[Care of the focus of lesion during various stages of the surgical treatment of chronic osteomyelitis].
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Biomedical subjects
Publications and source records attributed to Z F Vasil'kova.
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The article deals with the comparative analysis of the results of treatment of 98 patients with chronic hematogenic osteomyelitis of the long tubular and pelvic bones with the use of hypervolemic and normovolemic hemodilution as a method of infusion-transfusion therapy of intraoperative blood loss and its compensation with donor blood. It is shown on the basis of clinical evaluation and the study of hemodynamic, hematological, and rheological blood values, the values of the blood coagulation system and the acid-base balance that the use of hypervolemic hemodilution is limited and can be applied in blood loss not exceeding 10% of the circulation volume. The use of the method of normovolemic hemodilution makes the transfusion of donor blood unnecessary and thus allows the complications associated with it, infectious among others, to be avoided. It can be used in blood loss of up to 20% of the circulation volume.
The article analyzes results of complex surgical treatment of 109 patients with chronic hematogenic osteomyelitis of long tubular bones and pelvis, 53 of them were subjected to correction of intraoperative blood loss with autogenic blood. Autohemotransfusion with procurement of 400-600 ml of blood immediately before operation in combination with normovolemic hemodilution allows to correct intraoperative blood loss up to 20% of the circulating blood volume. Autohemotransfusion with the preliminary taking of blood as much as 800 ml allows to correct intraoperative blood loss more than for 20% of the circulating blood volume.
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An original method of surgical treatment of purulent sacroiliitis is described. It was used in 8 patients and reduced the period of treatment from 3-6 to 1-1.5 months. Good remote results were noted during 2-10 years of follow-up observations.
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In the treatment of 328 patients trypsin immobilized on cellulose matrix was used in 110 patients, native enzymes were used in 148 patients and 70 patients were given means of physical antiseptics. The results have shown advantages of immobilized trypsin for the treatment of the wound process.
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Debrisan was used for the treatment of purulent wounds in 125 patients with postinjection and paraossal phlegmons, postoperative suppurations and tropic ulcers. Debrisan was shown to be an effective agent for physical antiseptics which can shorten the time of wound debridement.
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