[Possibilities if intraoperative local administration of antibiotics and antiseptics in patients with ENT cancer].
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Biomedical subjects
Publications and source records attributed to S I Belykh.
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The data on the first experience in the use of synthetic resolvable materials in plasty of the anterior abdominal wall in children are reported. Tissue glue compositions based on alpha-cyanoacrylates as well as connective biocompatible elements (CBE) developed at the SRIIMT were used. An aponeurotic suture-glue duplication was utilized for plastic enforcement of the anterior abdominal wall; individual methods were developed for each concrete localization of the defects. Operations were carried out on 201 children with congenital abnormality of the anterior abdominal wall: inguinal hernias, hernias of the linea alba, ventral hernias. Ninety-six (47.8%) children were examined in late postoperative periods of 2 to 9 years. Recurrences were not encountered. No inflammatory complications were found. It is concluded that the use of Russian synthetic resolvable materials for surgical treatment of pathological conditions of the abdominal wall in children is effective and safe.
Tissue response to the implanted iodine-containing thread and its antibacterial activity were studied in the experiment. When compared with the existing analogues, the thread studied, causes the lesser inflammatory response, has pronounced antimicrobial action and has no negative effect on the course of a wound process. Universality of antiseptic action of iodine creates wide possibilities for use of the threads in the surgical practice.
The experimental substantiation and clinical approbation of the absorbable antimicrobial threads "Capromed A" and "Caproiod" in the surgery of the extrahepatic bile-ducts were carried out. The complications caused by the use of suture material were not revealed. A high effectiveness of the "Caproiod" thread in the emergency surgery of the extrahepatic bile ducts was noted.
Examination was performed of 20 patients from 15 families with heterozygous deficiency of protein C (27-62% against the mean standard). Recurrent thromboses were seen in 17 of them. Thromboses of the lower veins, pulmonary artery thromboembolism, thromboses of the surface veins, those of cerebral vessels, myocardial infarction, of renal and mesenterial vessels were registered in 15, 5, 4, 3, 3, 1 and 1 patients, respectively. There was a tendency to recurrent thrombosis during pregnancy with high risk of spontaneous or induced abortions. The highest effect was produced with low-molecular heparin combined with transfusions of recently frozen plasma and introduction of disaggregating agents. Anabolic hormones were used to prevent thrombosis. The data are provided on a 4-fold increase in the prevalence of protein C deficiency in polythrombotic patients living in the West Siberia vs. deficiency of antithrombin III.
A single-row suturing of the incision on the uterus after cesarean section with separate muscular-muscular sutures by synthetic dissolving threads holds good promise. Such suturing helped optimize the reparative processes in the uterine cicatrix and reduce the incidence of postoperative pyoseptic complications. Kaproag, an antibacterial suture material made in this country, proved to be the best for the purpose.
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A new native synthetic absorbable antibacterial polyamide thread "Capromed DC" was used for liquidation of the abdominal wall defect in operation for postoperative recurrent hernia. The low incidence of complications caused by infection around the non-absorbable ligature was noted.
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In healthy volunteer donors, intranasal instillation of adiuretin-SD in doses of 0.0002-0.001 mg/kg a day provoked an increase of the activity VIII:WF in the plasma and acceleration of euglobulin lysis. Out of 15 patients suffering from Willebrand's disease, the activity of Willebrand's factor rose in 9 patients. Activated partial thromboplastic time became shorter in all the patients. In addition, acceleration of euglobulin lysis was noted. In view of that fact adiuretin was used later in combination with aminocaproic acid (0.2 g/kg a day). All the patients suffering from menorrhagias demonstrated the lowering of hemorrhagic diathesis. The data obtained allow recommending the use of adiuretin combined with aminocaproic acid in patients suffering from Willebrand's disease.
In the paper, apart from the results of clinical application of biocompatible polymeric fixatives, are presented the detailed characteristics of physical and mechanical properties of polymeric rods, indicated prospects for development of the following generations of biocompatible polymeric fixatives, exhibiting not only high strength but therapeutic activity as well due to incorporation of different medicinal substances as components of the polymeric base composition. The authors present detailed description of the combined osteosynthesis methods on a basis of use of biocompatible polymeric fixatives according to the fracture localization, period of time elapsed since the moment of trauma etc., analyze the remote results of the treatment.
Approved in the experiment and employed in 60 patients in atypical resection of a lung were the antimicrobial biocompatible absorbable polymers--"Capromed DC threads and ESBADCh film--in combination with MK-7 cyanoacrylate++ glue for formation of hermetic pulmonary suture. This facilitated good smoothing out of the lung remainder, sharp decrease of microbial colonization at the site, where the mentioned polymers were used.
In the work, the experimental substantiation and results of clinical approbation++ of the new Capromed DC antibacterial polymeric threads are given. It was established that the threads had no negative effect on reparative processes, created local concentration of an antiseptic, reduced the inflammatory reaction and microbial colonization. This contributed to decrease in the incidence of postoperative complications related to the quality of a suture material.
Antibacterial threads "Kapromed DKh" were used in experiments and clinic for the formation of lung sutures in combination with the antimicrobial film ESBADKh with the cyanacrylate glue. The application of polymers exerts a positive effect upon the regeneration of the lung wound and reduces the frequency of postoperative complications associated with the disturbed hermetic property of the suture and the development of the inflammatory process.
The authors have used grafts for stabilization of the spine in 16 patients including 12 patients after anterior decompression of the spinal cord and in 4 patients with spondylodesis. The grafts were used in combination with osteoplasty with autografts taken after resection of the vertebral bodies. The osseous block took place on the average 4 weeks earlier as compared with auto--and allobone owing to the autografts. Biodestruction and substitution of the allograft by bone tissue went on without kyphosis formation on the operation level.
The work is devoted to operative treatment of children with repeated dislocations and ankyloses of the hip joint after operative treatment of congenital dislocation of the hip. The dura mater, demineralized allocups and polymer self-resolving film were used as interlayers. Best results were obtained in arthroplasty with using demineralized allocups, polymer self-resolving film or their combinations.
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