Feleshtynsky Y. P., Derkach K. D., Diadyk O. O.

EVALUATION OF THE EFFECTIVENESS OF COMPLEX SURGICAL TREATMENT ALGORITHM OF INFECTED WOUNDS OF THE ABDOMINAL WALL AFTER ALLOHERNIOPLASTY

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Feleshtynsky Y. P., Derkach K. D., Diadyk O. O.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

Unsatisfactory results of treatment of infected wounds after allogernioplasty can lead to hernia recurrence. The aim is to evaluate the algorithm's effectiveness for treating infected wounds after allogernioplasty using ultrasound cavitation, VAC therapy and repeated decametaxine solution rehabilitation. The treatment of 2 groups of patients with infected abdominal wall wounds after allogernioplasty was analysed. Group I (n=37) was treated according to the developed algorithm, and Group II (n=34) was treated conventionally. We compared the frequency of postoperative complications, wound healing time, morphological changes in tissues during morphometric and (IHC) studies on days 3, 7, 12. In group I, seroma occurred in 3 (8.1%) patients versus 8 (23.5%) (p=0.097), the wound healing time was 16±1.05 versus 26±2.05 days (p=0.0001*), re-infection - in 2 (6.3%) patients versus 7 (26.9%) (p=0.031*), hernia recurrence - in 1 (3.1%) versus 7 (26.9%) (p=0.016*). On day 3, group I showed less severity of degenerative changes in the vessels, higher basement membrane thickness and vascular endothelial cell height, and on days 7 and 12 - higher dynamics of connective tissue maturation, higher specific volume of fibrous component and connective tissue fibre thickness, predominance of fibroblastic cells and reduction of haemodynamic disorders compared to group II, which was in favour of faster wound healing and germination of the mesh with connective tissue. The treatment algorithm with the complex use of ultrasound cavitation, VAC therapy and repeated decametaxine solution sanitisation increases the effectiveness of treatment by reducing the incidence of seroma, re-infection, hernia recurrence and reducing the wound healing time, which was confirmed by an increase in the specific volume of the fibrous component of the granulation tissue and a decrease in haemodynamic disorders in the dynamics.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2023 Issue 3, 170, 282-290 pages, index UDC 617.55-007.43-089.843/.844-089.168.1-06-001.4-022:615.84

DOI:

10.29254/2077-4214-2023-3-170-282-290