[SOME PROBLEMS OF ANESTHESIA AND POSTOPERATIVE CARE OF CHILDREN IN THE SURGICAL TREATMENT OF OSTEOARTICULAR TUBERCULOSIS].
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Chemotherapy for tuberculosis in general and osteoarticular tuberculosis in particular poses certain peculiar problems that include chronicity of infection, infection by resistant mycobacteria, persistent mycobacteria, possibility of concomitant human immunodeficiency virus infection, and drug toxicity during prolonged treatment. Although the success rate of chemotherapy is greater than 90% with optimum drug combination regimens currently used, there is a need for additional improvement. A successful outcome depends on using an optimum regimen, which contains safer and more effective drugs given regularly for an adequate period. The most important cause of treatment failure is poor patient compliance, which can be improved by using supervised drug treatment programs. In a few patients, surgical removal of infected tissue may be indicated to improve the efficacy of chemotherapy. In the future, safer and more effective antimycobacterial and anti-acquired immunodeficiency syndrome drugs may become available. Research in various related fields also is expected to additionally improve prophylaxis and treatment.
The paper provides the results of using original procedures for revascularization of the osseous bed and free bony grafts by transplanting osteovascular complexes in patients with tuberculosis of the hip joint and spine. A total of 20 patients with tuberculous coxitis and 14 with spondylitis were operated on. These interventions were found to have advantages over plastic surgery with bony grafts and mobilizing operations without plasty in similar skeletal lesions, appeared as a great scope of movements in the operated joints is achieved, less time for grafts to adhere with the bed and bony block of vertebrae, and enhanced accumulation of a radioopaque agent in the area to be replaced.
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