclinical evaluation of the effectiveness of the wound healing and antimicrobial effects of the prototype “Chitocol-CDA”, “Chitocol-CS” and “Chitocol-CSC” (porous plates 2×2×0.4 cm in size) in vivo was performed on white male Wistar rats weighing 180–200 g. The healing efficiency was evaluated on the basis of planimetric, hematological, histological research methods.Results. Quantitative indicators of medical and technical characteristics of the “Chitocol” and “Chitocol-Hemo” for use in the development of regulatory, technological and operational documentation on medical devices. An experimental study of wound dressings “Chitocol-CS”, “Chitocol-CDA” and “Chitocol-CSC” showed that their use leads to a reduction in the area of wounds by more than 90 % by 15 days of treatment, the maximum healing speed when applying the first two samples accounted for the first phase of the wound process (1–5 days), and in the group with purulent-necrotic process on 10–15 days of treatment. In the treatment of clean and infected wounds with the “Chitocol-CS” and “Chitocol-CDA” samples, complete healing and completion of the epithelization process began by 15 days, and in the group using “Chitocol-CSC” the proliferative phase of inflammation was in full swing.Conclusion. Quantitative indicators of medical and technical characteristics of innovative biologically active wound healing and hemostatic agents based on a (bio) polyelectrolyte complex of chitosan and collagen or chitosan with immobilized antimicrobial (dioxidine, colloidal silver), analgesic (anilokain) and proteolytic (chymotrypsin) positive results, as well preliminary preclinical study of wound healing agents with dioxidine
{"title":"Innovative biologically active wound healing and hemostatic agents based on chitosan and collagen: development stages, medical and technical characteristics","authors":"É. Fronchek, A. Grigoryan, L. A. Blatun","doi":"10.25199/2408-9613-2018-5-4-14-21","DOIUrl":"https://doi.org/10.25199/2408-9613-2018-5-4-14-21","url":null,"abstract":"Preservation of a consistently high number of domestic, industrial or military injuries, trophic ulcers, pressure sores, chronic wound defects in the morbidity structure makes the problem of effective and physiological healing of wounds extremely urgent. One of the most promising directions for solving this problem is the creation of wound healing and hemostatic agents of high efficiency (in comparison with traditional dressings from cellulose and non-woven textile materials) based on biologically active high-molecular natural and synthetic polymers with the immobilization of drugs with antibacterial, analgesic and necrolytic effects.Object: development of innovative biologically active wound healing and hemostatic agents based on chitosan and collagen.Materials and methods. As materials for determining medical and technical characteristics, new wound products were investigated: - means “Chitocol” performed by “Chitocol-S”, “Chitocol-CS”, “Chitocol-DA”, “Chitocol-CDA”, “Chitocol-SC”, “Chitocol-SCD”, sterile, “Chitocol-CSC”, “Chitocol-CSCD” with immobilized substances of colloidal silver, dioxidine and chymotrypsin; - means “Chitocol-Hemo” performed “Chitocol-Hemo C”, “Chitocol-Hemo CS”, “Chitocol-Hemo”, “Chitocol-Hemo S” with the immobilized substance colloidal silver. A preliminary preclinical evaluation of the effectiveness of the wound healing and antimicrobial effects of the prototype “Chitocol-CDA”, “Chitocol-CS” and “Chitocol-CSC” (porous plates 2×2×0.4 cm in size) in vivo was performed on white male Wistar rats weighing 180–200 g. The healing efficiency was evaluated on the basis of planimetric, hematological, histological research methods.Results. Quantitative indicators of medical and technical characteristics of the “Chitocol” and “Chitocol-Hemo” for use in the development of regulatory, technological and operational documentation on medical devices. An experimental study of wound dressings “Chitocol-CS”, “Chitocol-CDA” and “Chitocol-CSC” showed that their use leads to a reduction in the area of wounds by more than 90 % by 15 days of treatment, the maximum healing speed when applying the first two samples accounted for the first phase of the wound process (1–5 days), and in the group with purulent-necrotic process on 10–15 days of treatment. In the treatment of clean and infected wounds with the “Chitocol-CS” and “Chitocol-CDA” samples, complete healing and completion of the epithelization process began by 15 days, and in the group using “Chitocol-CSC” the proliferative phase of inflammation was in full swing.Conclusion. Quantitative indicators of medical and technical characteristics of innovative biologically active wound healing and hemostatic agents based on a (bio) polyelectrolyte complex of chitosan and collagen or chitosan with immobilized antimicrobial (dioxidine, colloidal silver), analgesic (anilokain) and proteolytic (chymotrypsin) positive results, as well preliminary preclinical study of wound healing agents with dioxidine ","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116175356","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 : 2020-05-31DOI: 10.25199/2408-9613-2018-5-4-28-33
P. A. M. Sapeda, Yu. S. Paskhalova, V. Mitish, I. Chekmareva, L. A. Blatun, E. R. R. Cosme, A. Ushakov, S. D. Magomedova, R. S. Sokov
The article presents a clinical case of a successful comprehensive treatment 29-years-old patient with a purulent necrotic wound of the hand, which occurs against the background of type I diabetes mellitus and massive immunosuppressive therapy (prescribed to prevent renal transplant rejection). The use of ultrasound cavitation as a part of the complex treatment after radical surgical debridement helped to normalize the wound healing process, to reduce the microbial contamination of the wound and to activate repair.
