Infectious and inflammatory complications after endoscopic hernioplasty in patients with postoperative ventral hernias: features of diagnosis and treatment strategies
- 作者: Semenov V.1, Prudyeva S.1, Kurygin A.1
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隶属关系:
- Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
- 期: 卷 23, 编号 3 (2021)
- 页面: 157-164
- 栏目: Clinical trials
- URL: https://journals.rcsi.science/1682-7392/article/view/75485
- DOI: https://doi.org/10.17816/brmma75485
- ID: 75485
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详细
An algorithm for the diagnosis and treatment of infectious and inflammatory complications after endovideosurgical hernioplasty in patients with postoperative ventral hernias using traditional and minimally invasive methods of therapy was proposed. The study was based on the treatment results of 177 patients who underwent endovideosurgery for postoperative ventral hernias. Despite the perioperative antibiotic prophylaxis according to the accepted at the S.M. Kirov Military Medical Academy, according to the protocol scheme (first-generation cephalosporin at a dose of 1 g once parenterally 30 min before the operation, followed by repeated administration in case of operation duration of > 3 h), course of the early postoperative period on days 3–5 in 8 (4,5%) patients after endovideosurgical hernioplasty was complicated by suppuration in the intervention area. When analyzing the causes of infectious and inflammatory complications, in both the main and control groups of observations, all suppuration in the area of surgical interventions was diagnosed in patients with metabolic syndrome (stages II–III obesity and type 2 diabetes mellitus). The use of the “negative pressure wound therapy” resulted in wound cleansing for 4.1 ± 2.5 days (p < 0.05) and was comparable with the traditional method of treatment, but more active growth of granulation tissue prevailed in the wound, which contributed to its accelerated healing. The “negative pressure wound therapy” is effective in the systemic infectious and inflammatory process, especially after prosthetic hernioplasty of large W3-postoperative hernias. Drainage of abscesses under ultrasound navigation is possible with small (S ≤ 10 cm2) delimited purulent processes in the area of the polypropylene implant with the preservation of the latter.
作者简介
Valery Semenov
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
编辑信件的主要联系方式.
Email: semvel-85@mail.ru
ORCID iD: 0000-0003-1025-332X
SPIN 代码: 1481-2592
candidate of medical sciences
俄罗斯联邦, Saint PetersburgSofya Prudyeva
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Email: sofia.prudieva@yandex.ru
SPIN 代码: 4453-2100
doctor-surgeon
俄罗斯联邦, Saint PetersburgAlexander Kurygin
Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation
Email: kurygin60@gmail.com
doctor of medical sciences, professor
俄罗斯联邦, Saint Petersburg参考
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