RU2768605C1 - Method for non-surgical treatment of omphalocele - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely surgery, and can be used for non-surgical treatment of an omphalocele with an aponeurosis defect in the umbilical ring 2-3 cm. The umbilical cord remainder is given an upright position. The contents of the hernial sac are set into the abdominal cavity. A device is superimposed on the defect at the level with the skin with the capture of all shells, represented by a lock in accordance with position 3 of dwg 1 contained in the description, located on ring-connected branches, the inner side of which has a ribbed work surface with teeth, and the outer side contains wings for weaving the tape. The free ends of the tape are pulled with 20% tension from the device to the sides and fixed to the skin at the level of the anterior or middle axillary line. The tapes are changed every 6-7 days with a break to rest from the tape for 1 day. The duration of taping is 3-4 months.

EFFECT: method provides the possibility of non-surgical treatment of small-sized omphalocele due to the peculiarities of applying tapes to the skin of the anterior abdominal wall of the patient.

1 cl, 2 dwg

Description

The invention relates to the field of medicine, namely to pediatric surgery, and is aimed at non-surgical treatment of small-sized embryonic eventeration.

As you know, today the hernia of the umbilical cord is treated mainly by surgery. However, the proposed methods of surgical correction of omphalocele have a number of disadvantages. So, after the Gross operation, which is carried out in several stages, the development of ventral hernias is possible, which makes it difficult to further nursing the child, and the plastic materials used in the implementation of the Schuster technique are practically inaccessible due to the high cost.

Umbilical cord clamps manufactured by the medical industry are also known.

In particular, clamps [US Patent No. 3,854,482, publ. 12/17/74; US patent No. 4,212,303, publ. 07/15/80; US Patent No. D 673,272 S, publ. 25.12.12], having a fixing lock and two jaws interconnected by a ring of the same material.

A common disadvantage of these devices is the inability to achieve the desired effect in the treatment of amniotic hernia, tk. their design features do not allow creating additional contraction of the anterior abdominal wall to the midline of the abdomen.

Based on this, the present invention is based on the task of creating a device and developing a method of using it, aimed at the non-surgical treatment of small omphaloceles.

The specified technical result in the implementation of the invention is achieved in that the method uses a device represented by a locking lock 3 located on the branches 1 connected by a ring 2, the inner side of which has a ribbed working surface with atraumatic teeth 4, and the outer side has wings 5 for fixing the elastic material, for example, teipa.

On fig. 1 shows a general view of the device in the open state.

On fig. 2 shows an example of the location of the device on the anterior abdominal wall of the patient according to the method.

The method is carried out as follows.

Upon admission, a child with an omphalocele (1st day of life after birth, intact membranes, the contents of the membranes of the loop of the small and large intestine, aponeurosis defect in the umbilical ring 2-4 cm) is hospitalized in the NICU. Under anesthesia in the form of 20% glucose orally, the umbilical cord is placed in a vertical position and gradually (15-30 minutes) the contents of the hernial sac are reduced into the abdominal cavity. After making sure that all intestinal loops are immersed, branches 1 connected by a ring 2 are superimposed at the level with the skin in such a way that the atraumatic teeth 4 tightly cover all the shells. Then the remnants of the hernial sac are cut off, the cut site is treated with an alcohol-containing solution, and elastic tapes with an adhesive coating on one side, for example, tapes (the length depends on the weight of the child), are woven into the wings 5. Their free ends are pulled (with 20% tension) from the device to the sides and fixed to the skin at the level of the anterior or middle axillary line. As a result, the aponeurosis defect in the umbilical region converges, leaving the umbilical residue fixed by the jaws 1 of the device, which are closed by the locking lock 3.

Further management of the newborn is carried out according to the state. There are no restrictions. It is possible to stay with the mother.

On the 5th-6th day, the tapes are removed (after preliminary wetting with water), the skin is treated with a cream with dexpanthenol for the purpose of healing (with a possible skin reaction in the form of irritation).

After 12 hours, taping the child is repeated (similar to the previous one).

As the umbilical cord dries out (7-10 days), the device is cut off with scissors, the umbilical cord residue is treated with an alcohol-containing solution. Tapes, the woven section of which was previously removed from the wings 5 by shifting away from the outer edge of the branch 1, remain in working order.

After 1-2 days after cutting off the device, the tapes are removed and, after skin treatment, the tapes are already applied through the umbilical cord residue with the latter immersed in the aponeurosis defect, forming a fold of tissues from above. To use this technique, 1 tape 5 cm wide is taken, the length depends on the weight of the child (10-12 cm). Tape bases are applied without tension on the middle part of the external oblique muscle of the abdomen at the level of the navel on the right and left. The strip of tape passes over the umbilical ring and the formed crease with a tension of 20%.

Tapes are changed every 6-7 days. Before changing, they are moistened with water, and the skin is treated with a cream with dexpanthenol. Rest from teip for 1 day. The duration of taping is 3-4 months.

At the end of treatment using this method, the child does not have a defect in the umbilical ring.

The positive effect of the claimed invention lies not only in the convenience of using the created device, but also in providing non-surgical treatment of small omphalocele due to the peculiarities of applying elastic tapes with an adhesive base, such as teips, to the skin of the patient's anterior abdominal wall.

Claims (1)

A method for non-surgical treatment of an omphalocele with an aponeurosis defect in the umbilical ring region of 2-3 cm, characterized in that the umbilical cord is placed in a vertical position, the contents of the hernial sac are pushed into the abdominal cavity, then a device represented by a locking device is applied to the defect at the level of the skin with the capture of all membranes. the lock in accordance with position 3 of figure 1 contained in the description, located on branches connected by a ring, the inner side of which has a ribbed working surface with teeth, and the outer side contains wings for weaving the tape, the free ends of the tape are pulled with 20% tension from the device to the sides and fixed to the skin at the level of the anterior or middle axillary line, the tapes are changed every 6-7 days with a break for rest from the tape for 1 day; duration of taping is 3-4 months.

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