Biomedical subjects
Publications and source records attributed to L A Blatun.
Anaerobic infection is one of the most complicated problems of pyosurgery. The algorithm of examination of patients with anaerobic infection including intraoperative diagnosis is proposed. Surgical treatment playing also diagnostic role is the basis of combined treatment of soft tissues anaerobic infection. Early diagnosis and active surgical policy is one of the main ways of problem solving.
Clinical and microbiological efficacies of a combined drug, a fixed combination of ciprofloxacin and tinidazole in the form of tablets (Cifran ST, Ranbaxy, India) were studied. The drug was given to 40 patients with skin and soft tissue infections in the complex surgical treatment. The clinical effect and bacteriological efficacy were observed in 97.5 and 75% of the cases respectively. The drug tolerability was good and no adverse reactions were stated.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The immunological study was made in which the drug sensitivity index according to S. M. Demyanenko was estimated in 76 patients (24 women and 52 men aged 17-73 years): in patients with soft tissue purulent infection (group 1, n = 46) and surface thermal burns (degree III-IV) of 40% body surface (group 2, n = 30). Patients with satisfactory drug tolerance served control (16 patients of group 1 and 10 ones of group 2). Correlations between humoral and cellular immunity parameters and drug sensitivity index were studied. The results may serve a basis for development of early and adequate correction of immunological disorders in the above patients, of drug-related complications caused by immunological imbalance.
Clinical and bacteriological efficacies of vancomycin (Edicin, LEK) in the treatment of 17 patients with wound infection and 13 patients with thermal affections were studied. The clinical efficacy in the group of the patients with purulent wounds of the soft tissues amounted to 94.1 per cent and that in the patients with thermal affections was 92.3 per cent. The bacteriological effect was recorded in 86.6 per cent of the patients with purulent wounds of the soft tissues and in 69.3 per cent of the patients with burn infections. The drug intolerability was observed in two cases.
Experiences with surgical treatment of 269 patients with chronic osteomyelitis of long bones based on the principles of active surgical treatment of purulent wounds were summarized. Certain aspects of surgical treatment of patients with chronic osteomyelitis were revised and supplemented. Different variants of surgical treatment of the osteomyelitis focus were shown depending on the volume and character of the injury and the methods of plastic substitution of defects of the bones and soft tissues. Main principles of antibacterial therapy for chronic osteomyelitis are described.
Explore the source record for details and available documents.
Results of clinical trial of new difluoroquinolone--Sparflo (sparfloxacin, Dr. Reddy's Laboratories Ltd) are presented. Sparfloxacin was used in the treatment of 24 patients at the Department of Wounds and Wounds infections (11 patients) and at the Department of burn wounds (13 patients) of the A.V. Vishnevsky Institute of Surgery. After the treatment with sparfloxacin pathogen eradication was stated in 18 patients, eradication with superinfection--in 13 patients, persistence--in 3 patients. Thus bacteriological efficacy amounted to 87.5 per cent. Pharmacokinetic data demonstrates long-term sparfloxacin circulation in the organism of patients with burns--elimination half-life amounted to 20 hours. Overall after the sparfloxacin use the favourable clinical effect was stated in 100 per cent patients--18 patients (75%) had clinical cure and 6 (25%)--clinical improvement. The drug tolerance was good. It is concluded that clinical and laboratory investigation demonstrated high efficacy of sparfloxacin (Sparflo, Dr. Reddy's Laboratories Ltd) in the treatment of patients with skin and tissue wounds of different localization and genesis, complicated with infections.
Pefloxacin was used in the treatment of 25 patients with wound infection in a dose of 400 mg orally twice a day for 10-12 days. As the monotherapy it was applied to 15 patients. 7 patients with clinical signs of non-clostridial anaerobic infection were treated with pefloxacin in combination with intravenous metronidazole. Pefloxacin was highly efficient in 96 per cent of the cases with extensive posttraumatic purulent wounds with and without bone affection, acute purulent wounds of the soft tissue, purulent wounds of the soft tissues in diabetic patients, trophic or decubitus ulcer. 266 clinical isolates of Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Proteus mirabilis, Enterobacter spp. and Acinetobacter spp, were tested and 75 to 100 per cent of them was shown to be susceptible to pefloxacin and ciprofloxacin. At the same time the isolates of Pseudomonas aeruginosa and Klebsiella spp. were more susceptible to ciprofloxacin. The pathogen eradication and eradication with superinfection in the cases treated with pefloxacin amounted to 92 per cent. The drug tolerance was good. No clinically significant adverse events were recorded.
