scholarly journals Changes in Indicators of Microcirculation in the Early Postoperative Period in the Treatment of Diaphyseal Fractures of the Shin Bones Using a Plate with Limited Contact

2019 ◽  
Vol 4 (3) ◽  
pp. 58-62
Author(s):  
A. I. Plakhov ◽  
L. I. Kolesnikova ◽  
L. I. Korytov ◽  
V. G. Vinogradov ◽  
M. A. Darenskaya
Keyword(s):  
Postoperative Period ◽  
Lower Limb ◽  
Blood Circulation ◽  
Early Period ◽  
Metal Plate ◽  
Early Postoperative Period ◽  
Control Group ◽  
Doppler Flowmetry ◽  
Results Of Treatment ◽  
Diaphyseal Fractures

Background. Unsatisfactory results of treatment, such as delayed consolidation and non-fusion of fractures, the formation of false joints and limb bone defects, have no tendency to decrease. We can assume that one of the leading factors of complications in traumatology is a violation of microcirculation in the affected segment of the limb.Aims. To identify patterns of changes in the parameters of the microcirculatory bed of the damaged segment of the lower limb when fixing bone fragments with a plate with limited contact in the early period after surgery.Materials and methods. In 25 patients, we studied four parameters of microcirculation of the lower limb segment with application of laser Doppler flowmetry. The control group consisted of 25 healthy volunteers, comparable in age and sex with the study group.Results. We found that in the early postoperative period (from the first to the 10th day after the surgery) in patients with diaphyseal fractures of the tibia operated with metal plate with limited contact there was an increase in microcirculation by 75.69 %, an increase in the proportion of the nutritive component of microcirculation compared to the shunt fraction by 24.64 %, as well as an increase in more than one ratio of the amplitude of the heart and respiratory range. All of that indicates a local circulatory disorder in the nutritive arterial hyperemia. We note that the increase in the amplitude of the respiratory component by 17.22 % and the equality of the amplitude of the cardiac range compared with the control group indicate violations of local blood circulation by the type of venous stagnation.Conclusion. On the basis of the results obtained, we note that patients with diaphyseal fractures of the shin bones treated with metal osteosynthesis with a plate with limited contact in the early postoperative period develop a violation of local blood circulation in the stagnant-hyperemic type.

scholarly journals The comparative analysis of MRI data in the early period after lumbar microdiscectomies with epidural injection of polyacrylamide hydrogel

2021 ◽  
Vol 27 (2) ◽  
pp. 16-24
Author(s):  
Eugene G. Pedachenko ◽  
Mykhaylo V. Khyzhnyak ◽  
Olena P. Krasylenko ◽  
Yuriy E. Pedachenko ◽  
Olexandr F. Tanaseychuk ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Postoperative Period ◽  
Early Period ◽  
Epidural Injection ◽  
Early Postoperative Period ◽  
Herniated Disc ◽  
Control Group ◽  
Epidural Administration ◽  
Polyacrylamide Hydrogel ◽  
Spinal Root

Objective: To perform a comparative analysis of MRI data obtained in the early postoperative period after repeated lumbar microdiscectomies in patients with and without epidural injection of “Nubiplant” polyacrylamide hydrogel (HG). Material and methods: The MRI data of the lumbar spine in the early postoperative period after repeated removal of herniated disc (on the 3-15th day) in 84 (100%) patients were analyzed: 30 (35,7%) patients were injected intraoperatively epidurally with “Nubiplant” HG to prevent epidural fibrosis (main group (MG) and in 54 (64,3%) patients the HG was not injected (control group (CG). Results: Comparative analysis of MRI data on the 3-15th day after surgery showed that the frequency of epidural edema and hemorrhage signs within the postoperative area in the MG was significantly lower as compared to the CG (p = 0,0444 and p = 0,0288 respectively). To assess the accuracy of the epidural administration of an artificial biopolymer Nubiplant during lumbar microdiscectomy, in the early postoperative period the following MRI criteria could be helpful: i) absence of the dural sac deformation and dislocations of the spinal root; ii) well-defined margin of the adjacent spinal root; iii) homogeneous MRI signals of the Nubiplant zone; iv) absence of Nubiplant areas outside the postoperative area; v) sufficient sectoral coverage of the adjacent root with epidurally administered Nubiplant (optimally >1800). Nubiplant” HG in the patients of the MG was evaluated, and MRI criteria for assessing the correctness of its introduction were proposed. Conclusions: In the early period after repeated lumbar microdiscectomies (on the 3-15th day), intraoperative epidural injection of “Nubiplant” HG was accompanied by a significant decrease of epidural edema and hemorrhage signs within the postoperative area. The proposed criteria of correctness of HG “Nubiplant” introduction allow unifying the approaches in radiological assessment of this patients.

