Prevention of purulent-inflammatory wound complications in the tactics of planned relaparotomies in patients with peritonitis

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Abstract

Patients with emergency abdominal surgical pathology (EASP) who underwent a single planned relaparotomy (SPR) face difficulties in preventing purulent-inflammatory wound complications (PIWC), since in the interoperative period the wound is subject to hypercontamination by infectious agents from the abdominal cavity.

Objective: To improve the treatment outcomes of patients with EASP who underwent SPR by using improved methods for preventing PWC.

Materials and methods: Clinical studies were conducted in 103 patients with various EASP who underwent single SPR, including retrospective studies in 64 (comparison group) and prospective studies in 39 (main group). Exclusion criteria included deceased patients.

Results and discussion: In the comparison group, PIWC after SPR developed in 46,9 % (30 out of 64) of cases. Before the primary operation and in the interoperative period, standard prevention of wound suppuration was carried out. In the main group, prevention of PIWC in the interoperative period was carried out on the basis of prolonged irrigation of wounds with antibiotics, with anaerobic flora, additional insufflation of the wound with oxygen. In the main group, it was possible to reduce the development of PIWC by 23.8 % (р = 0,021).

Conclusions: Improved methods for preventing PIWC in patients with EASP who underwent SPR can statistically significant reduce the percentage of suppuration of postoperative wounds.

About the authors

Igor N. Klimovich

Volgograd State Medical University

Author for correspondence.
Email: klimovichigor1122@yandex.ru
ORCID iD: 0000-0002-7933-2635

Doctor of Medical Sciences, Professor of the Department of Hospital Surgery

Russian Federation, Volgograd

Sergei S. Maskin

Volgograd State Medical University

Email: maskins@bk.ru
ORCID iD: 0000-0002-5275-4213

Doctor of Medical Sciences, Professor, Head of the Department of Hospital Surgery

Russian Federation, Volgograd

Konstantin A. Shmyrev

Clinical Hospital № 5, Volgograd

Email: drkash@yandex.ru
ORCID iD: 0009-0007-4545-4689

surgeon

Russian Federation, Volgograd

Vyacheslav A. Golbrah

Volgograd State Medical University

Email: golbrah@yandex.ru
ORCID iD: 0000-0003-2589-4322

Doctor of Medical Sciences, Professor of the Department of Hospital Surgery

Russian Federation, Volgograd

Tatyana V. Derbentseva

Volgograd State Medical University

Email: tatyana-derbenceva@yandex.ru
ORCID iD: 0000-0001-5735-9557

Сandidate of Medical Sciences, docent of the Department of Hospital Surgery

Russian Federation, Volgograd

Vasiliy V. Aleksandrov

Volgograd State Medical University

Email: 79178304989@yandex.ru
ORCID iD: 0000-0001-8364-8934

Candidate of Medical Sciences, Docent, Associate Professor of the Department of Hospital Surgery

Russian Federation, Volgograd

Dmitrii V. Orlov

Clinical Hospital № 5, Volgograd

Email: Platmed@yandex.ru
ORCID iD: 0000-0001-8233-4538

chief physician

Russian Federation, Volgograd

Igor A. Dubrovin

Clinical Hospital № 5, Volgograd

Email: dubrovinigor1985@mail.ru
ORCID iD: 0009-0006-7265-8858

head of the Department of surgery

Russian Federation, Volgograd

References

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Copyright (c) 2025 Klimovich I.N., Maskin S.S., Shmyrev K.A., Golbrah V.A., Derbentseva T.V., Aleksandrov V.V., Orlov D.V., Dubrovin I.A.

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