{"title":"Art, craft and science of limb amputation Part 2. Сraft of amputation: from Ambroise Pare to Pierre Dionis (late XVI century – early XVIII century)","authors":"S. Glyantsev","doi":"10.25199/2408-9613-2021-8-2-6-27","DOIUrl":"https://doi.org/10.25199/2408-9613-2021-8-2-6-27","url":null,"abstract":"Since the XVI century until the beginning of the XVII century an operation of limb amputation has undergone changes and improvements that have affected all its aspects: preparation for carrying out, the technique of performing and postoperative treatment of patients. The invention of the ligature (1552) and the tourniquet (1674) became revolutionary. Wet and dry gangrene, extensive trauma to soft tissues and bones, traumatic limb amputation and osteomyelitis were considered of indications for amputation. The deontological and legal framework for amputation was developed, including the patient’s consent to the operation and the awareness of relatives about its outcomes. The article presents an instrumental and dressing apparatus of the XVII century for the operation; medicines used for general and local treatment of the patient before and after truncation of the stump; sedation and pain relief issues; technique of circular and one soft tissue flap (1679) amputation; the choice of tissue dissection level; methods of stopping bleeding (astringents, pressure bandage, cauterization, ligation and stitching of blood vessels); a method of stitching a stump wound, applying a bandage on it and strengthening it; postoperative management (regimen and diet, dressing change, staged wound treatment, complications); the phenomenon and causes of “phantom limbs”.","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128174024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Use of triclosan-coated suture material as prevention of surgical site infections (literature review)","authors":"S. Sharkov, S. R. Ikhsanova","doi":"10.25199/2408-9613-2021-8-2-28-32","DOIUrl":"https://doi.org/10.25199/2408-9613-2021-8-2-28-32","url":null,"abstract":"According to international data, the incidence of infections in the field of surgery in children and adults varies from 2.0 to 20.0 %. The occurrence of the above infections is influenced by many factors: the presence of comorbidities, ASA index, surgical wound class, NNIS risk index. Important factors include the quality of the suture. According to experts of the World Health Organization, 40.0–60.0 % of infections in the field of surgery can be prevented. The first microbiological study of suture (polyglactin 910) with triclosan was published in 2002. According to international studies, the use of a triclosan reduces the adhesion of bacteria to the suture, the viability of microbes and the release of inflammatory mediators. Triclosan actively prevents the colonization of the filament, in addition, concentrations sufficient to suppress the growth and reproduction of pathogens are maintained in the environment for a long time, resulting in the prevention of the development of infectious complications.","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114673710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anterior prompt for debridement and myoplasty femoral neck and head osteomyelitis","authors":"V. M. Bensman, Y. Savchenko, V. Malyshko","doi":"10.25199/2408-9613-2021-8-2-34-40","DOIUrl":"https://doi.org/10.25199/2408-9613-2021-8-2-34-40","url":null,"abstract":"The known anterior prompts to the femoral neck are non-traumatic, but they exclude the possibility of myoplasty and are not large enough for intra-articular sequestrectomy.Objective. The aim of the study was to develop an anterior prompt to the hip joint for sequestrectomy with myoplasty.Materials and research methods. For surgery neck and head of the hip osteomyelitis we perform a semi-oval incision in the projection of the femoral head, from the anterior spines of the ilium we cut off the tendons of the sartorius and rectus head of the quadriceps femoris muscles. An operating field is formed, which allows sequestrectomy to be performed. Plasty of the osteomyelitis cavity is performed with the proximal parts of the two anterior ileofemoral muscles. The operating field, if necessary, can be increased by temporary transection of the lumbar-iliac muscle tendon.Research results. The key to the anterior surgical prompt to the hip joint is the sartorius and rectus head of the quadriceps. The length of the surgical wound reaches 17–22 cm, and the width is 16–18 cm. With the mobilized proximal part of the sartorius muscle, we fill the entire bone cavity in the neck and head of the femur. Of the 12 operated patients, 11 (91.7 ± 7.6 %) had a stable long-term remission.Conclusion. The proposed approach is less traumatic and allows you to operate at an angle of about 90°. It complements the advantages of the known anterior prompts and