scholarly journals The Effects of Vibration and Pressure Treatments in the Early Postoperative Period of Rhinoplasty

2019 ◽  
Vol 40 (6) ◽  
pp. 605-616 ◽  
Author(s):  
Süleyman Taş
Keyword(s):  
Postoperative Period ◽  
Early Postoperative Period ◽  
Control Group ◽  
Level Of Evidence ◽  
Vibration Treatment ◽  
The Face ◽  
Anti Inflammatory ◽  
Group 2 ◽  
A Prospective Study ◽  
Nasal Cast

Abstract Background The early postoperative period can be distressing for the patients undergoing rhinoplasty since edema and ecchymosis are common complications. Objectives To analyze the effects of the vibration and pressure treatments in the early postoperative period of rhinoplasty. Methods Sixty patients, who had undergone rhinoplasty, were randomized into 3 groups: group 1 (control group, n = 20) received classic nasal casting, group 2 (n = 20) received nasal cast with an elastic bandage to hold it on the face, and group 3 (n = 20) received vibration treatment in addition to that in group 2 following the rhinoplasty. They were evaluated preoperatively and postoperatively at 3 and 7 days in a prospective study. The postoperative edema and ecchymosis were scored by 2 independent surgeons. The postoperative pain was measured using the visual analog scale, and the necessity of anti-inflammatory medication (and the dose needed) and the cast comfort was questioned. The sebaceous activity of the nose skin was examined. A preoperative and postoperative seventh day sonographic study was performed to evaluate the tissue edema objectively. Results The pressure treatment decreased the edema and ecchymosis significantly compared with the control group. The vibration treatment minimized edema, ecchymosis, sebaceous activity of the nose skin, pain score, and the need for anti-inflammatory medication, and increased the cast comfort significantly compared with the other groups (P < 0.0001). Conclusions Rapid regression of edema and ecchymosis may be achieved using the vibrating nasal cast technique that may minimize patient discomfort, pain, and sebaceous activity following rhinoplasty. Level of Evidence: 1

Acceptance of Illness after Surgery in Patients with Breast Cancer in the Early Postoperative Period

2015 ◽  
Vol 87 (11) ◽  
Author(s):  
Andrzej Nowicki ◽  
Elżbieta Krzemkowska ◽  
Piotr Rhone
Keyword(s):  
Breast Cancer ◽  
Postoperative Period ◽  
Early Period ◽  
Conservative Surgery ◽  
Early Postoperative Period ◽  
Economic Situation ◽  
White Collar Workers ◽  
Acceptance Of Illness ◽  
High Level ◽  
Type Of Surgery

AbstractThe breast cancer is the most common cancer in women, both in Poland and in the world. Consequences entail a disruption in the physical, psychological and social functioning.was to assess the acceptance of illness by patients treated for breast cancer in the early postoperative period.The research was conducted on the group of 100 consecutive patients aged 32-80 years (median 56 years) who underwent surgery for breast cancer in the Centre of Oncology in Bydgoszcz w 2014 roku. 68 of women had mastectomy, 32 of women had conservative surgery. Polling was conducted in the early period after surgery. The original questionnaire containing closed questions the scale of acceptance of the disease (AIS) as well as mental adaptation to cancer (Mini-Mac) was used in the study.38% of patients had high acceptance of the disease, 48% averageand 14% had low acceptance. Patients after conservative surgery had a higher average values for the mental strategies to cope with the disease, for the fighting spirit (23.1), helplessness and hopelessness (13.5), positive revaluation (23), the patients had a lower average (16.5) in the strategy to absorb anxiety. Patients after conservative surgery had a higher average for constructive style (2.6) but lower for destructive style (1.5). High level of mental coping with the disease was observed in 53%of patients with constructive style and 4% of patients with destructive style. While, a low level of mental coping with the dosease was observed in 5% of patients with constructive style and 46% of patients with destructive style.Almost half of women after mastectomy or conservative surgery had an average acceptance of the disease. The disease was accepted best by educated women living in the cities, white-collar workers with a good economic situation. The following factors were affected the better management of the disease, in order: age, education, current occupation and economic situation, while the type of surgery did not affect better management. More than half of women, regardless of the type of surgery reflected the high level of constructive style.

