RU1804843C - Method for prophylaxis of infectoinflammatory complications following osteosynthesis - Google Patents

Abstract

To reduce the number of infectious and inflammatory complications, the places where the spokes exit from soft tissues are treated with a solution of dimephosphone. The use of dimephosphone in 96.7% provided hardware correction of limb deformities without complications.

Description

The invention relates to medicine, namely to orthopedics and traumatology, and can be used in the treatment of patients with transosseous osteosynthesis apparatus.

The purpose of the invention is to reduce the incidence of infectious and inflammatory complications in the treatment of patients with transosseous osteosynthesis apparatus.

The goal is achieved by using the known drug dimephosphone as a means of preventing spoke infection.

The drug, unlike antiseptics (alcohol, furatsilina), has both a set of properties: antiseptic, anti-inflammatory, antihistamine, and also stimulates the regeneration and barrier-protective functions of the skin and mucous membranes.

The method is carried out as follows.

At the end of the operation of applying the compression-distraction apparatus (Ilizarova, Volkova-Oganes, etc.), sterile gauze balls moistened with a solution of dimephosphone are applied to the skin in the area of the spokes (rods). In the postoperative period, once daily, these balls are moistened with 1-2 ml of a solution of dimephosphone. The balls are changed once a week. This procedure continues until the unit is removed. The method of treatment with dimephosphone was tested in the pediatric ward of the CF of the All-Russian Scientific Center for Hygiene and Injection Medicine using the Ilizarov apparatus in 30 patients. In 29 cases, no needle exit sites were detected. When using furatsilin solution, complications were detected in 13.3% of cases (control group, our data). If we compare with the average rates of infection of the places of exit of the needles by other authors (11.8 - 66.9% according to S. S. Tkachenko), we can conclude that the proposed method provides a significant improvement in the treatment results. .

Example 1. Clinical evaluation of the method for the prevention of spoke infections using a 15% solution of dimephosphone.

Under observation were 60 children aged 2-15 years, who were proope (L

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were diagnosed for various orthopedic diseases (congenital dislocation of the thigh, clubfoot, cystic processes of bone tissue of various localization, etc.), as well as for injuries (fractures of the humerus, femur, and other bones). All patients underwent the same background therapy: antibiotics, desensitizing agents, physiotherapy).

Locally in the main group (30 patients), a 15% solution of dimephosphone was used; in the control group, a solution of furatsilin 0.02%. A tissue moistened with a solution of dimephosphone or furatsilin immediately after surgery was placed on the surface of the wound or around the exit site of the knitting needle. The solutions were poured daily, and a change of napkins was carried out once a week.

In clinical trials, it was found that topical application of the dimephosphone solution has a beneficial effect on the wound healing process. A particular effect of the drug was noted in the first period of the wound healing process. Infiltration was significantly reduced, the wound surface was cleaned. After the second or third day of application of the drug, the amount of detachable from the wound decreased, granulation growth was observed, and the size of the inflammation zone was reduced.

In a comparative aspect, the use of dimephosphone had a dramatic effect compared with a solution of furatsilin, inflammation resolved much faster, wound healing by primary intention was observed in most cases, a local analgesic effect was revealed, a solution of dimephosphone.

The use of dimephosphone as a prophylactic in the places of exit of the spokes provided in 29 out of 30 cases (96.7%) the hardware correction of limb deformities without any complications. In the control group, infection was in 4 of 30 patients (13.3%), in the main

1 out of 3 (3.3%).

Dimephosphon did not cause allergic reactions in any case, nor did it have any damaging effect on the skin.

. Example 2. Patient N., 5 years old, operated on for a congenital dislocation of the thigh using the Ilizarov apparatus, was immediately ligated using the apparatus immediately after the operation and in the postoperative period

a solution of dimephosphone. Specified preparation was applied to the places of exit of the needles / wipes on a postoperative wound were wetted. During treatment (1.5 months) no infection or signs were observed

inflammation in the area of the exit points of the spokes and the surgical wound. Wound healing - primary intention.

Claims (1)

SUMMARY OF THE INVENTION A method for the prevention of infectious and inflammatory complications in osteosynthesis by treating the exit points of needles from soft tissues with bactericidal agents, characterized in that, in order to reduce the number of complications, the treatment is carried out with 1,1-dimethyl-3- dimethyl ether solution ketobutylphosphonic acid (dimephosphone).