{"title":"Ultrasonic cavitation in the treatment of purulent wound occurring against the background of juvenile diabetes mellitus and massive immunosuppressive therapy. Clinical case","authors":"P. A. M. Sapeda, Yu. S. Paskhalova, V. Mitish, I. Chekmareva, L. A. Blatun, E. R. R. Cosme, A. Ushakov, S. D. Magomedova, R. S. Sokov","doi":"10.25199/2408-9613-2018-5-4-28-33","DOIUrl":"https://doi.org/10.25199/2408-9613-2018-5-4-28-33","url":null,"abstract":"The article presents a clinical case of a successful comprehensive treatment 29-years-old patient with a purulent necrotic wound of the hand, which occurs against the background of type I diabetes mellitus and massive immunosuppressive therapy (prescribed to prevent renal transplant rejection). The use of ultrasound cavitation as a part of the complex treatment after radical surgical debridement helped to normalize the wound healing process, to reduce the microbial contamination of the wound and to activate repair.","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114660461","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 : 2020-05-31DOI: 10.25199/2408-9613-2018-5-4-22-27
A. K. Volkovoy, V. Obolensky, V. Protsko, E. Komelyagina, S. V. Gorokhov, M. Antsiferov
The article presents the experience of an interdisciplinary approach to the management of diabetic foot syndrome using the example of treating a patient with a neuropathic form, which manifests itself as a chronic wound of the foot plantar surface.
{"title":"Interdisciplinary approach to the management of the neuropathic form of diabetic foot syndrome. The role of the orthopedist","authors":"A. K. Volkovoy, V. Obolensky, V. Protsko, E. Komelyagina, S. V. Gorokhov, M. Antsiferov","doi":"10.25199/2408-9613-2018-5-4-22-27","DOIUrl":"https://doi.org/10.25199/2408-9613-2018-5-4-22-27","url":null,"abstract":"The article presents the experience of an interdisciplinary approach to the management of diabetic foot syndrome using the example of treating a patient with a neuropathic form, which manifests itself as a chronic wound of the foot plantar surface.","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128809287","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 : 2020-05-28DOI: 10.25199/2408-9613-2018-5-3-16-24
W. M. Rdeini, V. Mitish, Yu. S. Paskhalova, S. L. Sokov
Diabetic foot syndrome (DFS) is a serious public health problem in developing countries, where medical resources are limited, and the vast majority of patients turn to medical facilities too late with severe forms of the disease and often in advanced stages.Objective: to evaluate the effectiveness of negative pressure wound therapy (NPWT) in treating patients with a neuropathic form of DFS compared with traditional methods to reduce the number of high amputations and overall mortality in Ghana.Materials and research methods. A prospective, non-randomized, comparative clinical study of the results of examination and treatment of 59 patients with type 2 diabetes mellitus (DM) was performed at the Seventh-day Adventist City Hospital (Ghana, West Africa), Kumasi University Hospital and the Effiduase District Hospital (Ghana, West Africa) in the period from January 1, 2011 to December 31, 2013, there were 37 female patients (63.3 %), 22 male patients (36.7 %). The volume of foot tissue damage varied from II to IV degree according to Wagner classification (II degree was diagnosed in 55.6 % of cases). The average age of patients was 31.5 ± 7.3 (20–72) years. The average duration of DM was 7.3 ± 4.2 years. Bacteriological examination of wounds showed that Staphylococcus aureus was most often an isolated pathogen. All microorganisms identified from patients’ wounds had high resistance to commonly used antibiotics. Patients were randomly assigned to groups. NPWT is the only topical treatment in the main group; traditional dressings with antiseptic solutions (iodophors) were used in the comparison group.Study results. Comprehensive treatment of patients in both groups included surgical debridement of purulent foci, local