scholarly journals IMPROVING THE RESULTS OF TREATMENT OF PATIENTS WITH URETERAL CONCREMENTS AFTER CONTACT URETEROLITHOTRIPSY

2017 ◽  
Vol 4 (2) ◽  
pp. 8-12
Author(s):  
R. M. Solh ◽  
M. I. Andrukhin ◽  
O. V. Makarov ◽  
V. V. Fedchenkov
Keyword(s):  
Laser Therapy ◽  
Postoperative Period ◽  
Acute Pyelonephritis ◽  
Main Group ◽  
Ureteral Stones ◽  
Control Group ◽  
Results Of Treatment ◽  
Group 6 ◽  
Beta 2 ◽  
Beta 2 Microglobulin

Purpose. Im proving the results of treatment of patients with ureteral stones and reducing the dam aging effects of contact lithotripsy.Materials and methods. In this study, 48 patients were examined aged 20 to 63 years. All patients admitted to the urology department with diagnoses: urolithiasis, calculus of the ureter. In all cases contact ureterolithotripsy with stenting of the upper urinary tract were performed. The patients were divided into two groups: main and control. 25 patients (52 .1%) were included into the main group, which in the postoperative period, we used low-level laser therapy (L-therapy). 23 patients were included in a control group (47.9%) who did not receive low-laser therapy. Laboratory tests and ultrasound with Doppler renal blood vessels scan were performed on admission, on the first day after the operation and on the 5-th day of hospitalization. Low-intensity laser therapy was performed within 5 days after contact ureterolithotripsy on projection of placement of stone and kidney projection by series for 5 minutes.Results. All patients admitted to the hospital, were spared from ureteral stones. In the main group during the treatment with L-therapy a decrease in the level of beta-2 microglobulin to normal was observed. (4.8 ± 0.1 mg/l on the first day. On the 5th day 2 .3 + 0.1 mg/l). In the control group during the treatment without the use of L-therapy, the average level of beta-2 microglobulin decreased but did not reach normal levels. (5.5 ± 0.1 mg/l on the first day. On the 5th day 3,2 ±0, l mg/l).Resistance index in the study group decreased compared to the control. In the control group, cases of acute pyelonephritis were observed. The average hospital stay for patients of the main group (6 days) was less than in the control group (6 .5 + days).Conclusion. The use of laser therapy in the treatment of patients who did undergo ureterolithotripsy can reduce the length of stay of the patient in the hospital and reduce the risk of acute pyelonephritis in the postoperative period. Also it can reduce the damaging effect of lithotripsy on the renal tissues.

scholarly journals Peripheral microcircuiation in patients over 60 years with atherosclerosis of lower limb arteries

2015 ◽  
Vol 17 (2) ◽  
pp. 22
Author(s):  
O. V. Kamenskaya ◽  
A. S. Klinkova ◽  
A. A. Karpenko ◽  
A. M. Karaskov ◽  
V. B. Starodubtsev ◽  
...  
Keyword(s):  
Lower Limb ◽  
High Volume ◽  
The Elderly ◽  
Early Postoperative Period ◽  
Lower Limbs ◽  
Orthostatic Test ◽  
Doppler Flowmetry ◽  
Functional Reserves ◽  
Before And After ◽  
Fontaine Classification

We investigated peripheral microcirculatory blood flow (MBF) by using laser Doppler flowmetry in 146 patients with IIB-IV stage chronic ischemia of lower limbs (CILL) according to the Pokrovsky-Fontaine classification. The objective was to study the state of peripheral MBF while carrying out functional tests in patients over 60 years with IIB-IV stage CILL before and after revascularization of lower limb arteries. When ageing, CILL patients demonstrate a decrease in the peripheral MBF baseline indicators and an increase in the quantity of defects of regulatory mechanisms and functional reserves of microcirculation, which manifest themselves as a severe paradoxical reaction of the microvasculature during an orthostatic test. In the early postoperative period the elderly patients tend to have reduced functional reserves and regulation mechanisms of MBF, with a high volume and degree of severity of MBF paradoxical reactions during an orthostatic test.

scholarly journals Photodynamic therapy in the treatment of stomach cancer

2018 ◽  
Keyword(s):  
Photodynamic Therapy ◽  
Postoperative Period ◽  
Intestinal Anastomosis ◽  
Effective Means ◽  
Combined Treatment ◽  
Early Postoperative Period ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Biopsy Channel ◽  
Small Intestinal

