scholarly journals The benefits of early surgical treatment of deep cervical burns in children

2020 ◽  
Vol 8 (1) ◽  
pp. 25-34
Author(s):  
Pavel A. Gnipov ◽  
Alexey G. Baindurashvili ◽  
Marina A. Brazol ◽  
Ekaterina V. Mitrofanova ◽  
Maxim R. Melnikov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Main Group ◽  
Control Group ◽  
Surgical Removal ◽  
Treatment Results ◽  
The Third ◽  
Graft Success ◽  
The Moment ◽  
Early Surgical Treatment

Background. The frequency of deep cervical burns in children is four times higher than that of deep face burns. Currently, there is no consensus on the methods for surgical treatment of deep burns in cervical areas; meshed skin autografts continue to be used. Aim. To evaluate the benefits of early surgical treatment of deep сervical burns in children between the third and fifth days from the moment of injury. Materials and methods. Case-control study. Surgical treatment was performed in 81 children with deep cervical burns. The main group with early surgical treatment included 46 children and underwent surgical treatment at 3.37 0.14 days from the moment of injury; the control group received autograft during stage treatment for 35 children at 27.17 0.18 days. The treatment results were evaluated by the following indicators: the number of dressing changes, the period of skin restoration, and the area of graft success. In the long term, functional and cosmetic treatment results were evaluated. Results. In the study and control groups, 7.93 0.45 and 18.75 0.61 dressings were required to complete the treatment, respectively (p 0.001). The skin restoration periods were 16.54 0.68 and 36.94 0.89 days, respectively (p 0.001). The graft success areas were 99.50% 0.13% in the main group and 93.91% 2.68% in the control (p 0.001). During the staged surgical treatment, one patient showed a loss of 90% of the graft, which required regrafting. Other complications in the treatment process have not been noted. When assessing long-term cosmetic results using the Vancouver Scar Scale, the average score was 4.0 0.26 points in the main group and 7 0.28 points in the control (p 0.001). The presence of post-burn cicatricial contracture in the main group was noted in 12 (26%) people and the absence in 34 (74%) children. In the control group, 20 (57%) patients required surgical removal of post-burn deformity, and 15 (43%) children did not need further surgical interventions. Conclusions. Early surgical treatment of deep cervical burns in children on the third and fifth days from injury allows not only to accelerate the process of restoration of the skin but also to directly affect the cosmetic and functional results in a better way.

scholarly journals Structure, diagnosis, prevention and treatment of postoperative complications of childbirth perineal tears complicated by anal incontinence

2015 ◽  
Vol 96 (5) ◽  
pp. 779-783
Author(s):  
S G Sultanova
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Anal Canal ◽  
Anal Incontinence ◽  
Main Group ◽  
Long Term Results ◽  
Control Group ◽  
Perineal Tears ◽  
Second Degree

Aim. Improving the results of surgical treatment of complications of second and third degree perineal tears complicated by anal incontinence. Methods. The study included 248 patients aged 16 to 50 years. The patients were allocated to three groups: the first group - 40 women who underwent traditional surgery and conservative treatment; the second group - 128 women with second degree perineal tear; group III - 80 women who underwent sphincteroplasty (I option) and sphincteroplasty combined with levatorplasty (II option) in our modification (sphincter-saving surgery with precision sutures). The main group included 111 patients who additionally received conservative treatment [1 mL of 1% enoxaparin sodium intravenously and 1 ml of 30% vitamin E (alfa-tocopherol acetate) by intramuscular injection]; control group - 97 patients who underwent standard treatment. Long-term results were assessed by a survey, physical examination in the clinic, telephone and Internet surveys in 35 patients of the main group and 31 women of the control group. Results. In 91 (82%) patients of the main group, the pain intensity decreased after 7-10 days of treatment was antioxidants, 8 (7.2%) patients had pain in the perineum or anal canal, in 12 (10.8%) cases intense pain in the anal canal were still present. Long-term results were evaluated as good in 16 (51.6%) and 25 (69.4%) patients, as satisfactory - in 9 (29%) and 8 (22.2%) patients, as unsatisfactory - 6 (19.4 %), and 3 (8.3%) patients of the main and the control groups, respectively. The test group showed earlier formation of granulation tissue (3.1±0.3 days earlier compared to the control group). At sphincterometry on the 12th day, 6 patients of the control group had first degree anal incontinence, 3 - second degree anal incontinence compared with only 1 (1.8%) case in the study group (second degree sphincter incontinence). Conclusion. A proposed diagnostic strategy in women with anal incontinence due to perineal tears of II-III degrees after the labor trauma, allowed choosing the optimal method of surgical treatment and improving treatment outcomes.

