Abstract
AIM: to improve the results of treatment in hemorrhoid Grade IV.PATIENTS AND METHODS: the prospective randomized study included 101 patients with combined hemorrhoids Grade IV were divided in two groups. Both groups were homogenous in age and gender. All patients underwent open hemorrhoidectomy with monopolar coagulation. Low-temperature argon plasma application was implemented in postoperative period as an additional option in the main group at 2, 4, 6, 8, 14, 21, 30 days after surgery. Visual Analogue Scale (VAS, 0 to 10 points) was used to assess pain intensity. Bacteriological and cytological tests performed at 2, 8, 14, 21, 30 days and then every 7 days until the wounds were completely healed. The area of the postoperative wound and the rate of healing were calculated using a planimetric method. Quality of life was assessed before surgery, and on days 8 and 30 using the SF-36 questionnaire.RESULTS: on the 30th day after surgery, cytology confirmed wound healing occurred in 38 (76.0%) patients of the main group and in 18(36.0%) patients in the control group, p = 0.0001. VAS score at day 8 after surgery was 3 (3; 4) and 4 (3; 5) points in main and control group, respectively, p = 0.00003. Quality of life measuring showed significant difference in the physical component between groups: 48 (44; 53) vs 42 (38; 48) points in the main and control group, respectively (p < 0.05). On the 30th day after the procedure, the physical component of the quality of life was 48 (44; 53) points in the patients of the main group, 42 (38; 48) — in the control group, p = 0.005. There was found significant difference in wound microbial content between groups: 104 vs 107 CFU on the 30th day after the surgery.CONCLUSION: the low-temperature argon plasma accelerates wound healing, as well as reduces the pain intensity. A significant antimicrobial effect was detected.
Highlights
101 patients with combined hemorrhoids Grade IV were divided in two groups
Both groups were homogenous in age and gender
Low-temperature argon plasma application was implemented in postoperative period as an additional option
Summary
Применение низкотемпературной аргоновой плазмы в лечении ран после открытой геморроидэктомии. После операции пациентам основной группы в качестве физиотерапевтического лечения применялся сеанс низкотемпературной аргоновой плазмы (НАП). РЕЗУЛЬТАТЫ: на 30 день после операции заживление раны произошло у 38 (76,0%) больных основной группы и у 18 (36,0%) пациентов контрольной группы, р = 0,0001, что подтверждается цитологическим исследованием. На 8 день после операции уровень болевого синдрома у пациентов основной группы составил 3 (3; 4) балла, у больных контрольной 4 (3; 5) балла, р = 0,00003. На 30 день после операции физический компонент качества жизни составлял 48 (44; 53) балла у пациентов основной группы, 42 (38; 48) у больных контрольной группы, р = 0,005. На 30 день после операции у больных основной группы после применения НАП по результатам микробиологического исследования выявлена E.coli — среднее количество 10*4 КОЕ, а в контрольной группе 10*7 КОЕ.
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