The analysis of the results of treatment of 10 patients with gastric cancer with high surgical risk, who in the treatment complex used photodynamic therapy with photosensitizer Photolon and further irradiation with a semiconductor laser with a wavelength of λ = 0.67 μm cross-irradiation fields introduced through the biopsy channel of the endoscope. Endoscopic PDT can be used at the stage of combined treatment in combination with drug therapy and surgical interventions and is an effective means of preventing the development of esopha- geal-small intestinal anastomosis failures in the early postoperative period. Endoscopic PDT can also be used in the postoperative period as a prophylaxis of early postoperative complications in cases of detection of tumor cells in the margins of resection.

scholarly journals Hybrid approach of arterial allograft application in reconstructive surgery of the great arteries

2021 ◽  
Vol 102 (1) ◽  
pp. 104-109
Author(s):  
R E Kalinin ◽  
I A Suchkov ◽  
V V Karpov ◽  
N A Solianik ◽  
A S Pshennikov ◽  
...  
Keyword(s):  
Balloon Angioplasty ◽  
Postoperative Period ◽  
Blood Circulation ◽  
Hybrid Approach ◽  
Clinical Situation ◽  
Early Postoperative Period ◽  
Patient Treatment ◽  
Tibial Arteries ◽  
Arterial Allograft ◽  
Dacron Prostheses

The article presents a case of a hybrid intervention using an arterial allograft on the great arteries of the lower extremities in a patient with chronic limb threatening ischemia and prosthetic infection. The patient has a history of repeated operations using synthetic polytetrafluoroethylene and dacron prostheses. In the early postoperative period, a clinical presentation of the prosthesis bed suppuration developed. The article shows the main phases of patient treatment: removal of synthetic prostheses, transplantation of the donor femoral artery, and balloon angioplasty of the popliteal and anterolateral arteries. In the postoperative period, blood circulation in the lower limb is fully compensated, and the dorsal pedis artery pulse is determined. Wounds were healed by primary intention. At the control visit after 6 months, no adverse events were revealed; according to the data of duplex scanning, the main blood flow in the arteries of the leg was recorded, the blood circulation was fully compensated. Thus, hybrid intervention using arterial allograft and balloon angioplasty of the popliteal and anterolateral tibial arteries proved to be an effective method of treatment in the current clinical situation.

scholarly journals Anti-Vascular Endothelial Growth Factor Therapy as an Adjunct to Diabetic Vitrectomy

2021 ◽  
Vol 15 (1) ◽  
pp. 137-143
Author(s):  
Mushfig Karimov ◽  
Lala Akhundova
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Vitreous Cavity ◽  
Control Group ◽  
Diabetic Vitrectomy ◽  
Clinically Significant ◽  
Bevacizumab Injection

Introduction: The purpose of this work is to study the efficacy of the preoperative intravitreal administration of bevacizumab as an adjunct to vitrectomy in patients with Proliferative Diabetic Retinopathy (PDR). Methods: This retrospective comparative study was performed on 118 eyes (118 patients) with proliferative diabetic retinopathy (PDR), which underwent vitrectomy surgery at the Department of Diabetic Eye Disease at Zarifa Aliyeva National Ophthalmology Centre (Baku, Azerbaijan) in 2015-2019. The main group (the bevacizumab group) included 48 eyes with PDR that received intravitreal administration of bevacizumab (Avastin; Genentech Inc., USA) within one week before vitrectomy; the control group included 70 eyes that did not receive a bevacizumab injection for at least 3 months before the vitrectomy. The minimum follow-up was 12 months. Results: In both groups, complete retinal attachment after primary vitrectomy was achieved in all eyes (100%). Clinically significant intraoperative haemorrhage was observed in the preoperative bevacizumab injection group in 31.2% and the control group- 51.4%, p = 0.030. The preoperative bevacizumab injection reduced the risk of clinically significant haemorrhage by 2.3 times and the need for endodiathermy by 2.7 times (p = 0.031 and p = 0.024, respectively). Early vitreous cavity haemorrhage was observed in 15.0% in the bevacizumab group and in 35.5% in the control group (p = 0.038). The preoperative injection of bevacizumab before vitrectomy reduced the risk of vitreous cavity haemorrhage in the early postoperative period by 3.0 times (p = 0.036). Conclusion: The preoperative use of bevacizumab as an adjunct to diabetic vitrectomy can help reduce the incidence of intraoperative and early postoperative vitreous cavity haemorrhage, which leads to better functional results in the early postoperative period. Over the long-term follow-up period, the effect of the preoperative bevacizumab injections decreases.

