Year 2013 Vol. 21 No 6

GENERAL AND SPECIAL SURGERY

V.A. SAMARTSEV 1, V.A. GAVRILOV 1, A.G. KUCHUMOV2

DIFFERENTIATED APPLICATION OF SINGLE-ROW SUTURE FOR PREVENTION OF SURGICAL INFECTION IN ABDOMINAL SURGERY

SBEE HPE Perm State Medical Academy named after academician E.A. Wagner 1,
FSBEE HPE Perm National Research Polytechnic University 2,
The Russian Federation

Objectives. To improve surgical treatment results of the abdominal diseases by means of the differentiated use of a single-row continuous suture and modern synthetic antibacterial-coated suture materials and specified terms of absorption.
Methods. Biomechanical model has been designed and the characteristic parameters of simple interrupted and continuous sutures of the anterior abdominal wall aponeurosis have been calculated. The suture parameters have been experimentally proved on the laboratory animals and in clinical practice. Depending on the conducted treatment the surgical patients were subdivided into two groups. In the main group the continuous sutures for forming interorgan anastomoses and sewing of the abdominal wall hermetically according to algorhythm of prevention of surgical site infection have been applied. In the comparison group the laparotomic wounds and interorgan anastomoses were sewed with traditional interrupted suture by non-absorbable suture materials.
Results. The biomechanical modeling of the anterior abdominal wall aponeurosis sutures taking into consideration experimentally gained parameters of elasticity of aponeurosis and surgical thread have permitted to calculated the optimal characteristics of a single-row continuous suture as well as make a differentiated choice of surgical suture material. In the experiment on animals more rapid healing of surgical wounds by soft-fibrous scar using the modern absorbable surgical threads compared with the traditional sewing by capron have been shown. The advanced conception of prophylaxis of surgical infection site has been clinically applied that has permitted to reduce the number of postoperative complications from 14,2% to 3,6%.
Conclusions. The conducted study has confirmed the efficacy of single-row continuous suture application with absorbable suture materials in the complex prophylaxis of surgical site infection.

Keywords: suture materials, surgical site infections, biomechanical modeling of abdominal wall closure techniques
p. 38 46 of the original issue
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Address for correspondence:
614107, Rossiiskaia Federatsiia, g. Perm', ul. Kim, d. 2, GBOU VPO Permskaia gosudarstvennaia meditsinskaia akademiia im. ak. E.A. Vagnera, kafedra obshchei khirurgii lechebnogo fakul'teta,
e-mail: samarcev-v@mail.ru,
Samartsev Vladimir Arkad'evich
Information about the authors:
Samartsev V.A. MD, professor, a head of a chair of general surgery of medical faculty SEI HPE "Perm State Medical Academy named after academician E.A. Wagner". Gavrilov V.A. assistant of a chair of general surgery of medical faculty SEI HPE "Perm State Medical Academy named after academician E.A. Wagner". Kuchumov A.G. PhD, associate professor of theoretical mechanics SEI HPE "Perm National Research Polytechnic University."
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