is devoid of their disadvantages.","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129971002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Post release of the Symposium on Advanced Wound Care “SAWC 2021 Virtual” (May 10–14, 2021, USA)","authors":"Yu. S. Paskhalova","doi":"10.25199/2408-9613-2021-8-2-48-51","DOIUrl":"https://doi.org/10.25199/2408-9613-2021-8-2-48-51","url":null,"abstract":"This article presents the chronology of the Symposium on Advanced Wound Care “SAWC 2021 Virtual” that took place May 10–14, 2021. SAWC is an annual event that has been held for more than 30 years and brings together various specialists in the field of wound care: dermatologists, plastic surgeons, orthopedists, nurses, nutritionists, sports medicine doctors, physiotherapists, research doctors. The scientific program of the symposium included 150 reports devoted to both the results of scientific and experimental research and advanced applied medical technologies aimed at improving the results of chronic wounds by various etiology and localization treatment.","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115617519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Post-release of the International Scientific and Practice Congress “Diabetes Mellitus, Its Complications and Surgical Infections” (November 19–21, 2019, Moscow, Russia)","authors":"Yu. S. Paskhalova","doi":"10.25199/2408-9613-2020-7-3-6-13","DOIUrl":"https://doi.org/10.25199/2408-9613-2020-7-3-6-13","url":null,"abstract":"The article presents the chronology of the International Scientific and Practice Congress “Diabetes Mellitus, Its Complications and Surgical Infections” (November 19–21, 2019).","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115506348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Experience in the treatment of Fournier's gangrene in a hospital of the Far North","authors":"N. Bruklich, A. Orunbaeva, E. G. Nersesyan","doi":"10.25199/2408-9613-2020-7-3-32-39","DOIUrl":"https://doi.org/10.25199/2408-9613-2020-7-3-32-39","url":null,"abstract":"The article presents several clinical observations about the experience of treating Fournier's gangrene in a hospital in the Far North.","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124896597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anniversary of Leonid Aleksandrovich Blatun (March 29, 1941)","authors":"Yu. S. Paskhalova","doi":"10.25199/2408-9613-2021-8-1-6-11","DOIUrl":"https://doi.org/10.25199/2408-9613-2021-8-1-6-11","url":null,"abstract":"The article presents a brief biography of the senior researcher in wounds and wound infections department and clinical microbiologist of the Federal State Budgetary Institution “A. V. Vishnevsky National Medical Research Center of Surgery” Ministry of Health of Russia Leonid Aleksandrovich Blatun (03/29/1941) in honor of his 80th anniversary, of which 55 years passed within the walls of the A. V. Vishnevsky institute of surgery!","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116427742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Kuznetsov, G. Nasrashvili, D. Panfilov, R. S. Kozhanov, A. S. Pryakhin, V. Shipulin, B. Kozlov
{"title":"Influence of the combined method of air-plasma flows and NO-therapy on the blood system parameters in treatment of infectious wound complications in cardiac surgery","authors":"M. Kuznetsov, G. Nasrashvili, D. Panfilov, R. S. Kozhanov, A. S. Pryakhin, V. Shipulin, B. Kozlov","doi":"10.25199/2408-9613-2021-8-1-30-41","DOIUrl":"https://doi.org/10.25199/2408-9613-2021-8-1-30-41","url":null,"abstract":"Nitric oxide (NO) is a universal biological mediator that has a multifaceted effect on physiological and pathological processes in various organs and systems of the body. It is known that NO-therapy is a powerful stimulator of a positive effect on the course of the wound process, especially in complicated wounds.Objective: to evaluate the use of the combined effect of NO-containing air-plasma flows on the parameters of the blood system in the treatment of infectious wound complications in cardiac surgery patients.Materials and methods. A total of 60 patients were included in the study: 31 (52%) men and 29 (48%) women aged 29 to 79 years (mean 63.67 ± 7.6 years). All patients were divided into two groups: Group I – 30 patients who received treatment for sternomediastinitis using a combined exposure to air-plasma flow and exogenous nitric oxide; Group II – 30 patients who were treated for sternomediastinitis according to the clinical guidelines for the surgical treatment of patients with postoperative mediastinitis and osteomyelitis of the sternum and ribs.Results. The use of the combined effect of NO-containing air-plasma flows for the treatment of sternomediastinitis is accompanied by a decrease in the level of acute phase proteins already by 3 days, normalization of leukocytes and neutrophils by 10 days after the start of therapy, and prevents hyperaggregation and spontaneous aggregation of platelets.Conclusion. The use of the combined method of low-temperature plasma and exogenous nitrogen monoxide in the local treatment of infectious wound complications after cardiac surgery is justified and effective. No reliable confirmation of the cytotoxic effect of exogenous nitric oxide in the applied dosage on the elements of red blood was found in this study","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124134356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. M. Bensman, A. Baryshev, S. Pyatakov, K. G. Triandafilov, V. N. Ponomarev, V. V. Fedyushkin, D. Y. Sheremetyev, A. O. Sheremetyeva, A. Kiba