scholarly journals Standard open operative interventions in surgical treatment of patients, suffering an acute complicated pancreatitis

2018 ◽  
Vol 85 (7) ◽  
pp. 27-29
Author(s):  
V. P. Аndriushchenko ◽  
D. V. Аndriushchenko ◽  
Yu. S. Lysiuk
Keyword(s):  
Surgical Treatment ◽  
Comparison Group ◽  
Surgical Intervention ◽  
Main Group ◽  
Control Group ◽  
Treatment Results ◽  
Surgical Interventions ◽  
Second Stage ◽  
Standard Operations

Objective. To determine the character and optimal volume of standard open surgical interventions in an acute complicated pancreatitis (ACP) with elaboration of the main technical elements of the operations. Маterials and methods. There were operated 96 patients, suffering ACP. The main group consisted of 47 patients, in whom open interventions were performed primarily in 19, and as the second-stage procedure after application of miniinvasive interventional technologies (МIТ) – in 28. The comparison group consisted of 49 patients, in whom standard operations were done only. Results. Application of MIТ have promoted the indications narrowing for performance of primary open operations more than twice. In the main group the arcuate-like subcostal access was applied predominantly - in 26 (55%) observations (χ²=14.287; р=002), while in a control one – a median upper laparotomy – in 37 (76%) observations (χ²=38.43, р < 0.001). The method of closed draining in accordance to procedure of Beger was used predominantly in the main group of patients – in 43% of observations, comparing with a control group - 9% of observations (χ²=12.965; р=0.003). In 23% patients of the main group and in 26% patients of a control one (χ²=0.0013; р=0.05), when the extended purulent-necrotic inflammation process have presented, a staged sanation was applied, using programmed relaparotomies. Some technical elements of the surgical intervention were improved. Conclusion. Application of standard open operations in accordance to elaborated principle is accompanied by improvement of the treatment results in patients, suffering ACP.

The results of surgical treatment of the patients with a cochlear form of otosclerosis

2019 ◽  
Vol 18 (5) ◽  
pp. 46-53
Keyword(s):  
Surgical Treatment ◽  
Bone Conduction ◽  
Functional Results ◽  
Main Group ◽  
Differential Diagnostics ◽  
Control Group ◽  
Efficient Treatment ◽  
And Control

Despite the progress in otosurgery, the efficient treatment of patients with the cochlear form of otosclerosis (according to the classification of N.A. Preobrazhensky, 1962) remains an important task. The authors have developed and implemented an advanced stapedoplasty method, providing the improvement of hearing in this category of patients. and described the methods of differential diagnostics for selection of patients according to the developed method. The article describes in details the early and long-term functional results of surgical treatment of 60 patients with cochlear and mixed II forms of otosclerosis, divided into the main and control groups. The main group is represented by 30 patients who underwent a cartilage-on-vein stapedoplasty according to the improved method. The control group included 30 patients, in which 18 people underwent a cartilage-on-vein stapedoplasty according to the method developed by Lenin Prize winner V. F. Nikitina, and 12 people who underwent V. T. Palchun’s piston stapedoplasty. The results demonstrate a statistically significant improvement of bone conduction in the main group in average by 15–20 dB throughout the entire tone scale (except for high frequencies in some patients) and the complete closure of the bone-air interval with subsequent preservation of the results. Based on the obtained data, the authors present the expediency and perspectivity of implementation of the advanced stapedoplasty method.

