RESUMO
It was analyzed the results of wounds treatment complicated by surgical infection. An apparatus for creating negative pressure VivanoTec/S042 was used for this in 74 patients. Types of surgical interventions depended on phase of inflammatory process and severity of clinical manifestations. It was done 153 operations. Surgical management of infected wounds, necrectomy were performed. As the relief of inflammatory process repeated surgical management with plasty by using of local tissue was done. Short-term good anatomical results were achieved in 97% of patients. Good functional result was marked in all patients. Wound healing occurred at the optimum time.
Assuntos
Antibacterianos/uso terapêutico , Desbridamento/métodos , Tratamento de Ferimentos com Pressão Negativa/métodos , Procedimentos de Cirurgia Plástica , Infecção da Ferida Cirúrgica , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos de Cirurgia Plástica/instrumentação , Procedimentos de Cirurgia Plástica/métodos , Recuperação de Função Fisiológica , Reoperação/métodos , Índice de Gravidade de Doença , Retalhos Cirúrgicos , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/fisiopatologia , Infecção da Ferida Cirúrgica/terapia , Resultado do Tratamento , CicatrizaçãoRESUMO
Results of the use of the biocomposite nanostructured material "KollapAn" in the treatment of 374 patients with osteomyelitis were followed up. 412 operations were performed, depending on the stage of the inflammatory process and clinical picture. Majorly, operation was performed on the 5-7th day after primary necrosequestrectomy. Good early anatomic results were achieved in 86% patients. All patients demonstrated the good functional results of the treatment; the wound healing was on-time. The lethality rate was 1.2%; all these patients had severe sepsis. The long-term follow up (1.5 years) revealed the complete substitution of the bone defect by the autobone; no cases of the osteomyelitis recurrence were observed.
Assuntos
Substitutos Ósseos/administração & dosagem , Osso e Ossos/cirurgia , Colágeno/administração & dosagem , Nanoestruturas/administração & dosagem , Osteomielite/cirurgia , Osteotomia , Osso e Ossos/patologia , Osso e Ossos/fisiopatologia , Feminino , Humanos , Masculino , Teste de Materiais , Pessoa de Meia-Idade , Osseointegração , Osteomielite/mortalidade , Osteotomia/efeitos adversos , Osteotomia/métodos , Cuidados Pós-Operatórios/métodos , Análise de Sobrevida , Resultado do TratamentoRESUMO
Treatment results of 63 patients with surgical sepsis (aged 17-92 years) were analyzed. The necessity of intravenous immunoglobulin infusion in the complex treatment of sepsis was proved by the comparative morphological study of immunocompetent tissues of 30 patients, died of sepsis and nonseptic reasons. The rational use of intravenous immunoglobulin should be based on the condition of the patient and defined by the APACHE II and SOFA scores.
Assuntos
Antibacterianos/uso terapêutico , Sistema Imunitário/patologia , Imunoglobulinas Intravenosas/uso terapêutico , Reoperação/métodos , Infecção da Ferida Cirúrgica , Síndrome de Resposta Inflamatória Sistêmica , APACHE , Adulto , Idoso , Técnicas Bacteriológicas , Terapia Combinada , Feminino , Humanos , Sistema Imunitário/fisiopatologia , Imunidade/efeitos dos fármacos , Fatores Imunológicos/uso terapêutico , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Infecção da Ferida Cirúrgica/imunologia , Infecção da Ferida Cirúrgica/mortalidade , Infecção da Ferida Cirúrgica/patologia , Infecção da Ferida Cirúrgica/terapia , Síndrome de Resposta Inflamatória Sistêmica/imunologia , Síndrome de Resposta Inflamatória Sistêmica/mortalidade , Síndrome de Resposta Inflamatória Sistêmica/patologia , Síndrome de Resposta Inflamatória Sistêmica/terapia , Resultado do TratamentoRESUMO
The results of treatment of 73 patients with confirmed diagnosis of sepsis are analyzed. The most frequent immune disorders in septic patients are: decrease in lymphocyte count, both T (60%) and B (45.7%) populations, decrease of T-helpers and T-suppressors (52.6%) count, increase of C3-complement activator titre (50%) and phagocytic coefficient (52.4%). The more expressed immune depression observed in patients with gram-negative sepsis in comparison with the gram-positive. Standard immunoglobulins were used in the treatment of 38 patients: "Endobulin" (ImmunoAG, Austria)--in 9 cases; "Intraglobin" (Biotest, Germany)--in 14 and "Pentaglobin" (Biotest, Germany)--in 15 cases. Analyze of the control immunogramms showed the reliable improvement of immune indices and normalization of T-cell counts. Lethality among septic patients treated with immunoglobulins was 14.5%.
