MICROBIOLOGICAL FEATURES OF A LAPAROTOMY WOUND COMPLICATED BY POSTOPERATIVE EVENTRATION AGAINST THE BACKGROUND OF AN ONCOLOGICAL PROCESS.

This article presents the results of a study of the qualitative and quantitative microflora content of the wound exudate of a laparotomy wound complicated by eventration in patients with malignant neoplasms of the abdominal cavity. This study aimed to investigate the peculiarities of the qualitative and quantitative composition of the laparotomy wound microflora in cancer patients with postoperative eventation. After all, postoperative event is always accompanied by the occurrence of purulent-septic complications from the laparotomy wound. These microbiological features should be taken into account in order to timely prevent or treat postoperative event in cancer patients, that is, in the appointment of antimicrobial therapy, features of purulent wound treatment, etc. We studied 34 patients with surgical diseases of the abdominal cavity with postoperative eventration. We studied the species content of microorganisms, their population level, the index of constancy, the frequency of species detection, the index of significance, and the index of quantitative dominance. The microbiological spectrum of laparotomy wound exudate, in case of postoperative eventration in patients with malignant neoplasms of the abdominal cavity, is characterized by a probable predominance of the number of cultivated strains of the genus Proteus, Pseudomonas aeruginosa, the appearance of yeast-like fungi of the genus Candida and the absence of S. aureus growth in the early stages. There was an increase in the population level of E. coli, Pseudomonas aeruginosa, and microorganisms of the genus Proteus, with a prevalence of the latter compared to non-cancer patients, and a lower number of Staphylococcus aureus colonies. The dominant microorganisms of wound exudate are E. coli and Enterococcus faecalis; in patients with malignant abdominal neoplasms, the highest coefficient of quantitative dominance is observed in microorganisms of the genus Proteus. The presence of secondary immunodeficiency, cachexia, anaemia, etc. in patients with malignant neoplasms of the abdominal cavity causes a 'sluggish' purulent-inflammatory process in the laparotomy wound area in the event of postoperative eventration.

THE INFLUENCE OF THE ONCOLOGICAL PROCESS ON THE MECHANICAL STRENGTH OF THE POSTOPERATIVE SCAR OF THE LAPAROTOMY WOUND.

The aim - to examine mechanical strength of the postoperative scar of the laparotomy wound depending on the stage of oncological process at various terms after surgery performed. Examined 194 physical bodies of deceased persons, according to the protocols of the pathological examination (in which the card numbers of the patients are indicated) and who underwent surgical intervention on the organs of the abdominal cavity. Summarizing the results of the study, it should be noted that on the 1st day after surgery, the mechanical strength of the postoperative scar of the laparotomy wound does not depend on the stage of the oncological process and the type of surgery performed, which proves that there is no significant difference in the above-mentioned study groups. Reduced mechanical strength of the postoperative scar was found in the main group on the 1st day of the study. Similar to the 1st day situation is seen on the 2nd and 3rd days of the research. This confirms the morphological experimental studies carried out earlier, which indicate that malignant neoplasm in the body considerably inhibits and slows down the processes of maturation of the granulation tissue. The study once again proves the negative influence of the presence of a malignant neoplasm on the mechanical strength of the postoperative scar of a laparotomy wound. Oncological process negatively affects the mechanical strength of the postoperative scar. Mechanical strength of the postoperative scar of the laparotomy wound is directly proportional to the stage of oncological process and the size of the tumor removed.

[Role of heat flow generated by an abdominal cavity in monitoring of acute surgical pathology of abdominal organs].

Despite of significant development of modern surgery results of treatment of acute diffused peritonitis and acute intestinal obstruction are still unsatisfactory. Successful treatment of these conditions depends considerably on timely and adequate diagnosing as it gives a choice of optimal treatment tactics. Measuring of a human body heat flow in areas of organs affected by pathology in cases of acute diffused peritonitis and acute intestinal obstruction provides a possibility to improve the principles of early differential diagnosing, to form new approaches to treatment tactics and monitoring of general health status of a patient during early postoperative treatment. 47 patient suffering from acute diffused peritonitis and 42 patients suffering from acute intestinal obstruction have been examined; the patients were divided into groups based on abdominal cavity exudates character, intestinal obstruction type and intra-abdominal hypertension grade. Measurement of abdominal cavity heat flow was performed by a contact method with use of thermoelectric medical thermometer. Intra-abdominal hypertension was measured by generally used transvesical method. It has been established that abdominal cavity heat flow correlates with character of abdominal cavity exudates; this is also confirmed by reliable difference between serous peritonitis and fibrinopurulent peritonitis indices. Indices in case of acute intestinal obstruction are lower than ones in case of acute diffused peritonitis as there are no inflammatory changes of peritoneum. Development of intra-abdominal hypertension of grades 3-4 directly influences the heat flow extent; this is explained by accelerated and aggravated pathological changes of inner organs cased by the main disease. Thus, abdominal cavity heat flow fully reflects degree of purulent and inflammatory processes of abdominal cavity organs and can be used for additional diagnosing and clinical course monitoring.

[Changes of biochemical content of the duodenal mucosa in early recurrence of bleeding].

Using the duodenal bleeding and its early recurrence modelling on 48 mongrel dogs the dynamics of content of general protein, urea and glucose in duodenal mucosa were investigated. There was established that the dynamics of investigated indices of anterior and posterior duodenal wall appeared different and that the level of urea while early recurrence of duodenal bleeding owes consistent tendency for lowering, especially in posterior duodenal wall. The glucose level in these both walls is merely stable.

[Changes of duodenal biochemical content in the early duodenal recurrent hemorrhage].

The dynamics of the indices changes concerning the general protein, urea and glucose content was investigated in 32 mongrel dogs while modelling the hemorrhage from duodenum and its early recurrence. There was established that the urea content and somewhat the general protein content reflect most accurately the hazard of the early recurrent hemorrhage occurrence.