scholarly journals SURGICAL TREATMENT OF PATIENTS WITH FRACTURES OF THE CALCANEUS

2020 ◽  
Vol 19 (1) ◽  
pp. 109-112
Author(s):  
M. Gasko ◽  
P. Kovalchuk ◽  
S. Tulyulyuk ◽  
D. Gasko
Keyword(s):  
Surgical Treatment ◽  
Closed Reduction ◽  
Skin Necrosis ◽  
Image Intensifier ◽  
Long Term Results ◽  
Treatment Results ◽  
The Third ◽  
Articular Fractures ◽  
Heel Bone

The article analyzes the results of treating 45 patients with fractures of the calcaneus. To study the effectiveness of the treatment of patients with fractures of the heel bone, all patients were divided into three clinical groups. The first group consisted of 12 (26,60 %) patients with extra-articular fractures of the calcaneus, which was carried out surgery using the screws and wire loop. The second group is represented by 19 (42,30 %) patients with intra-articular fractures of the calcaneus, who underwent closed reduction under image intensifier control and locking the spokes. The third group included 14 (31,10 %) patients with intra-articular fractures of the calcaneus, which held an open reduction and osteosynthesis with plates and screws. In 4 (28,6 %) patients in the postoperative period were observed skin necrosis, 3 (21,4 %) patients came deforming ar-throsis of the subtalar joint with severe pain and impaired gait and only 7 (50,0 %) patients with good results treatment – 79 points on the AOFAS scale. Thus, the analysis of the long-term results of surgical treatment of intra-articular fractures of the calcaneus has shown that the use of closed reduction under image intensifier control and locking the spokes leads to better treatment results and reducing the time of disability.

scholarly journals Comparison of the Effectiveness of Antiglaucomatous Surgeries with Various Glautex Drainage Models

2019 ◽  
Vol 16 (1S) ◽  
pp. 91-95 ◽  
Author(s):  
I. I. Khusnitdinov ◽  
A. E. Babushkin
Keyword(s):  
Surgical Treatment ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Hypotensive Effect ◽  
Main Group ◽  
Control Group ◽  
Open Angle ◽  
The Third ◽  
Total Failure ◽  
The Absolute

Purpose: comparative study of trabeculectomy results with various models of domestic “Glautex” drainage in the surgical treatment of primary open angle glaucoma (POAG). Patients and methods. The results of surgical treatment of 98 (105 eyes) patients with POAG aged 50–83 years who underwent trabeculectomy with various Glautex drainage models were analyzed. There were 43 men (43.9 %) and 55 (56.1 %) women. The second (II) stage of POAG was diagnosed in 49 eyes (46.7 %), the third (III) stage in 56 (53.3 %). All patients were divided into 3 groups. The first (main) group consisted of 34 (37 eyes) patients who underwent trabeculectomy in combination with the implantation of Glautex DDA drainage model. The second (main) group included 29 (30 eyes) patients with trabeculectomy and implantation of the SDA model of this drainage. The third group was the control group and consisted of 35 (38 eyes) patients with the classical method of surgery without using any drainage. Results. There was a significant 71.7 % decrease in IOP compared with baseline data in the 1st patients group after antiglaucomatous surgery, 72 and 74 % decrease was in the 2nd and 3rd groups respectively (p < 0.05). An increase in IOP was noted predominantly in the control and in the second study group within 1 month of follow-up. Normalization of ophthalmotonous pressure was achieved by using needling in 13.3 % (4/30) patients in the second group, in 7.9 % (6/38) cases in the control group. The absolute hypotensive effect in the 1st group was noted in 75.7 % of cases; the relative hypotensive effect was in 8.1 %; total failure was in 16.2 %. In the 2nd group the absolute hypotensive effect of the surgery was in 73.3 % of 30 cases, the relative was in 6.7 %, total failure was in 20 %. In the control group (38 eyes), absolute success was in 63.1 %, the relative hypotensive effect was in 13.2 %, and the total failure was in 23.7 %. Conclusion. Trabeculectomy with Glautex drainage and with various models in case of primary open-angle glaucoma provided a sufficiently high relative hypotensive effect in 82 % of cases in a year after the surgery. The achieved surgery outcomes with this drainage in the studied periods did not depend on applied model: DDA or SDA (83.8 and 80 % respectively), but was higher than the classical trabeculectomy (76.3 %). However, in case of the SDA model, needling was required in 13.3 % of cases in the early postoperative period. 

