Method for preventing postoperative pyoinflammatory complications

FIELD: medicine.

SUBSTANCE: method involves introducing anti-staphylococcus-proteus-blu-pus-bacillus vaccine twice: once before and once after an operation with 7-10 days long interval. Antibiotic and vaccination therapy is administered in combination with immunomodulator introduced. The immunomodulator is selected from a group composed of immunomodulator of microbial origin, synthetic chemical substance immunomodulator, immunomodulator obtained from marrow and nucleic acid-based immunomodulator. The treatment is continued by administering probiotics combined with biologically active nutrient additive selected from a group composed of blackberry syrup with Echinacea, Echinacea with vitamin C added and Immunostat E, given beginning from 5th-10th day.

EFFECT: enhanced effectiveness in restoring soft tissue structure in postoperative wound region.

6 cl

 

The invention relates to medicine, in particular to surgery, and can be used for the prevention of inflammatory complications after surgery.

The problem of prevention of wound infection in surgery due to a high prevalence of inflammatory complications after major surgical interventions.

Known methods of prophylaxis of septic complications in the postoperative period by antibiotic therapy. Apply broad-spectrum antibiotics intramuscularly within 5-7 days after surgery (Ahistrom and other Acute diffuse peritonitis. M., 1987, s-229; Aigultul, Ndzalama, Vigersky. Operative gynecology. M.: Medicine, 1990).

The closest is a method of prevention of inflammatory complications accidental traumatic and surgical wounds by treatment of wounds with antibacterial drugs and the introduction of stafilo-proteaceae-associated Pseudomonas (SPSA) vaccine (EN 2193890 AND 61 TO 39/116, 2000).

However, these methods are not always effective because patients who are subject to surgical treatment, as a rule, there has been a violation of metabolism, immunity, and the operation itself is a significant stress, which exacerbates these violations.

The purpose of izobreteny is - shorter period of recovery patterns of the soft tissues in the surgical wound at the expense of increasing the activity of reactions General and local immunity and increase resistance to various damaging factors (stress, infection and so on).

To achieve this goal, the proposed method of prevention of postoperative inflammatory complications, including antibiotic therapy and the introduction stafilo-proteaceae-associated Pseudomonas vaccine according to the invention the introduction stafilo-proteaceae-associated Pseudomonas vaccines carry out at least 2 times, and once before surgery and once after surgery or twice before the operation with an interval of 7-10 days, while in the early postoperative period are immunized in combination with the introduction of the immunomodulator selected from the group: immunomodulator microbial origin; immunomodulator, representing a synthetic chemical substance; immunomodulator derived from bone marrow; immunomodulator on the basis of nucleic acid, and from 5 to 10 days after surgery treatment continues probiotics in combination with a biologically active additive to food selected from the group: BlackBerry syrup with Echinacea, Echinacea with vitamin C, inrain, green Dr., immunotec E.

As immunodeficiency, is modulator microbial origin use riboni, or bronchosan, or IRS - 19, or immunovet VP-4, or Likopid.

As a chemical synthetic immunomodulator polyoxidonium use, or allopurin, or Gelon, or Galavit.

As immunomodulator derived from bone marrow, use mielopid or caramel.

As an immunomodulator on the basis of nucleic acids using sodium nukleinat, or Derinat, or Poludan.

As probiotics use Bifidumbacterin, or Lactobacterin, or bificol, or baktisubtil, or backspin.

The proposed method is carried out prevention of inflammatory complications in 50 patients.

Of these 20 patients was performed surgery for acute appendicitis.

In 15 patients completed the planned operation for cancer of the stomach.

The rest of the patients with concomitant traumatic injuries.

Conducted prevention avoiding the development of inflammatory processes in 90% of cases.

In the control group of patients out of 50 people the occurrence of septic complications was observed in 60% of cases. They were manifested by increased body temperature, deviation from baseline blood count (WBC count, offset, leukocyte formula to the left, ESR etc), significant edema and infiltration of the suture line in the operated patients,suppuration of wounds.

