Abstract
Abstract. Introduction. The treatment of complicated forms of acute destructive appendicitis remains an urgent problem of urgent abdominal surgery. Aim. The aim of our investigation was to substantiate the use of VAC-therapy to improve the results of surgical treatment of patients with acute destructive appendicitis complicated by typhlitis and periappendicular abscess. Material and methods. The present investigation is based on the results analysis of 84 patients aged from 17 to 78 years with acute destructive appendicitis, complicated by typhlitis and periappendicular abscess, being treated at the department of surgery 2 of the State Medical Institution City Clinical Hospital 7 of Kazan. Open ligature appendectomy was performed in all cases due to pronounced infiltration of the cecum dome. Two groups of patients were singled out according to the method of ОБМЕН ОПЫТОМ ВЕСТНИК СОВРЕМЕННОЙ КЛИНИЧЕСКОЙ МЕДИЦИНЫ 2021 Том 15, вып. 2ВЕСТНИК СОВРЕМЕННОЙ КЛИНИЧЕСКОЙ МЕДИЦИНЫ 2022 Том 15, вып. 4110 surgical intervention completion. In 54 patients of the comparison group the surgical intervention was terminated by gauze- gingival drainage of the appendix bed, since there was a high probability of appendix residual limb failure and necessity of purulent process isolation from the free abdominal cavity. Penrose drainage was removed through the surgical wound. In addition, the pelvis was drained through the contraperitoneum with a tubular drain. In 30 patients of the main group after appendectomy for abdominal cavity drainage we connected a Vacuum–assisted closure-system using Vivano apparatus and consumables of Hartman, Germany. Statistical processing of the results was carried out using Statistiсa 10 software package and Miсrosoft Exсel 2010. The differences were considered statistically significant at p<0.05. Results and discussion. Analysis of the used surgical techniques showed that in the main group the wound postoperative complications decreased by 3 times and were 23,3%; formation of the abdominal cavity infiltrates was 2 times less; period of hospitalization decreased by 1,8 times. Conclusion. Ease of implementation of VAC-therapy method, therapeutic and economic feasibility allow us to recommend it as the final stage of treatment of acute destructive appendicitis complicated by typhlitis and periappendicular abscess
Published Version
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