ABSTRACT
Results of examination and treatment of 690 patients with peritonitis including 124 patients with laparostoma are analyzed. Criteria of prediction and early diagnosis of postoperative peritonitis are offered. Control of risk factors of postoperative peritonitis, prophylactic measures, dynamic ultrasonic control permit to choice treatment method promptly and correctly. Early relaparotomy with standard complex treatment is regarded as method of choice.
Subject(s)
Peritonitis/diagnosis , Peritonitis/surgery , Postoperative Complications/diagnosis , Adult , Aged , Female , Humans , Laparotomy , Male , Middle Aged , Postoperative Complications/surgery , Prognosis , Reoperation , Risk Factors , Time FactorsABSTRACT
Combined changes in the mucous membrane of the esophagus, stomach, and duodenum were studied in 110 patients with acute and chronic diseases of the lungs on the basis of the endoscopic method, taking into account the immunological mechanisms and analysis of data of 1,000 autopsy records. Combined changes in the lungs and organs of the upper digestive tract were found in 90.9% of patients, erosive-ulcerative lesions of the mucous membrane in 39.3%, and gastrointestinal hemorrhages in 1.7% of patients. Ulcers of the cardiac part of the stomach were encountered most frequently in this category of patients, but hemorrhage occurred mostly as a complication of ulcers of the body of the stomach.
Subject(s)
Bronchial Diseases/complications , Duodenal Diseases/etiology , Esophageal Diseases/etiology , Lung Diseases/complications , Stomach Diseases/etiology , Adult , Aged , Bronchial Diseases/immunology , Female , Humans , Immune Tolerance , Lung Diseases/immunology , Male , Middle AgedABSTRACT
The results of the study on the composition, properties and antibiotic sensitivity of pathogenic microbes isolated from purulent wounds of the soft tissues of patients treated in the Institute clinic in 1977-1980 are presented. The frequency of secondary infection of the purulent wounds was estimated. During this period the percentage of gram-negative bacteria isolated from opened purulent foci increased. In some cases investigation of the time course of the purulent processes revealed new microbial strains, such as pathogenic staphylococci or opportunistic gram-negative bacteria. Sometimes replacement of the causative agent by new organisms was observed. The new strains were high- and multiple-resistant to the antibiotics.
Subject(s)
Anti-Bacterial Agents/pharmacology , Bacteria/isolation & purification , Surgical Wound Infection/microbiology , Bacteria/drug effects , Drug Resistance, Microbial , Humans , Microbial Sensitivity TestsSubject(s)
Wound Infection/etiology , Acute Disease , Drainage , Enzymes, Immobilized/therapeutic use , Humans , Necrosis , Peptide Hydrolases/therapeutic use , Postoperative Care , Sepsis/etiology , Sepsis/prevention & control , Sepsis/therapy , Wound Infection/prevention & control , Wound Infection/therapyABSTRACT
Under analysis were 282 patients operated for acute cholecystitis, cholecystectomy being added by the external or internal drainage of bile ducts. It was established that the presence of jaundice, cholangitis, cholecystopancreatitis and gallstones in the ducts were considered as indications for choledochotomy in elderly and senile patients. The general lethality among the patients operated for acute cholecystitis complicated by injuries of the common bile duct made up 10,6%, in the group of elderly and senile patients it was 15,5.
Subject(s)
Cholecystitis/surgery , Common Bile Duct/surgery , Acute Disease , Aged , Cholecystectomy/mortality , Cholecystitis/diagnosis , Cholecystitis/mortality , Cholelithiasis/diagnosis , Cholelithiasis/mortality , Cholelithiasis/surgery , Humans , Middle AgedSubject(s)
Enzymes, Immobilized/therapeutic use , Peptide Hydrolases/therapeutic use , Protease Inhibitors/therapeutic use , Animals , Dogs , Drainage , Drug Evaluation , Drug Evaluation, Preclinical , Enzymes, Immobilized/isolation & purification , Granulation Tissue/drug effects , Guinea Pigs , Humans , Methods , Peptide Hydrolases/isolation & purification , Postoperative Complications/drug therapy , Protease Inhibitors/isolation & purification , Rabbits , Rats , Solubility , Sutures , Wound Healing/drug effectsSubject(s)
Surgical Wound Infection/prevention & control , Sutures , Wound Healing , Adult , Animals , Catgut , Child , Evaluation Studies as Topic , Furazolidone/therapeutic use , Guinea Pigs , Humans , Phthalic Acids/therapeutic use , Polyethylene Glycols/therapeutic use , Polyethylene Terephthalates , Rabbits , Rats , Suture Techniques/instrumentation , TextilesABSTRACT
The enzyme therapy, the application of microbial proteases in particular, is one of rational ways of removing necrotic tissues from purulent wounds. The use of proteolytic enzymes combined with the methods of early closure of granulated wounds (primary, primary-delayed, early secondary sutures) considerably reduces the terms of treatment of patients with purulent wounds.
Subject(s)
Peptide Hydrolases/therapeutic use , Surgical Wound Infection/drug therapy , Adolescent , Adult , Aged , Bacterial Infections/drug therapy , Humans , Middle Aged , Necrosis , SuppurationABSTRACT
Clinico-bacteriological examination of patients with purulent infections showed that Staphylococcus was the predominating microflora in the wounds. Simultaneously an increasing role of gram-negative conditionally pathogenic bacteria was shown. Multiple drug resistance was found in the organisms tested. The highest sensitivity levels were observed to gentamicin, kanamycin, tetracycline, levomycetin. It was shown by means of special typing methods that staphylococci of phage group III and Ps. Aeruginosa of serotype II predominated in the infected wounds. When the pathological material contained the antibiotic resistant cultures of Ps. aeruginosa, Proteus, Klebsiella and toxigenic strains of Staphylococcus, a tendency for prolongation of the suppurative process was observed.
