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.

THE ROLE OF ONCOLOGICAL PROCESS IN OCCURRENCE OF POSTOPERATIVE EVENTRATION.

Eventration is one of the rare but the most dangerous postoperative complications in the abdominal surgery registered in 0.5-2.35% of patients. Eventration occurs most frequently after urgent surgery on the abdominal organs of weakened patients of the old and elderly ages with a low immune-biological condition of the body. Examination of certain specific features of eventration occurrence with underlying oncological process will allow better understanding the latter in the development of the postoperative complication. Therefore, the objective of the research was to examine experimentally the effect of malignant neoplasm on the mechanical strength of the laparotomy wound postoperative scar on small laboratory animals, and to study clinically occurrence of postoperative eventration development in patients with malignant neoplasms of the abdominal organs. The experimental studies were carried out on 78 laboratory rats operated on by means of laparotomy 3,0 cm in length. Heren's carcinoma was preliminary grafted under the skin of the external femoral surface in the main group of animals. The mechanical strength of the laparotomy wound scar was determined on the 1st, 3rd and 5th days after surgery by means of measuring abdominal pressure at the moment of scar rupture. 140 were examined who underwent midline laparotomy for surgical treatment of abdominal diseases. The main group included 98 patients with malignant neoplasms of the abdominal organs who were divided into two groups depending on the stages of oncological process. The first subgroup included 46 individuals at the I-II stages of the disease, and the second subgroup of the main group included 52 patients at the II-IV stages of the disease. The group of comparison involved 42 patients with acute surgical non-oncological pathology of the abdominal organs. Both groups of patients were comparable by the age and gender. An average age of patients in both groups of the study was 60.1±0.95 years. An average length of the laparotomy wound was 27.1±0.25 cm. The obtained results were statistically processed on the personal computer by means of electronic tables Microsoft Excel and the package of statistical processing program IBM SPSS Statistics. The results of the experimental studies are indicative of the fact that malignant process in the body results not only in inhibited maturation of the granulation tissue in the laparotomy wound, but in reduced strength of the postoperative scar beginning with the 3rd day after surgery performed. Analysis of the results of our clinical study enables to admit reliable increase of occurrence of "local" postoperative complications including suppuration of the postoperative wound and eventration, especially when oncological process is at the late stages of the disease. This specific feature should be considered when sutures and drainage are applied on the laparotomy wound in this group of patients. Thus, oncological process at the late stages of the disease promotes reduced strength of the laparotomy wound postoperative scar and results in an increased occurrence of eventration and suppuration of the postoperative wound.

FEATURES OF GRANULATION TISSUE MORPHOLOGY AROUND THE NET ALLOTRANSPLANT WHEN APPLYING POSTOPERATIVE RADIATION THERAPY.

The aim of the research was to study experimentally the morphologic peculiarities of the granular tissue around the elements of the reticular allotransplant of the muscular aponeurotic layer of the anterior abdominal wall when using postoperative distant gamma therapy. The experiment has been done on 168 laboratory rats which were implanted with a prolenic mesh allograft into the tissues of muscular aponeurotic layer of the anterior abdominal wall. From the 13th to 19th day after the implantation of the reticular allograft, animals from the main group (96 rats) received irradiation of the site of the last one. Taking of the biological material was carried out on the 20th, 30th, 40th and 50th day after surgery. For optical research at histological examination the samples of biopsy were fixed in 10% neutral formalin. Paraffin sections were stained with hemotoxylin and eosin. To identify collagen fibres the method of histological sections' coloring was applied. The results of the research indicate that the use of distant gamma therapy after reticular allotransplant implantation leads to uneven maturation of the granulation tissue, its edema, probable decrease in the percentage of fibroblasts, increase of lymphoid cells as well as the appearance of plasma cells and macrophages on the 40th and 50th days of observation. At the histologic sections coloring with aquious blue-chromotrope B2, there is a predominance of the specific volume of collagen fibers and an increase in the specific volume of blood vessels on the 50th day of observation. Thus, the use of the postoperative radiotherapy at the plasty of the anterior abdominal wall with a reticular allograft leads to the distortion of the maturation process of the granular tissue, its edema, which shows itself in the probable reduction in the percentage of fibroblasts, increase in lymphoid cells, appearance of plasma cells and macrophages as well as prevalence of specific volume of collagen fibres, increase in the specific volume of vessels.

Equine Embryo Sexing and Ultrasonographic Foetal Sexing - Interests and Applicability.

The ability to choose the sex of the offspring is of upmost economic importance for horse breeders. Unlike other species, horses present several reproductive peculiarities that interfere with assisted reproductive technologies used in other large animals (such as bovine) and make them difficult to apply. Thus, there is a great interest to determine the sex of the offspring as soon as possible. This has led to the development of several technologies to serve this purpose, which can be classified into two categories. One is equine embryo sexing by either non-invasive biotechnological methods, such as monitoring of X-linked enzymes before X chromosome inactivation and detection of sex-specific antigen, or by invasive biotechnological methods, such as cytogenetic analysis and polymerase chain reaction (PCR). The other one is equine foetus sexing using ultrasound scanning in different stages of its development (early, mid or late), by different approaches (transrectally or transabdominally). This can be performed with classic B-mode ultrasound machines or using 3D-mode and Doppler-mode scanners. This review article offers a comprehensive overview of the current status of these procedures as well as an assessment of their interests and applicability.