[Bacteriophages in complex treatment of septic diseases of the hand]. / Ispol'zovanie lekarstvennykh preparatov bakteriofagov v kompleksnom lechenii gnoinykh zabolevanii kisti.

OBJECTIVE: To evaluate the effectiveness of bacteriophages in complex surgical treatment of septic diseases of the hand. MATERIAL AND METHODS: We analyzed treatment outcomes in 111 patients with septic diseases of the hand (septic arthritis, tendovaginitis, phlegmon). Surgical treatment was finished by primary sutures and drainage. They were divided into two groups. Bacteriophages were used in the main group. Other components of treatment were identical. «Pyobacteriophage complex¼ was injected into drainage tubes during dressings. Effectiveness of treatment was evaluated considering elimination of septic process, bacterial flora and healing of surgical wound. In addition, we performed in vitro testing of microorganisms for sensitivity to Pyobacteriophage. RESULTS: Staphylococcus and Streptococcus genus prevailed in hand infections. Pasteurella multocida has been isolated after pet bites. Growth of microflora in drainage tubes was observed in 16.7% and 21.1% of cases, respectively (p=0.02). Wound healing via primary intention was found in 83.6% and 71.4%, respectively (p=0.03). When testing in vitro, we observed lysis of cultures of Staphylococcus aureus in 83.6% of cases, Streptococcus pyogenes - in 33.3% of cases. CONCLUSION: «Pyobacteriophage complex¼ was effective for septic diseases of the hand. However, its partial lytic activity against the most common pathogens makes it advisable to combine phages and antibiotic therapy. Systematic renewal of phages is important due to widespread resistance of bacteria.

[Acute haematogenous osteomyelitis of the pelvis with multifocal pyogenic abscesses in an adult]. / Ostryi gematogennyi osteomielit taza u vzroslogo s mnozhestvennymi gnoinymi metastazami.

Acute hematogenous osteomyelitis (AHO) in adults is a rare disease complicating timely diagnosis. Even greater difficulties are observed in case of pelvic bone lesion. The authors report AHO of the pelvis an adult. Osteomyelitis was complicated by generalized infection and multiple pyogenic abscesses in subcutaneous adipose tissue of the upper and lower extremities. Detection of primary infectious focus was complicated by extreme severity of the patient's condition and low informative value of X-ray and ultrasound at the early stage of disease. Staphylococcus aureus was obtained from blood culture and infectious foci. Surgical debridement along with complex intensive care ensured a positive outcome.

[Transoral endoscopic thyroid surgery]. / Transoral'nyi éndoskopicheskii dostup k shchitovidnoi zheleze.

OBJECTIVE: To analyze own initial experience of transoral thyroid surgery. MATERIAL AND METHODS: There were 7 patients thyroid nodules who underwent surgery for the period from March 2018 to May 2019. All patients signed an informed consent to be included in the study. Surgical approach was performed through three incisions in the lower arch of the vestibule of the mouth with deployment of 10 mm endoscope and two 5 mm tools. Gas insufflation was used. All patients were females aged 43.3±11.8 years. Thyroidectomy was performed in 2 cases, hemithyroidectomy - in 5 patients. Dimensions of nodules varied from 10 to 42 mm. RESULTS: Mean time of hemithyroidectomy and thyroidectomy was 206.4±63.8 and 232±37.5 min, respectively. Papillary carcinoma was histologically verified in 1 case. Injuries of recurrent laryngeal nerve, postoperative hypocalcemia and local complications were absent. Drainage was not applied. Postoperative hospital-stay was 3.7±1.1 days. CONCLUSION: Transoral approach to the thyroid gland is technically feasible with standard endoscopic instruments, safe for important anatomical structures and more precise due to the optical capabilities of endoscopic equipment. Any types of procedures are possible. Undoubtedly, aesthetic outcome is also favorable.