RU2296577C1 - Method for preventing affected healing of aseptic wounds in early post-surgical period - Google Patents

Abstract

FIELD: medicine, surgery.

SUBSTANCE: during the period of 5 d before operation and 10 d after it is important to prescribe the intake of ADP-37 preparation for patients at the dosage of 6 capsules/d. The innovation enables to decrease traumatism of prophylactic procedures carried out at pre- and post-surgical stages.

EFFECT: higher efficiency of prophylaxis.

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Description

The invention relates to medicine, in particular to surgery and gynecology, and can be used in the early postoperative period in the surgical treatment of various diseases.

The urgency of the problem of the prevention of wound infection in general surgery and gynecology is explained by the significant spread of purulent-inflammatory diseases, a decrease in immunological reactivity and an increase in allergization of the population, a change in the species composition of the microbial flora, and an increase in the resistance of microorganism strains to a wide range of antibiotics and antiseptics.

A known method for the prevention of purulent-inflammatory complications in gynecological practice by endolymphatic infusion of gentamicin, including the introduction of the first dose 30 minutes before surgery, followed by twice the same dose with an interval of 24 hours after surgery (Pat. RF No. 2093168, MKI AK61K 35/74 publ. 1997).

The disadvantage of antibiotic therapy as the prevention of purulent-septic complications during surgical treatment is an increase in the resistance of microorganism strains to antibiotics, a decrease in immunity, and the development of allergic reactions in patients.

A known method of treatment and prevention of purulent-inflammatory diseases of the abdominal cavity, including postoperative antibiotic therapy, consisting in the fact that during the treatment, mexidol is additionally administered at a dose of 100-200 mg / ml 3-4 times a day for 3-4 days (patent RF №2039557, IPC A61K 31/44, publ. 07.20.95).

However, the known method does not allow to exclude the use of antibiotics, which leads to the manifestation of the known negative consequences of antibiotic therapy.

Known closest to the claimed method of treatment and prevention of purulent-inflammatory diseases of the abdominal cavity and in gynecology in the postoperative period, including the introduction of a patient mexidol intravenously at a dose of 100 mg 30 minutes before surgery and within 3 days after surgery intramuscularly in the same dose every 12 hours (Pat. RF №2191014, IPC. A61K 31/4412, publ. 2002).

The disadvantages of this method include the need for intravenous and intramuscular injections, i.e. invasiveness of preventive procedures.

The invention solves the problem of developing a non-traumatic method for preventing violations of the healing of aseptic wounds in the early postoperative period in general surgery and gynecology, increasing the effectiveness of preventive procedures, as well as expanding the range of tools for the prevention of postoperative complications.

The problem is solved due to the fact that the method of preventing aseptic wound healing in the early postoperative period in general surgery and gynecology consists in the fact that for five days before surgery and ten days after surgery, patients take the drug ADF-37 at a dose of 6 capsules per day .

ADF-37 is a biologically active food supplement, including spirulina containing selenium, copper and zinc, obtained by special cultivation, bioflavonoid complexes from natural raw materials, concentrated dry extracts of ginseng, echinacea, green tea, vitamins B, C, E , beta-carotene, manufacturer "Veta-Grand", Russia. Registration No. 77.99.20.919 B. 0003 12.10.03. Available in capsules of 504.6 mg.

The technical result of the proposed method of prevention is to reduce the morbidity of prophylactic procedures - the method completely eliminates intravenous and intramuscular injections, eliminates the use of antibiotics and prevents allergic, immunological and other complications associated with them, increases the effectiveness of preventive procedures, and also widens the range of tools for the prevention of postoperative complications in gynecological practice.

The method is as follows.

After establishing a clinical diagnosis and setting the date of the operation, within five days before the operation and ten days after the operation, the patient takes the drug ADP-37 at a dose of 6 capsules per day.

Clinical trials of the proposed method were carried out as follows: all patients were divided into two groups - the main and control. The main group included patients who received ADP-37, 110 patients, 75 of whom underwent surgery from the laparotomy, the rest of the patients in this group underwent surgery using laparoscopic surgery. The control was 120 patients who received prophylactic mexidol; 80 patients from the control group had operations performed from laparotomic access, 40 - laparoscopically.

In the formation of the main and control groups, patients were selected so that they were representative.

Patients of the main group for five days before surgery and ten after surgery received ADP-37 at 6 capsules per day.

Patients in the control group 30 minutes before the operation were injected with mexidol intravenously in a dose of mg, and within three days after the operation, mexidol was administered intramuscularly in the same dose every 12 hours.

The postoperative period in all patients of the main group proceeded without complications, the sutures from wounds were removed on the seventh day. All patients showed healing of surgical wounds by primary intention. Discrepancies of the edges of the wound, hyperemia and swelling of the skin along the wound channel were not observed.

In patients of the control group, despite prophylactic therapy, local purulent-inflammatory complications were noted in 1.7% of cases.

The same picture is observed when studying pain. In all patients of the main group, pain on palpation in the area of the postoperative wound disappeared on the 2nd day after surgery. In the control group, by the 7th day, pain during palpation persisted in 25% of patients.

In the postoperative period, all patients studied the temperature reaction. Among the patients of the main group on the third day after the operation, the temperature was within normal limits.

In the control group of patients treated with Mexidol, a temperature of 37.5-37.8 degrees was observed in 15% of patients, on the 3rd day in 5% of patients, on the 7th day the temperature returned to normal.

Thus, the use of the antioxidant ADF-37 for 5 days before surgery and ten days after surgery, the postoperative treatment of the proposed method helps to reduce the time to eliminate post-traumatic local disorders, prevents the development of purulent complications, stimulates the reparative process, helps restore the structure and functioning of the microcirculatory system of soft tissues .

The invention is illustrated by examples.

Example 1

Patient K, 48 years old, was admitted to the clinic for uterine fibroids.

A laparoscopic hysterectomy was performed.

5 days before the operation and within ten days after the operation, the patient received the drug ADP-37 at a dose of 6 capsules per day.

A temperature reaction in the postoperative period was not observed. Primary healing.

Blood test in the first day:

GB - 95 g / l, L - 9.2; ESR - 12.

On the seventh day:

GB - 98 g / l; L - 4.6; ESR - 19.

Example 2

Patient J., 64 years old, was admitted to the clinic with a long-term non-healing purulent fistula of the postoperative (p / o) scar of the anterior abdominal wall, grade II hypertension, and type II diabetes mellitus. A history of 2004 was a cholecystectomy for acute cholecystitis. A month after the operation, a purulent fistula formed in the area of the sc of the scar of the anterior abdominal wall. The fistula did not close for about 6 months, separated purulent, scanty. The results of fistulography - fistulous passage with a length of about 12 cm in the thickness of the anterior abdominal wall, runs along the p / o scar.

A purulent fistula was excised, ligatures removed from the aponeurosis.

5 days before surgery and within 10 days after surgery, the patient received the drug ADP-37 at a dose of 6 capsules per day.

A temperature reaction in the postoperative period was not observed. Primary healing. Sutures were removed on the 9th day

Blood test in the first day:

GB - 112 g / l, L - 10.2; ESR - 28.

On the seventh day:

GB - 118 g / l; L - 8.4; ESR - 15.

The patient was examined after a month - the scar was clean, without signs of inflammation.

Claims (1)

A method for the prevention of aseptic wound healing disorders in the early postoperative period in general surgery and gynecology, which consists in the fact that patients take ADP-37 at a dose of 6 capsules per day for 5 days before surgery and 10 days after surgery.