Year 2020 Vol. 28 No 5

GENERAL & SPECIAL SURGERY

A.M. KUZMINOV 1, S.A. FROLOV 1, D.V. VYSHEGORODTSEV 1, V.YU. KOROLIK 1, N.V. TUKTAGULOV 1, M.A. SUKHINA 1, I.V. VOROBYEVA 2

THE FIRST EXPERIENCE OF LOW-TEMPERATURE ARGON PLASMA APPLICATION IN THE TREATMENT OF WOUNDS AFTER OPEN HEMORRHOIDECTOMY

A.N.Ryzhikh National Medical Research Center of Coloproctology of the Ministry of Health of Russia 1, Moscow,
N.F.Gamaleya Federal Research Center of Epidemiology and Microbiology 2, Moscow,
The Russian Federation

Objective. To study the effect of low-temperature argon plasma in the wound treatment after open hemorrhoidectomy.
Methods. The patients (n=30) with combined grade IV hemorrhoids were included in the study and ran-domized into the main and control groups. The age and gender in both groups were homogeneous.
Patients underwent the open hemorrhoidectomy using monopolar electrocoagulation during the postoperative period. Cold atmospheric plasma (CAP) was used as an addition physiotherapy in the main group. Cytological and bacteriological examination taken from the surface of the wound was carried out on days 2nd, 4th, 6th, 8th, 14th, 21st, 30th. Visual analogue scale (VAS, 0 to 10 points) was used to determine pain syndrome. Quality of life was assessed before surgery, on the 8th and 30th days since using the SF-36 questionnaire.
Results. By the 30th day, wound healing in the main group had occurred in 12/15 (80%) patients versus only 3/15 (20%) in the control group (p=0.003). On the 8th day after surgery the first signs of wound repair were determined in the main group, while only the signs of inflammation were detected in the control group according to the cytological study. On the 21st day the epithelial cells appeared in the main group versus wound repair process in the control group. On the 21st day the number of gram-negative bacteria was 105 versus 107 CFU, p<0.05, respectively) and the number of gram-positive bacteria was 107 CFU versus 108, (p>0.05) in the main and control groups, respectively. One established a t rialable difference in the microbial load of gram-negative bacteria in the CAP and control groups (105 versus 107 CFU, p<0.05, respectively). Microbial load of gram-positive bacteria in the CAP group was 107 CFU versus 108 in the control group (p>0.05). On the 6th day after surgery VAS score was 4 and 6 points, respectively (=0,01) in the main and control groups. Quality of life was measured on the 8th and 30th days after surgery. The reliable difference was found in the physical component assessment (p<0.05). There were no relevant differences in levels of psychological component between groups (p>0.05).
Conclusion. CAP application leads to accelerated wound healing and reduction of pain syndrome which has been observed.

Keywords: hemorrhoids, hemorrhoidectomy, cold argon plasma, plasma scalpel, plasma flow, wound healing
p. 543-550 of the original issue
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Address for correspondence:
123154,Russian Federation,
Moscow, Salyam Adil str., 2,
A.N. Ryzhikh National Medical
Research Center of Coloproctology
of the Ministry of Health of Russia,
Department of General Coloproctology
with a Group Studying Familial the Colon Adenomatosis,
tel.: 8 926 188-31-29,
e-mail: dr.tuktagulov@gmail.com,
Tuktagulov Nikita V.
Information about the authors:
Kuzminov Alexander M., MD, Professor, Head of the Department of General Coloproctology with a Group Studying Familial Colon Adenomatosis, A.N. Ryzhikh National Medical Research Center of Coloproctology of the Ministry of Health of Russia, Moscow, Russian Federation.
https://orcid.org/0000-0002-7544-4752.
Frolov Sergey A., MD, Deputy Director, A.N. Ryzhikh National Medical Research Center of Coloproctology of the Ministry of Health of Russia, Moscow, Russian Federation.
https://orcid.org/0000-0002-4697-2839.
Vyshegorodtsev Dmitry V., PhD, Senior Researcher of the Department of General Coloproctology with a Group Studying Familial Colon Adenomatosis, A.N. Ryzhikh National Medical Research Center of Coloproctology of the Ministry of Health of Russia, Moscow, Russian Federation.
https://orcid.org/0000-0001-6679-1843
Korolik Vyacheslav Yu., PhD, Researcher of the Department of General Coloproctology with a Group Studying Familial Colon Adenomatosis, A.N. Ryzhikh National Medical Research Center of Coloproctology of the Ministry of Health of Russia, Moscow, Russian Federation.
https://orcid.org/0000-0003-2619-5929
Tuktagulov Nikita V., Post-Graduate Student of the Coloproctology Department, A.N. Ryzhikh National Medical Research Center of Coloproctology of the Ministry of Health of Russia, Moscow, Russian Federation.
https://orcid.org/0000-0001-7823-8770
Sukhina Marina A., PhD, Head of the Department of Studying Microbiological and Immunological Researches, A.N. Ryzhikh National Medical Research Center of Coloproctology of the Ministry of Health of Russia, Moscow, Russian Federation.
https://orcid.org/0000-0003-4795-0751.
Vorojebva Irina V., PhD, Senior Researcher, N.F.Gamaleya Federal Research Center of Epidemiology and Microbiology, Moscow, Russian Federation.
https://orcid.org/0000-0003-1153-4510
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