[The application of biopolymer-based antiseptic drugs for the surgical treatment of intranasal and paranasal tumours].

The authors report their experience with the application of the local antiseptic preparation Ambipor for the treatment of operative wound infection in the patients presenting with malignant neoplasms. Ambipor was used in 23 patients receiving surgical treatment of locally advanced intranasal and paranasal tumours. It was shown that the application of ambipor allows decreasing the risk of development of wound infection in the postoperative period.

[The use of exogenous nitrogen monoxide for the prophylaxis of postoperative wound infection].

The study covers treatment results of 220 patients operated on ventral hernia and in vivo experimental treatment of 36 rats proved the nitrogen monoxide (NO) to be the effective means of wound infection prophylaxis. NO potentiates antiseptic effects, minimizing intraoperative wound contamination. It, besides, stimulates endothelial and basal cells of epidermis proliferation. Wound infection was observed only in 9,8% of patients, treated with NO intraoperatively. All cases of infective complications were serous and infiltrative, but not purulent.

[Clinical significance and functional outcomes of ligation of exterior carotid artery in surgical treatment of oropharyngeal cancer].

This work was designed to analyse outcomes of the treatment of 65 patients with advanced oropharyngeal cancer who had received combined treatment including radical resection of the tumour. Thirty three patients underwent surgery without ligation of exterior carotid artery while the remaining 32 (control group) were operated after preceding ligation of this vessel. The influence of ligation of exterior carotid artery on cerebral circulation was evaluated by the following methods: estimation of the intraoperative blood loss from A.T. Staroverov's formula, ultrasound dopplerography of extracranial carotid segments, electroencephalography, measurement of the fields of vision using statistical quantitative perimetry, evaluation of the patients' neurologic status. It was shown that ligation of exterior carotid artery has no apparent effect on the intraoperative blood loss during radical surgery for the management of oropharyngeal cancer nor does it influence healing of the postoperative wound and oncological outcome of this treatment.

[Application of polymer-based iodine-containing antiseptics to the surgical treatment of laryngeal cancer].

The objective of the present study was to accelerate the wound healing process following laryngectomy. Analysis of the treatment outcomes included 132 patients with stage III-IV laryngeal cancer. One group of patients (n=48) was treated with biocompatible polymer-based iodine-containing antiseptics (iodopor and iodopolikom) applied pre-, intra-, and post-operatively. The control group of 54 patients received traditional wound treatment following laryngectomy. The microbiological study demonstrated that the use of iodopolikom polymer-based antiseptic designed for cutaneous application allowed to reduce microbial colonization of the skin and to treat the postoperative wound without a dressing. Analysis of the results of local thermometry, cytological study, and wound tensiometry showed that polymer-based iodine-containing antiseptics reduce severity of local inflammatory reactions and stimulate regenerative processes in the wound after laryngoscopy. Wound healing by first intention in the group of patients treated by these preparations amounted to 81.2% compared with 55.6% in the control group.

[Functional and oncological outcomes of surgical treatment of outer ear skin cancer].

Results of the surgical treatment of external ear skin cancer in 71 patients are evaluated. Based on the TNM classification, the patients were allocated to the following groups: T1 - 25 (35.2%) patients, T2 - 23 (32.4%) patients, T3 - 11 (15.5%), T4 - 12 (16.9%) patients. Eight patients underwent total removal of the auricle and 26 ones its resection. Extensive resection of the tumour in 36 patients was immediately followed by plastic reconstruction of the resulting defect on the outer ear with the use of the following graft varieties: rotation cutaneous flap (n=22), composite musculocutaneous flap vascularized by a. thoracoabdominalis (n=2), and free full-thickness cutaneous flap (n=4); Trendelenburg operation was performed in 8 patients. Clinical efficiency of the new method for the reconstruction of the defect in the initial portion of the external auditory canal using rotation cellulocutaneous postaural flap was evaluated. It is concluded that surgical treatment of external ear malignant tumours results in rather a high frequency of postoperative wound healing by first intention (91.5%). The post-surgery recurrence rate of outer ear skin cancer amounts to 7% with the highest percentage among the patients of groups T3 and T4. It is concluded that the proposed method for the reconstruction of the defect in the initial portion of the external auditory canal yields good functional and aesthetic outcome.

[Reconstructive surgical treatment of nasal skin cancer].

Results of reconstructive surgical treatment of malignant nasal skin tumours in 96 patients (46 men and 50 women) are presented. All of them underwent surgery including extensive excision of the affected nasal skin. The postoperative defect was substituted by the following varieties of grafts: sliding cellulocutaneous flap (n=38), rotation cellulocutaneous buccal flap (n=36), free full-thickness flap (n=2), free chondrocutaneous flap (n=5), cutaneous-aponeurotic forehead flap (n=2), composite graft (cellulocutaneous buccal flap with a fragment of free auricular cartilage) (n=13). A new modification of reconstructive surgical treatment was proposed to correct a through defect of the nasal ala using a rotation cellulocutaneous buccal flap. The frequency of continued growth or relapse of nasal skin tumours following plastic reconstruction by different methods was 7.3%. Wound healing by first intention was documented in 90.6% of the patients. The new variant of reconstructive treatment of through defects in the nasal alae ensures efficacious healing of the postoperative wound and a good cosmetic result.