NON-INVASIVE METHODS FOR DAMAGE DIAGNOSIS OF MENISUS OF THE KNEE JOINT

Vestnik ◽  
2021 ◽  
pp. 162-165
Author(s):  
Е.Н. Набиев ◽  
А.Р. Байзаков ◽  
У.А. Абдуразаков ◽  
Р.А. Аскеров ◽  
И.М. Лиров ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Knee Joint ◽  
Exercise Therapy ◽  
Main Group ◽  
New Method ◽  
Control Group ◽  
Treatment Results ◽  
Non Invasive ◽  
Meniscus Suture ◽  
Early Passive

Цель исследования: оптимизация результатов хирургического лечения пациентов с повреждениями менисков коленного суставас использованием малоинвазивной органосохраняющей технологии «сшивания мениска». В статье приведены результаты хирургического лечения 70 больных с повреждениями менисков коленного сустава, лечившийся ГКП на ПХВ ГКБ № 7 г. Алматы за период с 2017 по 2020 гг. Все больные были распределены на контрольную и основную гроуппу. В контрольную группу вошли 40 (57,2%) больных. Им выполнена артроскопическая резекция мениска. Коленный сустав не иммобилизовали, больные получали физиолечение, ЛФК и массаж. 30 (42,8%) больных отнесены к основной группе, которым выполнен шов менисков под астроскопом по новому способу (свидетельство на авторское право № 9602 от 04.05.2020.). Коленный сустав иммобилизовали на 4 недель, больтные получали также физиолечение, ЛФК и массаж конечности. Комплексное лечение больных с использованием нового способа артроскопического сшивание мениска (свидетельство на авторское право № 9602 от 04.05.2020.), ранние активные движения в здоровых суставах нижней конечности (голеностопных и тазобедренных со второго дня) и ранние пассивные и активные движения в оперированном коленном суставе (со второго дня), поздняя нагрузка на оперированную конечность (через 4 недель), способствовало в 96,7% случаях получить хороших и удовлетворительных результатов лечения у пациентов основной группы. Частота неудовлетворительных исходов лечения в основной группе встречается на 6,2% реже в сравнении с пациентами контрольной группы. Objective of the study: to optimize the results of surgical treatment of patients with injuries of the knee menisci using the minimally invasive organ-preserving technology of "stitching the meniscus". The article presents the results of surgical treatment of 70 patients with injuries of the knee menisci, who were treated by the MCP at the PCV City Clinical Hospital № 7 in Almaty for the period from 2017 to 2020. All patients were divided into control and main groups. The control group included 40 (57.2%) patients. He performed arthroscopic resection of the meniscus. The knee joint was not immobilized, the patients received physiotherapy, exercise therapy and massage. Thirty (42.8%) patients were referred to the main group, who had meniscus suture performed under an astroscopic technique using a new method (copyright certificate № 9602 dated 05/04/2020). The knee joint was immobilized for 4 weeks, the patients also received physiotherapy, exercise therapy and limb massage. Complex treatment of patients using a new method of arthroscopic suturing of the meniscus (copyright certificate № 9602 dated 05/04/2020), early active movements in healthy joints of the lower limb (ankle and hip from the second day) and early passive and active movements in the operated knee joint (from the second day), late loading on the operated limb (after 4 weeks), contributed in 96.7% of cases to obtain good and satisfactory treatment results in patients of the main group. The incidence of unsatisfactory treatment outcomes in the main group is 6.2% less common in comparison with patients in the control group.

