MODERN ANTICEPTIC HYDROGEL IN TREATMENT OF INFECTIOUS COMPLICATIONS OF WOUNDS IN SURGERY.

Treatment and prevention of infectious complications remain the actual problems of surgery. Purulent complications very often arise in operative interventions with an application of various fixing devices. A study of the adhesive surgical antiseptic (ASA) «ARGAKOL¼ (Registration certificate № FS 012б2005/1878-05) was completed. The results of the preliminary antimicrobial activity of the developed composition showed that ASA «ARGAKOL¼ had a broad spectrum of antimicrobial action. There was used the method of twofold serial dilutions in a liquid medium and Cup-suspension. The study of the influence of the ASA «ARGAKOL¼ on the wound healing was made in the experiment on white outbred rats. There were carried out two series of experiments with 10 rats in each group: on the model of just contaminated wound (the first series) and on the model of infected wound with delayed application of the glue (after 3 days) after trauma (the second series).

[OBJECTIVE CRITERIA OF PATIENT'S READINESS TO FREE AUTOPLASTY IN CASE OF GRANULATING WOUNDS (CRITERIA OF READINESS OF GRANULATING WOUNDS TO OPERATION)].

The article based on the analysis of 84 follow-up of the patients. The authors suggested using the indices of microbiological and immunological investigations and data of laser Doppler ultrasonography to determine the readiness of granulating wound to free autoplasty. The data obtained allowed developing an algorithm of treatment, patient's preparation to surgery and determination of operation terms.

[Effect of perfluorane on the time course of changes in endogenous intoxication in victims with severe thermal injury].

The investigation was undertaken to study the effects of perfluorane on the degree of endogenous intoxication in the severely burnt. Sixty-five victims aged 20 to 55 years who had burns of the skin, involving more than 30% of the body surface area, without comorbidity (less than 9 SAPS scores), were examined. All the examinees were divided into 2 groups. They were comparable in age and burn injury degree. Perfluorane was administered in a dose of 4 ml/kg body weight within the first 24 hours after the moment of injury (a study group; n = 30). During the investigation, the authors estimated blood gas composition and acid-base balance, the level of lactate in mixed venous blood, the content of low and medium molecular-weight substances (LMMWS) in venous and arterial plasmas, on red blood cells and urine; erythrocytic deformity index; the level of reduced glutathione; total plasma antioxidative activity, and the plasma concentration of malonic dialdehyde. Blood was sampled on admission, an hour after administration of perfluorane, and onwards--on days 1, 3, 5, 7, 10, and 15. Perfluorane used in acute burn disease leads to normalization of oxygen balance, a reduction in the rate of free radical oxidation and lipid peroxidation, and a considerable decrease in LMMWS levels on the red blood cell membranes and plasma. Positive changes were recorded just an hour after administration of perfluorane and retained throughout the observation. In the study group victims, mortality was 15% less than that in the controls.

[Clinical and immunological criteria of burn sepsis].

A hundred and twenty-nine victims aged 16 to 60 years who had skin burns in the area of 15 to 60% of the body surface without severe concomitant somatic disease (SAPS less than 9 scores). The clinical symptoms of a systemic inflammatory response (SIR) and the signs of wound infection were recorded in all the examinees. The victims underwent a comprehensive clinical and laboratory examination, 55 of them were immunologically studied over time (on admission, on days 3 and 10). To reveal the predictive clinical and immunological criteria for sepsis, the examinees were divided into 3 groups. Group 1 comprised 33 burnt persons who were observed to have the symptoms of SIR and the signs of burn wound infections without impaired function of organs and systems. Group 2 included 46 victims with severe sepsis and a good outcome of burn disease. Group 3 consisted of 50 patients who had died from severe sepsis. Analysis of the results of the study has indicated that the count of formed blood elements by calculating the leukocytic intoxication index, the estimation of the level of lysosomal cation proteins in the neutrophilic granulocytes, the detection of populations of T helper cells, cytotoxic lymphocytes, as well as histomorphological and bacteriological findings are early and valid criteria for the development of infectious complications. Their use for the diagnosis and prediction of sepsis permits initiation of its treatment at early stages, without awaiting the appearance of the signs of a septic process.