{"title":"Ways to reduce the frequency of high amputations, post-amputation complications and mortality in diabetic foot syndrome","authors":"V. M. Bensman, A. Baryshev, S. Pyatakov, K. G. Triandafilov, V. N. Ponomarev, V. V. Fedyushkin, D. Y. Sheremetyev, A. O. Sheremetyeva, A. Kiba","doi":"10.25199/2408-9613-2021-8-1-12-23","DOIUrl":"https://doi.org/10.25199/2408-9613-2021-8-1-12-23","url":null,"abstract":"Despite the success in treatment, currently 30.0% of patients with diabetic foot syndrome (DFS) still undergo high amputations with a mortality rate of up to 54.0–68.0 %. The causes of high low limb amputations in 28.0 % of patients are infection, and in 46.0 % – arterial insufficiency in the stage of critical limb ischemia.Objective: to improve the results of patients treatment by reducing the number of high amputations of the lower extremities, reducing the occurrence of complications and deaths of the disease.Materials and methods. To study the results of treatment of patients with DFS, they were divided into two comparison groups and two main groups. From 1982 to 2019, the frequency of amputations, mainly at the hip level, was 71.0 % (177 amputations in 248 patients). These patients formed the first comparison group of observations. The second comparison group (1988–1994) included 58.3 % of patients in whom amputations were performed according to more stringent indications (157 amputations in 269 patients). The first main group of observations (1995–2013) included 9.9 % of patients with DFS who were amputated only for wet gangrene, incurable critical limb ischemia, and infection with a systemic inflammatory response (130 amputations out of 1312 patients). In ischemia with preserved blood flow through the deep artery of the thigh, amputation of the lower leg was performed in a sequential-two-flap method with removal of the soleus muscle. Amputations were completed with the imposition of drainage removable muscle-fascial sutures. The second main group (2014) consisted of 11.4 % of patients who underwent amputations only for sepsis or wet gangrene (124 amputations in 1083 patients). The difference between the second main group and the first was the division of the high amputation intervention into 2 stages.Results. Comparison of the treatment results in the main groups and in the comparison groups revealed a 6-fold decrease in the number of high amputations (from 64.6 to 10.69 %) and a significant improvement in the main quality indicators. This concerns a 6-fold decrease in mortality, which was a consequence of the introduction of a two-stage tactic for high amputation treatment of the most severe patients and the limitation of indications for amputation of the hip. Using of removable drainage muscle-fascial sutures decreased postoperative wound complications from 51.9 to 13.0 %, and the number of re-amputations decreased in 17th times.Conclusion. Amputation of the lower extremities for irreversible critical limb ischemia can be performed with a decrease in TcP02 of the stitched stump tissues to no more than 30 mm Hg. Preserving the knee joint improves the possibilities of prosthetics, which allows older diabetics to lead an active life. Methods of performing parallel- or sequential-two-flap high amputation improve the conditions for cutting out racquet-shaped wound flaps, which provides free displacement of the soft tissues of the stump connec","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130351300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Post release International Scientific and Practice Conference “High low limb amputations in children and adult”","authors":"Yu. S. Paskhalova","doi":"10.25199/2408-9613-2020-7-1-67-73","DOIUrl":"https://doi.org/10.25199/2408-9613-2020-7-1-67-73","url":null,"abstract":"The article presents the chronology of the International Scientific and Practice Conference “High low limb amputations in children and adult” (May 20–21, 2019).","PeriodicalId":366300,"journal":{"name":"Wounds and wound infections. The prof. B.M. Kostyuchenok journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114381243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}