Limbal conjunctival approaches to extraocular muscles in the surgical treatment of previously operated strabismus

2021 ◽  
pp. 27-32
Author(s):  
V.N. Kurochkin ◽  
◽  
Y.I. Trilyudina ◽  
Keyword(s):  
Surgical Treatment ◽  
Strabismus Surgery ◽  
Main Group ◽  
Cosmetic Result ◽  
Control Group ◽  
Good Cosmetic Result ◽  
Tenon’S Capsule ◽  
Good Cosmetic ◽  
Tenon's Capsule

Purpose. Тo analyze clinical efficacy of the surgical treatment of previously operated strabismus using limbal incisions which are lengthening the conjunctiva and Tenon's capsule. Material and methods. The study included 440 patients (440 eyes) with previously operated strabismus at the age of 4 to 68 years old. The main group included 240 patients (240 eyes) who underwent strabismus surgery by limbal approach; the control group included 200 patients (200 eyes) who underwent surgery by paralimbal conjunctival approach. Horizontal strabismus occurred in 146 patients (60,8%) in the main group and in 158 (79%) in the control group. Horizontal strabismus in combination with vertical strabismus was found in 94 patients (39.2%) in the main group and in 42 patients (21%) in the control group respectively. The following approaches were applied: Y-shaped limbal approach, T-shaped incision of the conjunctiva, lower limbal peritomy, circular limbal approach with an additional horizontal incision towards the muscle being strengthened. Results. Good cosmetic result in the main group was achieved in 94.7% of cases, in the control group in 87% of cases, р<0.001. Re-surgery in the long term period was required for 39 patients (19.5%) in the control group and 14 patients (7%) in the main group, р<0.001. Conclusion. Limbal approaches performed to lengthening the conjunctiva and Tenon's capsule on the side of the weakened muscle and shortening on the side of the muscle being strengthened, are enhancing the effect of recession and resection, thereby contributing to the achievement of the state of orthotropy in 83% and have a good cosmetic result in 94.67% of cases. Key words: limbal conjunctival approaches, limbal conjunctival incisions, strabismus, children.

Reconstruction of Deltoid Ligament Using Low Invasive Surgical Technique at Treatment of Ankle Joint Fractures

2009 ◽  
Vol 16 (2) ◽  
pp. 29-33
Author(s):  
A B Kazantsev ◽  
V G Golubev ◽  
Pavel Pavlovich Chekeres ◽  
S M Putyatin ◽  
Yu M Kashurnikov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Excellent Result ◽  
Main Group ◽  
Ligament Injury ◽  
Control Group ◽  
Deltoid Ligament ◽  
Treatment Technique ◽  
Joint Stability ◽  
Treatment Results ◽  
American Orthopaedic

Comparative analysis of treatment results of 68 patients with malleolus fractures and injury of deltoid ligament was performed. Depending on the treatment technique all patients were subdivided into four groups. Main group - surgical treatment of fractures and reconstruction of deltoid ligament with Twinflix screw (n=30), comparative groups - surgical treatment of fractures with transcutaneous suturing of deltoid ligament (n=10) and ligament plasty with Р -shaped sutures (n=8); control group - conservative treatment of fractures and deltoid ligament injury (n=20). Follow-up time made up 6 months - 2 years. Evaluation of treatment results was performed by adopted scale of American Orthopaedic Foot and Ankle Society. Patients were examined using clinical and roentgenologic methods as well as ultrasound and rheovasography. In the main group excellent result was achieved in 23.1%, good result - in 65.3%, satisfactory - in 11.6% of patients. In control group they made up 16.8%, 61.2% and 19.5%, respectively, with poor result in 2.5% of patients. It was demonstrated that application of low invasive osteosynthesis in combination with reconstruction of deltoid ligament using Twinfix screw reduced considerably the probability of posttraumatic arthrosis development as well as provided for complete restoration of the ligament with preservation of its elastic properties and joint stability.

