Method for treating osseous cavity after necrsequestrectomy

FIELD: medicine, surgery.

SUBSTANCE: the present innovation refers to treating osseous cavity in patients with chronic post-traumatic osteomyelitis, so, after necrsequestrectomy one should irrigate an osseous cavity with aqueous solution of sodium chloride, then it is necessary to treat the cavity with 3%-hydrogen peroxide solution with subsequent removal of foam with 0.02%-chlorohexidine bigluconate aqueous solution. Then twice during 1 min it is necessary to treat osseous cavity with 0.9%-ozonized sodium chloride solution at ozone concentration being 9000-10000 mgl/l. After that, one should introduce the mixture of anti-infectious chemotherapeutic preparations along with ultrasound cavitation for 3 min at frequency of 40 kHz followed by treating the cavity with the flow of nitrogen monoxide for 5 min at concentration being 5000 mg/cu. m. The innovation enables to increase penetrating capacity of medicinal preparations due to matching the desired mode of cavitary treatment.

EFFECT: higher efficiency of antiseptic treatment.

1 ex

 

The invention relates to medicine, namely to the field of surgical treatment of chronic diseases, post-traumatic osteomyelitis.

Pyo-inflammatory processes occupy a leading place in the structure of morbidity and mortality. Especially notable among them by severity, diagnostic difficulties and adverse outcomes of chronic post-traumatic osteomyelitis.

Today surgical treatment is the primary and most effective in the treatment of this pathology.

Radical surgery itself involves not only the removal of osteomyelitis focus per se, but also the elimination of favorable conditions for the existence of infection. The most important element operative intervention is necrsequestrectomy with subsequent grafting postoperative cavity. Consequently, high-quality training cavity before grafting the graft is one of the necessary conditions for a successful and effective treatment.

There is a method of treatment of the wound by washing with sea water, wrapping and subsequent suturing [1].

The disadvantage of this method is the relatively high number of recurrent osteomyelitis after treatment of bone cavities sea water.

However, application of this method does not exclude the possibility of postoperative complications and does not reduce the healing time of the wound.

There is a method of treatment of purulent-inflammatory wounds by surgical treatment and rinsing with an antiseptic solution applied to the surface of the wound in the form of a vortex flow [3].

The disadvantage of this method is the low efficiency of the treatment.

A method of processing bone cavity with a solution of antiseptic liquid, for example with furatsilina [4].

The disadvantage of this method is the low penetration ability in the bone tissue and often the lack of bactericidal activity in the bone cavity.

There is a method of treatment of the wound by irrigation water solution of a drug and subsequent suturing. Moreover, as the medicinal product applied solution of sodium chloride with a concentration of from 3.0 to 3.2% [5].

The disadvantage of this method is low efficiency antiseptic treatment of bone processing after sequestrectomy.

The aim of the invention is to improve the effectiveness of the antiseptic treatment of bone cavities after necrsequestrectomy.

This goal is achieved by the fact that after irrigation aqueous solution of sodium chloride cavity treated with 3% solution of p is rekishi hydrogen, remove the foam 0.02% aqueous solution of chlorhexidine digluconate, twice within 1 minute ozonated process with 0.9% sodium chloride solution with a concentration of ozone 9000-10000 MGL/l was injected into the cavity solution of anti-infective chemotherapeutic agents with simultaneous ultrasonic cavitation for 3 minutes with a frequency of 40 kHz and handle cavity flow monoacid nitrogen for 5 minutes with a concentration of 500 mg/m3.

Comparison of proposed method with other solutions known in the field of medicine, has demonstrated its compliance with the criteria of the invention.

The proposed method of processing bone cavity after necrsequestrectomy is implemented as follows.

Place the solution of sodium chloride declared concentration in the vial 200-400 ml and saturate it by barbotage ozone-oxygen mixture for 5-10 minutes with ozone concentration 9000-10000 IPF/L. Bone cavity is irrigated with an aqueous solution of sodium chloride with a concentration of 0.9%, and then treated with 3% hydrogen peroxide solution, remove the foam 0.02% aqueous solution of chlorhexidine digluconate, twice within 1 minute ozonated process with 0.9% sodium chloride solution, which was already prepared, injected into the cavity solution of anti-infective chemotherapeutic agents with simultaneous ultrasonic cavitation within 3 mine is with a frequency of 40 kHz and process cavity flow monoacid nitrogen for 5 minutes with a concentration of 500 mg/m 3.

Clinical example. Patient N., 35 years old, diagnosed with chronic post-traumatic osteomyelitis of the left tibia. Performed necrsequestrectomy. The dimensions of the cavity 50×20×8 ml, manufactured irrigation water solution of sodium chloride with a concentration of 0.9%, then treatment with 3% hydrogen peroxide solution, the foam was removed 0.02% aqueous solution of chlorhexidine digluconate in subsequent cavity twice within 1 minute was treated with ozonated 0.9% sodium chloride solution, introduced into the cavity of a solution of anti-infective chemotherapeutic agents with simultaneous ultrasonic cavitation for 3 minutes with a frequency of 40 kHz and processed cavity flow monoacid nitrogen for 5 minutes with a concentration of 500 mg/m3. The size of the bone cavity was prepared graft and replaced them with postoperative cavity. Layers left the house taking the wound tightly. The wound healed by first intention after one week with good distant result.

The use of the proposed method can improve the effectiveness of the antiseptic treatment of bone cavities after necrsequestrectomy, which in turn reduces the treatment time.

The use of the proposed method is reasonable in purulent surgical departments of medical institutions for the treatment of chronic posttraumatic osteomyelitis of the Horno musculoskeletal system.

Sources of information

1. Shakhnazarov A.B., Lukasz IV Sea water and its therapeutic application. M.: Medicine, 1966. P.40-41.

2. Pods VI and other Purulent wound. M.: Medicine, 1975. S-289.

3. Auth. mon. The USSR №1593631, CL AV 17/00, 1990.

4. Khomich LI Chronic osteomyelitis. Minsk, 1977. S.

5. Auth. mon. The USSR №1109168, CL 61K 33/14, 1984.

The method of processing bone cavity after necrsequestrectomy by irrigation water solution of sodium chloride, characterized in that after irrigation aqueous solution of sodium chloride cavity treated with 3%hydrogen peroxide solution, remove the foam of 0.02%aqueous solution of chlorhexidine digluconate, twice for 1 min ozonated process of 0.9%sodium chloride solution with a concentration of ozone 9000-10000 MGL/l was injected into the cavity solution of anti-infective chemotherapeutic agents with simultaneous ultrasonic cavitation for 3 min with a frequency of 40 kHz and handle cavity stream of nitrogen monoxide for 5 min with a concentration of 500 mg/m3.



 

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