Khirurgiia
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Biography Historical Article
[Role of S.S. Iudin in the development of anesthesia in surgery].
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The authors conducted a comparative analysis of the course of traumatic disease in 1,920 persons with chest injury, according to the character of the injury, the time of surgical aid, and the features of the therapeutic tactics. The surgical tactics consisted mostly in closed active drainage of the pleural cavity (in 52.5%) and surgical debridement of the wounds in the chest wall (in 36.8% of patients). ⋯ The duration of in-patient treatment for chest injuries was 36.4 +/- 3.8 days, but increased by 2.5-3 times with the development of purulent complications. The lethality rate among the patients of the analysed group was 16.2%, among which were 1.9% of deaths from severe purulent complications.
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Due to changes of humoral immunity, patients with rheumatic heart disease present, even before the operation, a high-risk group with regard to the development of infectious complications. Contamination of intraoperative material was revealed in 61.7% of cases during the operation. ⋯ Immunocorrection by means of myelopid in the early postoperative period accelerates restoration of cellular and humoral immunity, and reduces the frequency of pneumonia occurrence and suppuration of the postoperative wound. Therefore, the prevention of infectious complications after operations on an open heart should be complex and should include broad-spectrum antibiotics and immunocorrective therapy.
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Vacuum therapy was applied in the management of 63 patients with postoperative ventral hernias, 101 patients with a similar pathological conditions were treated by the traditional method for wound healing. From analysis of the results of treatment and with due consideration for the results of additional methods of examination it was established that vacuum prevents accumulation of exudate and blood clots in the wound cavity and removes the risk medium for the development of pyo-inflammatory complications. Moreover, by promoting the coming together of the wound edges and liquidation of the wound cavity, vacuum therapy affects the metabolic reorganizations in the tissues and leads to stabilization of the regeneration mechanisms. The use of vacuum therapy in the postoperative period creates the possibility of regulating the reparative reactions through an active effect on the healing of the wound in the phase of inflammation, protecting in this manner the biology of the wound process and preventing infectious complications.