[Restoration of tissue reparative ability during acute pancreatitis (in Russian only)]. / Vosstanovlenie reparativnoi sposobnosti tkanei pri ostrom pankreatite.

AIM: The purpose of the study was to establish the effectiveness of Remaxol in restoring tissue reparative ability of laparotomy wound in acute severe pancreatitis. MATERIAL AND METHODS: The work is based on the results of experimental and clinical studies. Experiments were carried out using acute total pancreatic necrosis model under anesthesia on 30 dogs. Furthermore, 28 patients with acute severe pancreatitis were examined and underwent surgery on various purulent-necrotic complications. In the postoperative period, healing and metabolic processes were evaluated in the tissues along the sutures line of the laparotomy wound. Also, such parameters as endogenous intoxication, oxidative stress, and phospholipase activity were evaluated at the organism level. In the studied groups, Remaxol is included in the postoperative therapy. RESULTS: It has been established that during acute severe pancreatitis reparative potential of tissues is significantly reduced, which is caused by a significant disruption of trophism, activation of phospholipases and peroxidation of membrane lipids. Disorders of homeokinesis at the organism level play a negative role in tissue reparative potential reduction. Inclusion of Remaxol in the complex therapy of acute pancreatitis leads to a decrease in duration of wound healing by reduction in the phase of inflammation. Optimization of the healing process occurs due to complex effect of the drug at organ and body level, which results in improvement of the trophism and, what's more, stabilizes membranes of regenerating cells. CONCLUSION: In case of acute severe pancreatitis, the use of Remaxol in early postoperative period in the complex therapy leads to a significant correction of factors that adversely affect regeneration and contributes to the restoration of tissue reparative potential.

[The condition of the hemostatic system in acute severe peritonitis during remaxol therapy]. / Sostoianie sistemy gemostaza pri ostrom tiazhelom peritonite na fone terapii Remaksolom.

AIM: To evaluate the effectiveness of the Remaxol in the correction of hemostatic system in patients with severe acute peritonitis. MATERIAL AND METHODS: 52 patients with acute peritonitis of different severity were examined, and divided into 4 groups: I - mild, II - moderate, III - severe. The patients of these groups had treated using standard therapy. The IV group had patients with severe peritonitis, who received an additional Remaxol. The hemostasis system was evaluated using a TEG 5000 thromboelastograph and biochemical tests. RESULTS: It has been established that the acute peritonitis is accompanied by significant hemostatic disorders - hypercogulation and hyperfibrinolysis, independently of the disease severity. CONCLUSION: In the severe peritonitis, disorders of the coagulation-lytic system were especially expressed. The use of the Remaxol in patients of this group led to a decrease the blood coagulation disorders.

[Possibilities of tissue repair induction during mechanical jaundice of non-tumor genesis]. / Vozmozhnosti indutsirovaniia reparatsii tkanei pri mekhanicheskoi zheltukhe neopukholevogo proiskhozhdeniia.

AIM: The aim of this research was to study the effects of complex therapy with Remaxol inclusion on laparotomy wound tissue reparative process in patients with obstructive jaundice in early postoperative period. MATERIAL AND METHODS: Clinical and laboratory studies were carried out in 55 patients undergoing surgery of the biliary tract, including 35 patients with mechanical jaundice of non-tumor origin and 17 of them received Remaxol (for 5 days daily intravenous infusions of 400 ml each) in the early postoperative period. RESULTS: It has been proved that mechanical jaundice is a significant complication in the reparative process of laparotomy wound tissue structures. A significant decrease in the reparative potential of tissues can occur due to a local deterioration of the tissue metabolism of regenerating structures, and on the organism level - endogenous intoxication syndrome, hypoxia, oxidative stress, hypoalbuminemia. CONCLUSION: Remaxol is a drug with hepatoprotective, antioxidant and antihypoxant effects and its use in patients with obstructive jaundice makes it possible to correct disease pathogenetic impact on organic and organism level, which leads to optimization of reparative regeneration. A noticeable decrease in the early postoperative period of wound complications has been established as well as a significant reduction in days patients spent in the hospital.

[Prophylactics of postoperative complications in destructive appendicitis and typhlitis]. / Profilaktika posleoperatsionnykh oslozhnenii pri destruktivnom appenditsite i tiflite.

The method of extraperitonization of the blind gut cupola based on the removable monofilament sutures and drainage of the area was designed, approved in experiments in dogs (n=18) and corpses (n=14) and successfully applied in the clinic (n=25). Unlike the traditional method, the using of this one results in less impaired trophicity, LPO intensification and phospholipase activity of the tissues of regenerating structures that was the grounds of sufficiently rapid reparation process under conditions of inflammation. The proposed complex of surgical measures in patients with destructive forms of acute appendicitis complicated by the inflammatory-necrotic phenomena in the blind gut wall was shown to prevent the development of dangerous postoperative complications, incompetence of the sutures included.

[Experimental evaluation colonic anastomosis regeneration in various ages]. / Eksperimental'naia otsenka regeneratsii tosltokishechnogo soust'ia v raznom vozraste.

Experimental study determined, that the cause of protracted healing of colonic anastomosis made by multi-row suture in animals of younger age groups, is severe trophic disturbances in the area of anastomosis. The chief pathogenetic factor of comparatively unfavourable course of reparative process in younger age groups may be severe insufficiency of collateral blood flow of the organ. Adaptation mechanism aimed at the rise of the reactivity of blood erythrocytes not always was capable to support the reparative process in the region of the anastomosis at an adequate level. In older age groups of animals less pronounced microcirculatory disturbances provided comparatively quick restoration of tissue structures of the anastomosis.