SU1729509A1 - Method for transplanting an autoplastic skin graft - Google Patents

Abstract

The invention relates to plastic surgery. The goal is to reduce the frequency of complications by increasing the resistance to microbes of the recurrent zone. The antimicrobial resistance of an autodermatous graft is enhanced by treating the patient's donor bed 1 day before plasty with a 30% dimexid solution with antibiotics that are sensitive to the microflora of the patient. After 24 hours, the dermatome collects the grafts and transplants them onto an infected wound surface. The method allows to increase the resistance to germs of an infected wound. The method is recommended for clinical use.

Description

The invention relates to medicine, namely to plastic surgery, and can be used in the plastics of infected wounds.

The goal is to reduce the incidence of complications by increasing the resistance of the autograft to the microbes of the recipient zone.

The method is carried out as follows.

The donor bed, from where skin autografts are collected. For 1 day, plastics are treated with a 30% solution of dimexide with the maximum daily dose of the antibiotic dissolved in it, to which the microbial flora, which is isolated from the patient's wound, is sensitive. For this, a sterile cloth moistened with a freshly prepared solution of Dimexidum with an antibiotic is applied to the donor bed every 8 hours. After treatment, the infected wound is generally accepted.

techniques and preparing it for plastic under

infiltration novocainic anesthesia, with a previously treated donor bed with a solution of Dimexidum with an antibiotic, skin grafts of a given length, width and thickness are collected. Grafts taken in this way are placed on the wound surface and covered with wipes moistened in a solution of Dimexidum with an antibiotic. Reboot is performed on the first day to monitor the degree of viability of the graft.

Example. A 44-year-old patient was hospitalized for an open comminuted fracture of the lower third of the left tibia, an extensive scalped wound. The operation is primary, surgical treatment of the wound, osteosynthesis of the left large tibial bone. Immobilization with plaster Longuet. The purulent discharge was observed 5 days after the injury. AT

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the necrosis of soft tissues followed. Stage necrotomy was performed and by 30 days a wound of 20 x 10 cm with abundant purulent-necrotic detachment had formed. Bacterial research was conducted in dynamics. Due to the extensiveness of the wound surface, the presence of highly pathogenic flora, it was decided to produce a skin plate with a treatment of the donor surface. The day before the operation, the donor bed on the front-outer surface of the right thigh on an area of 300 cm2 was treated with a 30% dimexide solution of +5 g of ampicillin. The dressing changed every 8 hours 3 times a day.

Surgery: dermatomy plastic wounds of the left leg with autograft. After treatment of the wound of the left leg, according to generally accepted methods, from a donor bed on the anterior-outer surface of the right thigh, previously applied with 30% dimexide + 5g ampicillin, under chloroethyl anesthesia with a dermat, 2 autotransplants of 20 x 7 x 0.2 were taken cm, laid on the wound surface of the left leg, Belt with the same solution. In addition, from the donor surface on the right thigh and from the symmetric part of the left thigh, 2 skin disks of 0.5 x 0.5 cm are taken for control and sent to the bacteriological laboratory. End of operation

The next day inspection at the transfer station. The dressing was soaked with blood. By removing it, it is determined that the bluish-colored patches fit tightly to the wound. There is no separable from under them. Dressing with a solution of Dimexidum + ampicillin. After 10 days, inspection in the transfer room.

The dress is dry. By removing it, it is determined that the flaps are pink and lie tightly on the wound. In the upper corner of the marginal necrosis 1 x 0.3 cm, dry. Inflammatory effects are absent.

The wound healed in months c. The patches have the color of the surrounding fabrics. The area of necrosis has been epithelial. We state 98% of the engraftment of flaps.

Remote inspection in a year. Ran no. Shin fracture consolidated.

The method is recommended for clinical use.

Claims (1)

Invention Formula The auto-skin grafting method, including aseptic processing of the donor skin area, characterized in that in order to reduce the frequency of complications by increasing the microbial resistance of the recipient zone, the donor site is exposed during the day before the skin graft is taken. 30% solution of Dimexidum containing the maximum dose of antibiotic sensitive to the infection of the recipient zone.