scholarly journals Diagnostics and treatment of abdominal complications after gynecological endoscopic operations

2021 ◽  
Vol 1 ◽  
pp. 75-79
Author(s):  
Yu.P.  Vdovichenko ◽  
V.I.  Boyko ◽  
V.A.  Terehov
Keyword(s):  
Postoperative Complications ◽  
Postoperative Period ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Early Postoperative Period ◽  
Main Group ◽  
Laparoscopic Technique ◽  
Control Group ◽  
Diffuse Peritonitis ◽  
Abdominal Complications

The objective: to analyze the results of repeated laparoscopy in gynecological patients with suspected intraperitoneal postoperative complications.Materials and methods. The study involved 42 patients (mean age 46±11,3 years), in whom postoperative abdominal complications after surgical treatment of various gynecological diseases required repeated operations. Depending on the method of re-intervention, the patients were divided into 2 groups: the main group (n=20) – women who only used laparoscopy to correct postoperative complications; control (n=22) – women who were given indications for relaparotomy to correct postoperative complications during diagnostic laparoscopy. Relaparotomy was performed in 8 patients of the control group. All patients underwent a comprehensive examination using clinical, instrumental and laboratory research methods. The groups were homogeneous in terms of age and structure of operations performed on the pelvic organs, and statistically comparable.Results. During the study, the results of repeated laparoscopy of 34 gynecological patients with suspected intraperitoneal postoperative complications were analyzed. In all patients of the main group (47,6%), laparoscopy was revealed as the only and final method of treatment of postoperative complications, while in 7 women repeated relaparoscopy was used from 2 to 4 times, and in 13 women laparoscopy was performed once. In the control group (53,3%), 10 patients during diagnostic laparoscopy were exposed to indications for relaparotomy, in 4 patients the capabilities of the operating team and laparoscopic technique allowed performing some elements of the operation and completing it with a minilaparotomy approach, and 8 patients underwent relaparotomy immediately.Peritonitis and intraperitoneal bleeding prevail in the structure of early abdominal complications. The use of the video laparoscopic technique made it possible in 28,6% of patients with diffuse peritonitis to successfully eliminate the developed complication, eliminate its source and sanitize the abdominal cavity. Laparoscopic hemostasis was successfully performed in 7 patients.Compared with the standard, the use of video endoscopic technique allowed improving the indicators of diagnostic value: to increase the sensitivity level by 1,07 times, specificity by 1,39 times and diagnostic accuracy by 1,11 times.Conclusion. In general, in the early postoperative period, 47 relaparoscopies were performed for suspected complications, which is explained by programmed abdominal sanitization and the use of dynamic laparoscopy to control the course of intraperitoneal complications. Based on the analysis of the material under study, we proposed general indications and contraindications for relaparoscopy in the early postoperative period in order to diagnose and treat postoperative complications. Justifying each of the points, we were guided by the real possibilities of the method in general clinical practice, which in some cases are inferior in their effectiveness to relaparotomy.

scholarly journals Comparison of Ondansetron and Granisetron for prevention of PONV following elective LUCS

2009 ◽  
Vol 20 (2) ◽  
pp. 61-65 ◽  
Author(s):  
Md Raihan Uddin ◽  
Lutful Aziz ◽  
SN Samad Choudhury
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Postoperative Period ◽  
Elective Caesarean Section ◽  
Study Groups ◽  
Early Postoperative Period ◽  
Control Group ◽  
Group A ◽  
Group B ◽  
Oral Ondansetron

The aim of the study was to compare the antiemetic effects of oral ondansetron (8mg) and granisectron (2mg) for prevention of PONV following elective caesarean section. Ninety parturients scheduled for elective caesarean section under spinal anaesthesia were randomly allocated into three groups. Group A (n=30) were received vitamin tab, group B (n=30) parturients were received oral ondansectron (8mg) & group C (n=30) parturients were received oral granisetron (2mg). Anesthetic procedure was common to all groups. Emetic episodes in early postoperative period (1st 24 hrs.) were recorded and compared in different study groups. Emetic episodes were observed in six parturients (20%) in group A (control), 3 parturients in group B (3%) and 3 parturients in group C (3%). So to conclude, minimal emetic episodes were observed in early postoperative period in parturients who had received ondensetron or granisetron than the control group. Keywords: LUCS, PONV, Ondansetron, and Granisetron. Journal of BSA, Vol. 20, No. 2, July 2007 p.61-65

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