Application of Octenisept Solution as a Sanation Media in Surgical Treatment of Diffuse Purulent Peritonitis

P.G. Kondratenko, Ye.A. Koychev

Abstract


The results of treatment of 79 patients, operated for an acute diffuse purulent peritonitis, are adduced. The age of the patients varied from 18 to 90 years old.
The endoscopy and surgery clinic of Donetsk National Medical University based on the Donetsk city clinic № 16 admitted the patients in the period from 2000 to 2012. Index of abdominal cavity of all the patients was more than 13 points. The disease duration less than 3 days was in 41 (51.9 %) patients, more than 3 days — in 38 (48.1 %) patients, more than 6 days — in 16 (20.3 %). There were 27 (34.2 %) males, and 52 (65.8 %) females. Concomitant disease was detected in 53 (67.1 %) patients. The most frequent were cardiovascular and respiratory system pathologies.
The peritonitis was caused by perforation of duodenum — 31 (39.2 %) patients, perforation of small intestine — 12 (15.2 %), acute appendicitis — 17 (21.5 %), purulent salpingitis — 5 (6.3 %), stomach ulcer perforation — 4 (5.1 %), acute cholecystitis — 4 (5.1 %), perforation of sigmoid colon diverticulum — 4 (5.1 %), acute strangulated intestinal obstruction with necrosis of small intestine — 2 (2.5 %).
During the complex treatment in all the patients we used method of laparotomy suggested by V.S. Savelyev and his co-authors. (2006). The interval between staged sanations was from 24 to 72 hours. During the surgery a site of parietal peritoneum was taken with the purpose of further histological study in pathomorphology department of Central research laboratory of Donetsk national medical university. All the patients were divided into two groups. Study group (group 1) consisted of 42 patients who had the abdominal sanations programme with octenisept application.
The group 2 (comparison group) consisted of 37 patients who had the abdominal sanations programme with physiological saline.
During all the 79 observations of an acute diffuse purulent peritonitis after laparotomy and biopsy, quality and quantity morphological study of inflammation process in peritoneum was performed.
On the ground of the morphological study results it was found that during the treatment the relief of inflammation in abdominal cavity was observed in both groups. However, the reduction of purulent inflammation was much higher in the patients who had octenisept as sanation solution. Application of octenisept allows reduce the number of scheduled sanations of abdominal cavity, which, on the one hand, reduces the number of postsurgical complications, and on the other hand allows to avoid development of chronization of inflammatory process in peritoneum and to prevent development of tertiary type of peritonitis.


Keywords


acute diffuse purulent peritonitis; programmed sanination of the abdominal cavity; sanation media

References


Брюсов П.Г. Послеоперационный перитонит — актуальная проблема абдоминальной хирургии / П.Г. Брюсов, Н.А. Ефименко // Военно-медицинский журнал. — 1998. — № 9. — С. 25-29.

Гостищев В.К. Перитонит / В.К. Гостищев, В.П. Сажин, А.Л. Авдовенко. — М.: Медицина, 1992. — 224 с.

Повторные хирургические вмешательства при распространенном гнойном перитоните / Э.Х. Байчоров, Б.Б. Хациев, Р.З. Макушкин [и др.] // Хирургия. — 2009. — № 11. — С. 18-22.

Кондратенко П.Г. Роль и место релапаротомии в лечении тяжелых форм распространенного перитонита / П.Г. Кондратенко, Е.А. Мумров // Харьковская хирургическая школа. — 2005. — № 1.1. — С. 38-40.

Воронов Н.В. Лапаростомия при послеоперационном перитоните / Н.В. Воронов, Н.И. Стаценко, Рабах Закут Самир // Харківська хірургічна школа. — 2005. — № 1. — С. 18-20.

Глабай В.П. Релапаротомии после неотложных операций на органах брюшной полости / В.П. Глабай, А.И. Шаров, А.А. Абрамов // Медицинский академический журнал. — 2003. — Т. 3, № 2, приложение 3. — С. 28-29.

Казаков В.Н. Поляризационная микроскопия в биологии и медицине / Казаков В.Н., Шлопов В.Г. — Донецк: Каштан, 2008. — 320 с.

Перитонит: Практическое руководство / В.С. Савельев, Б.Г. Гельфанд, М.И. Филимонов [и др.]. — М.: Литтерра, 2006. — 208 с.

Bacteriological aspects implicated in abdominal surgical emergencies / Israil A.M., Delcaru C., Palade R.S. [et al.] // Chirurgia (Bucur). — 2010. — Vol. 105. — P. 779-787.




DOI: https://doi.org/10.22141/1997-2938.2.25.2014.83103

Refbacks

  • There are currently no refbacks.


Copyright (c) 2016 UKRAINIAN JOURNAL OF SURGERY

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2017

 

 Яндекс.МетрикаSeo анализ сайта Рейтинг@Mail.ru