The 25-year experience with the underbandage treatment of soft tissue purulent wounds of various location and genesis with modern ointments with polyethylene glycol as the basis was analyzed. Levocin, levomecole, dioxycole, 5-percent dioxydinic, 1-percent iodopyronic, 0.5-percent quinifuryl and furagel ointments proved to preserve their high activity against aerobic grampositive and gramnegative flora. 10-percent mafenide acetate ointment had a high selective effect on Pseudomonas aeruginosa. The new ointments nitacid and streptonitole containing nitazole and white streptocide were highly active against both aerobic and anaerobic infections. The use of the ointments with the polyethylene glycol as the basis made it possible to decrease 2 times the period of the patient hospitalization in surgical units and to shorten the terms of the systemic antibacterial therapy. The marked therapeutic effect of such ointments due to their high dehydrating capacity and broad antibacterial spectrum enabled to consider them as the drugs of choice in the local treatment of purulent wounds during the 1st phase of the wound process, trophic and decubic ulcers, infected burns, diabetic and atherosclerotic gangrene, furuncles, carbuncles, mastitis, etc. The ointments in the water soluble vehicle can be as well used with success for the prophylactic treatment of infected wounds after the suture. The multitarget effect of the ointments in the water soluble vehicle and their ability to prevent severe purulent complications permitted to consider them as the 1st order drugs in cases of emergency.
The analysis of the treatment of 900 patients with large festered wounds of various genesis and location for the period from 1973 to 1998 years in the intensive care department has shown, that infection of respiratory ways is encountered in 30% of cases (in patients with nonsporeforming anaerobic bacteria--in 11-12%), bacteriuria--in 70-80%, bacteriamia--in 75% of patients with sepsis. In acute pyogenous diseases of soft tissues microbes from the wounds in monoculture were isolated out in 83.3% of cases, associations of gram-positive and gram-negative bacteria--in 16.7%, in chronic pyogenous diseases of soft tissues--in 60 and 40% of cases, respectively. In sepsis associations of gram-positive and gram-negative microbes were isolated in 55.6% of cases. Most often (91%) pathogenic staphylococcus was found in hemocultures. Uring in 62% of cases contained association of gram-positive and gram-negative microorganisms, in sputum gram-positive microflora in monoculture (69%) prevailed. In the group of patients with peritonitis, phlegmon of the anterior abdominal wall, diabetic phlegmon and gangrene, crush syndrome the association of anaerobic and aerobic microflora (from 57.1 to 98.8%) prevailed in the wounds. Application of up-to-date antimicrobial means in the intensive care unit resulted in a decrease of mortality rate in sepsis and complicated course of wound infection up to 23%, and in anaerobic nonsporeforming infection--up to 15%.
Nitazole, a drug from the nitrotiazole group, was shown to be active in vitro against bacteroides, peptococci, peptostreptococci, clostridia, staphylococci, colibacilli and streptococci. By its activity and antibacterial spectrum nitazole had some advantages over metronidazole, a drug from the nitroimidazole group. Experimental study of nitazole aerosole formulation in 4 models of purulent wounds of rabbits infected by Bacteroides fragilis, B. melaninogenicus, Clostridium perfringens 27 and Staphylococcus aureus 209P revealed its high therapeutic efficacy. In the treatment of 37 patients with purulent wounds of the soft tissues including 12 cases isolating anaerobic microbes, the clinical process of the acute suppuration in all the patients at the average reduced to the 5th-7th day. By the data of the bacteriological and cytological examinations the wound surface was ready for putting in stitches or free perforated cutaneous graft by the 10th-12th day. The drug tolerance was good. No adverse reaction were observed under the nitazole dressing in any case during the treatment of the wounds.