The results of the research performance of local and General immunity and recovery processes and the patterns of the soft tissues showed that in the groups of patients that the proposed method is administered orally or intramuscularly stafilo-proteaceae-associated Pseudomonas vaccine at least 2 times, and once before surgery and once after surgery or twice before the operation with an interval of 7-10 days, and performed in the early postoperative period vaccination in combination with the introduction of the above immunomodulators, and 5-10 days after surgery treatment is continued above the probiotics in combination with the above-mentioned biologically active additives to food, compared with control group patients who were injected stafilo-proteaceae-associated Pseudomonas vaccine prevents the development of inflammatory processes in the postoperative period in patients, as well as reduced time and cost of treatment 2-3 times.

Specific clinical examples.

Example 1. Patient A. 40 years. The diagnosis of acute appendicitis. Diffuse peritonitis. Emergency surgery: medium-median laparotomy. In the abdominal cavity a significant amount of muddy effusion with fibrin. The belly is swollen, hyperemic, loops of bowel sduty, in many places with fibrinous overlays. Produced appendectomy, nl the cada root of the mesentery 1/4 solution of novocaine. The peritoneal cavity is drained, if possible, removed fibrinous overlay, washed with a solution of furacin and chlorhexidine, drained.

The patient spent antibiotics and introduced SPSA vaccine 1 times before surgery and 1 times in 7 days after the operation.

In combination with antibiotic therapy and vaccination were immunotherapy patient by intramuscular chemical synthetic immunomodulator - polyoxidonium in a dose of 6 mg

5 days after surgery treatment continued with the introduction of the probiotic in combination with a biologically active additive to food - BlackBerry syrup with Echinacea.

As the probiotic was administered Bifidumbacterin 1 ampoule 3 times a day for 30-40 minutes before meals.

The postoperative period was without complications. The wound healed by first intention, the formation of narrow linear cutaneous scar. Sutures were removed on the 5th day. The patient was discharged on the 10th day.

Example 2. Patient M 22 years. Diagnosis: chronic destructive appendicitis. Operation: medium-median laparotomy. In the abdominal cavity a significant amount of muddy effusion with fibrin. The belly is swollen, hyperemic, loops of bowel sduty, in many places with fibrinous overlays. Produced appendectomy, blockade of the root of the mesentery 1/4 solution of novocaine. The peritoneal cavity is drained, if possible, removed fibrinous imposed the I, the washed solution furacin and chlorhexidine, drained.

The patient was administered SPSA vaccine 1 times before surgery and 1 times in 7 days after the operation.

In combination with antibiotic therapy and vaccination was the immunotherapy of the patient by introducing immunomodulator microbial origin - branhamella 1 capsule (7 mg) a day for 10 days.

With 7 days after surgery treatment continued with the introduction of the probiotic in combination with a biologically active additive to food Echinacea with vitamin C.

As the probiotic was administered biosporin 1 dose 3 times a day for 30-40 minutes before meals.

The postoperative period was without complications. The wound healed by first intention, the formation of narrow linear cutaneous scar. Sutures were removed on the 6th day. The patient was discharged on the 10th day.

Example 3. Patient K. 30 years. The diagnosis of acute appendicitis. Diffuse peritonitis. Emergency surgery: medium-median laparotomy. In the abdominal cavity a significant amount of muddy effusion with fibrin. The belly is swollen, hyperemic, loops of bowel sduty, in many places with fibrinous overlays. Produced appendectomy, blockade of the root of the mesentery 1/4 solution of novocaine. The peritoneal cavity is drained, if possible, removed fibrinous overlay, washed with a solution of furacin and chlorhexidine, drained.

Upon admission to the hospital ill the mu introduced SPSA vaccine (0.5 ml), through 7 days after the operation repeated vaccination.

In combination with antibiotic therapy and vaccination were immunotherapy patient by intramuscular injection immunomodulator microbial origin of immunovak VP-4 on 4 mg a day.

