RU2728267C1 - Method of dental wound closure - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to surgery. Dental wound is closed with a purse-string suture. Collagen plate of the same shape corresponding to the size of the defect is sewn to the edges of the remaining defect. An opening for independent drainage from the wound is formed in the centre of the plate.

EFFECT: method accelerates the wound healing time, reduces the risk of infection, enables improving the aesthetic appearance after the operation.

1 cl, 1 dwg, 1 ex

Description

The invention relates to medicine, namely to surgery, and can be used in reconstructive and restorative operations.

The closest analogue of the invention is a method for closing a stomal wound [Randomized clinical trial of short-term outcomes following purse-string versus conventional closure of ileostomy wounds. Reid K, Pockney P, Pollitt T, et al. Br J Surg. 2010; 97: 1511-1517]. The existing method, which consists in closing the stomal wound with a purse-string suture, has significant drawbacks: the large size of the defect remaining on the abdominal wall after the purse-string suture is applied, significantly increases the risk of wound infection, prolongs its healing time, and serves as a prerequisite for the formation of a large skin scar. In addition, in patients with a dermal layer of skin more than 3 mm thick, a wound sutured with a purse-string suture is grossly deformed and subsequently acquires an unaesthetic appearance.

EFFECT: accelerated wound healing, reduced risk of infection, improved aesthetic appearance after surgery.

The proposed method is illustrated by the figure, which shows a diagram of the formation of a purse-string suture with the closure of the defect with a collagen plate and the formation of a drainage hole in the middle of the plate.

The proposed method of closing a stomal wound is carried out as follows: a stoma wound is sutured with a purse-string suture, after which a collagen plate of the same shape and corresponding to the size of the defect is sewn to the edges of the star-shaped defect formed in the middle of the wound. A hole is formed in the center of the plate for self-drainage.

The method allows to accelerate the healing time of the wound, reduce the risk of infection, improve the aesthetic appearance.

This method was applied in 11 patients with intestinal stoma.

Clinical example:

Patient R., 69 years old, was admitted routinely with complaints of colostomy. From the anamnesis: 3 months ago, the patient was operated on in a surgical hospital, resection of the sigmoid colon was performed from the median approach with the imposition of a double-barreled sigmoidostomy for perforated diverticulitis. After stabilization of the condition and the examination, the patient underwent restoration of intestinal continuity in the following way: with a bordering incision, the stoma was excised from the anterior abdominal wall to the abdominal cavity, the intestine was prepared for anastomosis. The stoma edge was resected, end-to-end bell anastomosis was formed with a single-row continuous suture with a monofilament thread. After that, the suturing of the peritoneum, aponeurosis and subcutaneous tissue was performed. A round cutaneous stoma wound, 5 cm in diameter, was sutured as follows: a purse-string suture was formed using a resorbable monofilament suture 3-0, capturing the dermal layer of the skin with a stitch pitch of 7-10 mm. The purse string suture is tightened. In addition, knotted stitches with the same thread are applied between the opposite edges of the wound to bring together and tightened. In this case, a defect of irregular stellate shape was formed in diameter up to 1 cm. A collagen plate (for example, from a collagen absorbable plate "Collost") was cut out according to the shape and size of the stellate defect. A 3-4 mm hole was formed in the center of the plate to allow drainage from the wound. The collagen plate is fixed to the resulting defect with interrupted sutures with a resorbable 4-0 suture. An aseptic bandage was applied. In the postoperative period, anesthetic therapy and dressings were performed. Through the drainage hole in the collagen plate, an independent drainage of the secretion from the wound was carried out. The postoperative period was uneventful. In the postoperative period, the ongoing treatment was continued, against which the patient's condition improved. Subsequently, at the site of the sutured stomal wound, a soft elastic scar of about 5-7 mm in size was formed. The scar has an aesthetic appearance, healing took place in a short time, no infection was detected.

Claims (1)

A method for closing a stomal wound, including applying a purse-string suture, characterized in that a collagen plate of the same shape is sewn to the edges of the remaining defect, corresponding to the size of the defect, and an opening is additionally formed in the center of the plate for self-drainage from the wound.

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