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№4' 2019

SURGERY

International Medical Journal, Vol. 25., Iss. 4, 2019, P. 9−12.

DOI (https://doi.org/10.37436/2308-5274-2019-4-2)

PREDICTION AND PREVENTION OF PURULENT-INFLAMMATORY COMPLICATIONS OF POST-SURGERY WOUNDS

State Institution "V. T. Zaitsev Institute of General and Emergency Surgery of the National Academy of Medical Sciences of Ukraine", Kharkiv, Ukraine

Improvement of the methods for prognosis and prevention of the post−surgery wound complications based on the use of new technologies in microbiology and surgery is of a great importance today. In order to develop and improve such methods, a study has been performed and it involved 230 patients who received a surgical treatment. Clinical and laboratory, biochemical, histological and microbiological methods have been applied. An automatic microbiological analyzer has been applied to identify and determine the sensitivity of the isolated microorganisms to antibacterial agents. The admission of the patient to a hospital assessed the degree of risk of purulent−inflammatory complications in the post−surgery wound on clinical grounds, namely they are: age (over 50 years old), disease duration (longer than 18 hours), accompanying pathology, unpredictable amount of surgical intervention. In the presence of these factors, the patients were assigned to the group of risk of purulent−inflammatory complications in the post−surgery period. To determine a more reliable prognosis, the bactericidal value of the patient's serum was evaluated for detecting the intensity of inhibition of anti−infective defense mechanisms. This allows during the preoperative period the prediction of not only purulent−inflammatory complications, but also identifying the microflora that contributes to their occurrence. As a result of this research, an algorithm for predicting and preventing the purulent−inflammatory complications of the post−surgery wounds was developed. In the case of establishing the fact of a suppression of protective anti−infective mechanisms of the organism in the preoperative period, the patients were given antibacterial prophylaxis with selection of the most effective drug.

Key words: surgical interventions, purulent−inflammatory complications, mechanism of anti−infective resistance.

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