treatment (NPWT or dressings with antiseptic solutions) and skin grafting or healing by secondary intention after the transition of the wound process to the reparative stage. None of the patients in both groups had a high amputation. Not a single fatal outcome has been recorded. In patients of the main group, the transition of the wound process to the reparative stage was carried out in a shorter time compared with those treated without NPWT.Conclusion. Treatment of the neuropathic form of DFS with the NPWT (for example, patients in Ghana) reduces the hospital stay and the number of high amputations of the lower extremities, and improves the quality of life of patients.
{"title":"Vacuum therapy in complex treatment of neuropathic form of diabetic foot syndrome in Ghana","authors":"W. M. Rdeini, V. Mitish, Yu. S. Paskhalova, S. L. Sokov","doi":"10.25199/2408-9613-2018-5-3-16-24","DOIUrl":"https://doi.org/10.25199/2408-9613-2018-5-3-16-24","url":null,"abstract":"Diabetic foot syndrome (DFS) is a serious public health problem in developing countries, where medical resources are limited, and the vast majority of patients turn to medical facilities too late with severe forms of the disease and often in advanced stages.Objective: to evaluate the effectiveness of negative pressure wound therapy (NPWT) in treating patients with a neuropathic form of DFS compared with traditional methods to reduce the number of high amputations and overall mortality in Ghana.Materials and research methods. A prospective, non-randomized, comparative clinical study of the results of examination and treatment of 59 patients with type 2 diabetes mellitus (DM) was performed at the Seventh-day Adventist City Hospital (Ghana, West Africa), Kumasi University Hospital and the Effiduase District Hospital (Ghana, West Africa) in the period from January 1, 2011 to December 31, 2013, there were 37 female patients (63.3 %), 22 male patients (36.7 %). The volume of foot tissue damage varied from II to IV degree according to Wagner classification (II degree was diagnosed in 55.6 % of cases). The average age of patients was 31.5 ± 7.3 (20–72) years. The average duration of DM was 7.3 ± 4.2 years. Bacteriological examination of wounds showed that Staphylococcus aureus was most often an isolated pathogen. All microorganisms identified from patients’ wounds had high resistance to commonly used antibiotics. Patients were randomly assigned to groups. NPWT is the only topical treatment in the main group; traditional dressings with antiseptic solutions (iodophors) were used in the comparison group.Study results. Comprehensive treatment of patients in both groups included surgical debridement of purulent foci, local treatment (NPWT or dressings with antiseptic solutions) and skin grafting or healing by secondary intention after the transition of the wound process to the reparative stage. None of the patients in both groups had a high amputation. Not a single fatal outcome has been recorded. In patients of the main group, the transition of the wound process to the reparative stage was carried out in a shorter time compared with those treated without NPWT.Conclusion. Treatment of the neuropathic form of DFS with the NPWT (for example, patients in Ghana) reduces the hospital stay and the number of high amputations of the lower extremities, and improves the quality of life of patients.","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129575646","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 : 2019-05-07DOI: 10.25199/2408-9613-2017-4-4-12-17
V. I. Babinkov
{"title":"Experimental study of score direct muscle excitability after synaptic blockade by stimulating impedance myography by using volt-omics characteristics","authors":"V. I. Babinkov","doi":"10.25199/2408-9613-2017-4-4-12-17","DOIUrl":"https://doi.org/10.25199/2408-9613-2017-4-4-12-17","url":null,"abstract":"","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133733308","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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