Tenorrhaphy as an Alternative to Resection in the Treatment of Horizontal Strabismus in Children

2020 ◽  
pp. 26-30
Author(s):  
Y.I. Trilyudina ◽  
◽  
V.N. Kurochkin ◽  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Modified Technique ◽  
Resection Control ◽  
Standard Resection ◽  
Alternative Method ◽  
Additional Correction

Purpose. To evaluate the effectiveness of surgical treatment of horizontal strabismus by modified tenorrhaphy in comparison with standard resection in children. Material and methods. For 3 years (2017–2019), 560 patients with horizontal strabismus at the age from 2 to 14 years were operated. Of these, 288 patients (51.4%) underwent tenorrhaphy using a modified technique (main group) as augmentation surgery, 272 patients (48.6%) underwent classical resection (control group). Results. The average age of patients in the main group was 6 (3.46) years, in the control group – 5.8 (3.34) years. In the main group of patients, orthotropy was achieved in 85.4% of cases, in the control group – in 83.5% of cases, p = 0.523. The residual strabismus angle (up to 5°) was observed in 40 patients (14%) in the main group and in 44 patients (16.5%) in the control group of patients, p = 0.449. In the main group, additional correction of the residual angle was performed on the day after the operation using adjustable suture in 8 patients (2.8%). Reoperation in the long-term period was required for 10 patients (3.7%) in the control group and 3 patients (0.7%) in the main group, p = 0.039. Significant postoperative conjunctival thickening was found in 7.2% of patients in the main group. Conclusion. The effectiveness of tenorrhaphy is not inferior to classical resection and, in combination with recession (tenomyoplasty), gives predictable stable results. The tenorrhaphy method is technically simpler, safer, more physiological, can be easily corrected in the immediate postoperative period, has no risk of «losing» muscle and can be recommended as an alternative method of resection.

scholarly journals Tactics of surgical treatment of deep intermuscular gluteal region phlegmons

2021 ◽  
Author(s):  
E.N. Byakova ◽  
V.K. Tatyanchenko ◽  
V.L. Bogdanov ◽  
Y.V. Sukhaya ◽  
Y.V. Krasenkov
Keyword(s):  
Surgical Treatment ◽  
Soft Tissues ◽  
New Technologies ◽  
Main Group ◽  
Gluteal Region ◽  
Control Group ◽  
Tissue Pressure ◽  
Results Of Treatment ◽  
Purulent Wound

Purpose. The purpose is to improve the results of treatment of patients with phlegmon of the gluteal region soft tissues by diagnosing the stage of tissue hypertension and determining the tactics of surgical treatment depending on this indicator. Materials and methods. Clinical studies were performed on 74 patients suffering from phlegmon of the gluteal region. All the patients were divided into 2 groups: in the main group (as opposed to the control group), acute tissue hypertension syndrome was diagnosed and decompressive fasciotomy was performed in tissue hypertension (30–35 mm Hg) (patent). The authors performed ultrasound cavitation and ozone therapy of a purulent wound. Results. With phlegmon of the gluteal region of soft tissues, an increase in tissue pressure by 25% above the norm is an indication for fasciotomy in the area of fascial nodes. The time of purulent wound cleaning against the background of normal tissue pressure (8–10 mm Hg) of the surgery in patients of the main group was reduced to 5 days (8 days in the control). In the long-term (0.5–1 years), good results were obtained in 92.8% of patients in the main group (64.7% in the control group). Conclusion. The developed tactics of treatment of patients with phlegmon of the soft tissues of the gluteal region are highly effective due to the development and application of new technologies for the diagnosis and treatment of tissue hypertension.

Sign in / Sign up

Export Citation Format

Share Document