5 days after surgery treatment continued with the introduction of the probiotic in combination with a biologically active additive to food - incasino.

As the probiotic was administered bificol 5 doses 3 times a day for 30-40 minutes before meals.

The postoperative period was without complications. The wound healed by first intention, the formation of narrow linear cutaneous scar. Sutures were removed on the 5th day. The patient was discharged on day 7.

Example 4. Patient K. 60 years. Diagnosis: gastric cancer stage III VOL 4 NO MO.

In the preoperative preparation of the patient is produced twice immunization of SPSA vaccine with an interval of 7 days.

Produced operation gastrectomy with resection of the body of the tail of the pancreas, transverse colon. From the first day after surgery in combination with intravenous antibiotics (Amoxiclav 1.2 g, 2 times a day for 3 days) and the vaccination was the immunomodulation by intramuscular injection immunomodulator microbial origin synthetic glikopeptid - Likopid 1 tablet 1 time per day.

With 7 days after surgery treatment continued with the introduction of the probiotic in combination with a biologically active additive to food immunostain E.

As of probiotic administered backspin 1 dose 2 times a day for 30-40 minutes before meals.

Postoperative smooth section, the wound healed by first intention.

Sutures were removed on day 7. The patient was discharged on the 20th day.

Example 5.

Patient N. 50. Diagnosis: gastric cancer stage III VOL 4 NO MO.

In the preoperative period, there was a 2-fold vaccination with an interval of 10 days.

Produced operation gastrectomy with resection of the body of the tail of the pancreas, transverse colon. From the first day after surgery in combination with intravenous antibiotics (Amoxiclav 1.2 g, 2 times a day for 3 days) and the vaccination was the immunomodulation by intramuscular injection immunomodulator derived from bone marrow - mielopid, at a dose of 3 mg daily for 5 days.

10 days after surgery treatment continued with the introduction of the probiotic in combination with a biologically active additive to food - immunostain E.

As of probiotic administered backspin 1 dose 2 times a day for 30-40 minutes before meals.

Postoperative smooth section, the wound healed by first intention.

Sutures were removed on day 7. The patient was discharged on the 20th day.

Thus, the developed mode of introduction of antibacterial, immunomodulatory and probiotic preparations enables to adequately Vosstania who placed the processes of local and General immunity and to provide postoperative wound healing by primary intention, and to prevent various chronic inflammatory postoperative complications, resulting in reduced time and cost for treatment in 2-3 times in comparison with the known and to reduce the severity of the disease.

1. Method of prevention of postoperative inflammatory complications, including antibiotic therapy and the introduction stafilo-proteaceae-associated Pseudomonas vaccine, characterized in that the introduction of stafilo-proteaceae-associated Pseudomonas vaccines carry out at least 2 times, and once before surgery and once after surgery or twice before the operation with an interval of 7-10 days, while in the early postoperative period spend antibiotics and vaccination in combination with the introduction of the immunomodulator selected from the group: immunomodulator microbial origin; immunomodulator, representing a synthetic chemical substance; immunomodulator derived from bone marrow; immunomodulator on the basis of nucleic acid, and from 5 to 10 days after surgery treatment continues with the introduction of probiotics in combination with biologically active additive to food selected from the group: BlackBerry syrup with Echinacea, Echinacea with vitamin C, immunotec E.

2. The method according to claim 1, characterized in. as immunomodulator microbial origin use riboni, or bronchosan, or Imudon, or IRS-19, or immunovet VP-4, or Likopid.

3. The method according to claim 1, characterized in that as a chemical synthetic immunomodulator polyoxidonium use, or allopurin, or Gelon, or Galavit.

4. The method according to claim 1, characterized in that as an immunomodulator derived from bone marrow, use mielopid or caramel.

5. The method according to claim 1, characterized in that as an immunomodulator on the basis of nucleic acids using sodium nukleinat, or Derinat, or Poludan.

6. The method according to claim 1, characterized in that as probiotics use Bifidumbacterin, or Lactobacterin, or bificol, or baktisubtil, or backspin.



 

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