Novosti
|
This journal is indexed in Scopus |
|---|
Year 2015 Vol. 23 No 5
GENERAL & SPECIAL SURGERY
V.A. SERGEEV 1, A.A. GLUKHOV 2
METHOD FOR PROGRAMMED IRRIGATION-ASPIRATION SANATION IN THE COMBINED TREATMENT OF PATIENTS WITH CHRONIC POSTTRAUMATIC LONG BONE OSTEOMYELITIS
SBEE HPE "Voronezh State Medical University named by N.N. Burdenko",
BME "Orel region clinical hospital"
The Russian Federation
Objectives. To study the efficiency of method for programmed irrigation-aspiration sanation in the combined treatment of patients with chronic posttraumatic long bone osteomyelitis.
Methods. Results of treatment for 112 patients (21-62 yrs old) with chronic posttraumatic long bone osteomyelitis have been analyzed. Depending on the method of suppurative focus sanation after radical osteonecrectomy, the patients were divided into two groups. In the control group drainage and sanation of the osteomyelitic focus were performed by conventional surgical method. In the main group the combined treatment was added by a new method of programmed sanation with the original AMP-01 device. The sequential programmed inclusion of cycles of pumping antiseptic solution into the pus pocket, its exposure and aspiration of spent solution has been applied.
Results. Application of the method for programmed irrigation-aspiration sanation in the combined treatment proved to exactly conforms to the principles of active surgical approach. Good short-term results were observed in the main group in 88,1% cases, in the control group – in 73,6% cases, including relevant 2,2-fold reduction of the number of purulence in the main group compared to the control one. After 2-year follow-up the long-term results of the treatment showed a 2-fold reduction of the number of recurrent osteomyelitis. Extremity function in the main group was recovered in 68,5% cases and was limited in 31,5% cases; in the control group – in 58,3% and 41,7%, respectively (p<0,05). The number of favourable outcomes increased by 12,3%.
Conclusion. The study conducted confirmed the efficiency of applying the method for programmed irrigation-aspiration sanation in the combined treatment of patients with chronic posttraumatic long bone osteomyelitis, since this method reliably improves the sanation quality, allowing adequately enhancing efficiency of the treatment.
- Amiraslanov IA, Svetukhin AM, Borisov IV. Sovremennye printsipy khirurgicheskogo lecheniia khronicheskogo osteomielita [Modern principles of surgical treatment of chronic osteomyelitis]. Infektsii v Khirurgii. Moscow, RF: 2004;(2):8-13.
- Vinnik IuS, Shishatskaia EI, Markelova NM, Shageev AA, Khorzhevskii VA, Per'ianova OV, Shumilova AA, Vasilenia ES. Primenenie biodegradiruemykh polimerov dlia zameshcheniia kostnykh polostei pri khronicheskom osteomielite [The use of biodegradable polymers to replace the bone cavities in chronic osteomyelitis]. Vestn Eksperim i Klin Khirurgii. 2013;(4)1:51-57.
- Gostishchev V.K. Osnovnye printsipy etiotropnoi terapii khronicheskogo osteomielita [The basic principles of causal treatment of chronic osteomyelitis]. Khirurgiia. 1999;(9):38-42.
- Amiraslanov IA, Svetukhin AM, Borisov IV, Ushakov AA. Vybor khirurgicheskoi taktiki pri lechenii bol'nykh osteomielitom dlinnykh kostei v zavisimosti ot kharaktera [The option of surgical approach in the treatment of patients with osteomyelitis of the long bones depending on the origin]. Khirurgiia. 2008;(9):46-50.
- Sonis AG. Rezul'taty primeneniia gravitatsionnoi terapii v lechenii patsientov s osteomielitom nizhnikh konechnostei [Results of application of gravitational therapy in the treatment of patients with osteomyelitis of lower extremities]. Vestn Eksperim i Klin Khirurgii. 2010;(3)4:377-83.
- Privalov VA, Krochek IV, Abushkin IA. i dr. Lazernaia osteoperforatspia v lechenii vospalitel'nykh i destruktivnykh zabolevanii kostei [Laser osteopunching in the treatment of inflammatory and destructive bone diseases]. Vestn Eksperim i Klin Khirurgii. 2008;(2)1:19-28.
- Lazzarini L, De Lalla F, Mader JT. Long Bone Osteomyelitis. Curr Infect Dis Rep. 2002 Oct;4(5):439-45.
- Goriunov SV, Romashov DV, Butivshchenko IA. Gnoinaia khirurgiia [Purulent surgery]: atlas/ red. Abramov IS. Moscow, RF: BINOM; 2004. 558 p.
- Nikitin GD, Rak AV, Linnik SA, Saldun GP, Kravtsov AG, Agafonov NA, Fakhrutdinov RZ, Khaimin VV. Khirurgicheskoe lechenie khronicheskogo osteomielita [Surgical treatment of chronic osteomyelitis]. Saint-Petersburg, RF: Russkaia Grafika; 2000. 288 p.
- Zaitsev AB, Mitrofanov VN. Sistemnyi podkhod k rekonstruktivno-vosstanovitel'nomu lecheniiu khronicheskogo osteomielita goleni [A systematic approach to reconstructive treatment of chronic osteomyelitis of the tibia]. Travmatologiia i Ortopediia. 2010;(2):215-18.
- Cierny G 3rd, DiPasquale D. Treatment of chronic infection. J Am Acad Orthop Surg. 2006;14(10 Spec No.):S105-10.
- Feltsan T, Mracna J, Holly D.Use of thrombocyte concentrates in treatment of bone defects. Bratisl Lek Listy. 2011;112(11):655-57.
- Filardo G, Kon E, Pereira Ruiz MT, Vaccaro F, Guitaldi R, Di Martino A, Cenacchi A, Fornasari PM, Marcacci M. Platelet-rich plasma intra-articular injections for cartilage degeneration and osteoarthritis: single- versus double-spinning approach. Knee Surg Sports Traumatol Arthrosc. 2012 Oct;20(10):2082-91.
- Greenfield EM, Bechtold J; What other biologic and mechanical factors might contribute to osteolysis? Implant Wear Symposium 2007 Biologic Work Group. J Am Acad Orthop Surg. 2008;16 (Suppl 1):S56-62.
394000, Rossiiskaia Federatsiia,
g. Voronezh, ul. Studencheskaia, d. 10,
GBOU VPO "Voronezhskii gosudarstvennyi meditsinskii universitet im. N.N. Burdenko",
kafedra obshchei khirurgii,
tel.mob.: 8 905 165-09-92,
e-mail: sergeevdoc60@yandex.ru,
Sergeev Vladimir Anatol'evich
Sergeev V.A., PhD, a surgeon of coloproctological department of BME "Orel Regional Hospital".
Glukhov A.A., MD, professor, a head of the department of general surgery, Director of the Institute of Surgical Infection of SBEE HPE "Voronezh State Medical University named after NN Burdenko".
Article in the .pdf format
