Surgical Treatment Of Injuries Research Articles

AN UNUSUAL WAY TO INDUCE THE CLOSURE OF A POSTERIOR POLE RETINAL TEAR IN A TRAUMATIC RETINAL DETACHMENT

Purpose. The authors present a case of both traumatic subluxated lens with zonular dialysis and a traumatic retinal detachment with posterior retinal tear. Methods. Some fragments have dropped into the vitreous chamber during phaco-emulsification and one of them has even passed through the retinal tear and has been removed from the subretinal space. A 3-piece intraocular lens with a tension ring supporting the capsular bag was implanted. Pars plana vitrectomy with accurate vitreous base shaving was approached by 23-gauge system. Subretinal fluid was removed by a complete fluid-air exchange. A large macular internal limiting membrane (ILM) peeling was performed and the posterior retinal tear was covered by multiple inverted ILM flaps. Results. Postoperatively, retinal reattachment was achieved, the retinal break was flat. The ILM flaps were well positioned within the retinal tear and covered the preoperatively bared RPE. Conclusions. The surgical treatment of injuries after a blunt ocular trauma are not standardizable. In this case surgical outcomes suggest the effectiveness of the surgeon’s intraoperative unusual maneuvers.

Disasters and kidney care: pitfalls and solutions.

Patients with kidney disease, especially those with kidney failure, are particularly susceptible to the adverse effects of disasters because their survival depends on functional infrastructure, advanced technology, the availability of specific drugs and well-trained medical personnel. The risk of poor outcomes across the entire spectrum of patients with kidney diseases (acute kidney injury, chronic kidney disease and kidney failure on dialysis or with a functioning transplant) increases as a result of disaster-related logistical challenges. Patients who are displaced face even more complex problems owing to additional threats that arise during travel and after reaching their new location. Overall, risks may be mitigated by pre-disaster preparedness and training. Emergency kidney disaster responses depend on the type and severity of the disaster and include medical and/or surgical treatment of injuries, treatment of mental health conditions, appropriate diet and logistical interventions. After a disaster, patients should be evaluated for problems that were not detected during the event, including those that may have developed as a result of the disaster. A retrospective review of the disaster response is vital to prevent future mistakes. Important ethical concerns include fair distribution of limited resources and limiting harm. Patients with kidney disease, their care-givers, health-care providers and authorities should be trained to respond to the medical and logistical problems that occur during disasters to improve outcomes.

Лечение пострадавших с сочетанной травмой органов нескольких полостей и опорно-двигательной системы

The aim of the study was to improve the results of treatment of patients with severe combined trauma of the organs of several cavities (skull, thoracic and abdominal cavities, retroperitoneal space) and of the musculoskeletal system. Materials and research methods. The study involved 72 patients treated between 2013 and 2017 in a Level I trauma center established at the Republican Clinical Hospital of the Ministry of Health of the Kabardino-Balkarian Republic. The Injury Severity Score (ISS) index was used to determine the severity of injury; “department of military field surgery, condition, admission” scale was used to assess the state of the injured. Results of the study and their analysis. Analysis of the findings showed the following: in severe combined injuries the main causes of death are: shock, cerebral edema and dislocation, posttraumatic pneumonia, multiple organ failure, acute respiratory failure, pulmonary embolism and DIC syndrome. The most satisfactory treatment outcomes can be achieved only with the use of a care tactic based on the principles of staged surgical treatment “Damage control”. The time frame and the sequence of surgical treatment of injuries depend on their severity, degree of life threatening and prevailing injury.

TRANSPLANTATION METHODS FOR CORRECTION OF MANDIBULAR SOFT TISSUE DEFECTS

Goal: This paper aims to identify optimal transplantation methods for correcting soft tissue defects of the face and mandible based on our medical records and study of up-to-date research literature. Materials and methods: The analysis of standard transplantation procedures was carried out, as well as research of patients charts with extensive defects of the lower jaw at the department of maxillofacial surgery of a Moscow oncological hospital. There was a comparative analysis of the following most popular methods of correction of soft tissue defects of the face and lower jaw: Trapezoidal flap Filatov and H.D. Gillies stem grafting Deltopectoral flap Thoracodorsal flap Temporal parietal flap - Lexer and Esser method Results: Plastic surgery with complex grafts on the neurovascular pedicle is used in the surgical treatment of injuries and diseases of the mandible, which are accompanied by deep defects in the soft tissues of the face and bones of the mandible. The most optimal methods for restoring the anatomical integrity of the mandible, which is necessary for adaptation of the patient in society, and restoration of speech and chewing functions have been identified. Conclusion: Nowadays, the most common and effective methods in the world of eliminating mandibular defects by transplantation are considered to be Lexer’s method (temporal parietal flap), transplantation of the delto-pectoral flap, as well as thoracodorsal on feeding pedicle. The clinical researches conducted in the Moscow Oncological Hospital confirmed generally successful outcomes without complications.

Development of patenting of domestic inventions for the surgical treatment of injuries of the shoulder joint

Domestic patents for inventions on surgical treatment of shoulder joint injuries are analyzed. The database of the Federal Institute of Industrial Property of Rospatent was searched. Eliminating the so-called search noise, we created an array of 215 patents for inventions for the surgical treatment of shoulder injuries (registration mainly from 01/01/1994 to 09/30/2020). The average annual number of patents for inventions was 7 1. Surgical treatment methods were presented in 74.3% of inventions, and devices (surgical instruments, endoprostheses, etc.) in 25.7%. In some inventions, both methods and devices were patented. Inventions for the surgical treatment of shoulder joint instability accounted for 23.4%, for the treatment of tendons and periarticular tissues 8.9%, for osteosynthesis of the bones of the shoulder joint 21.9%, for surgical devices and instruments 14.2%, for methods and shoulder arthroplasty devices 13.4%; other inventions (on assessment of lesions, the likelihood of a favorable outcome of surgery, pain relief, etc.) 18.2%. It is necessary to optimize the domestic inventive activity in areas of medicine to prevent a shotage of domestic medical equipment or tools in case of sanctions imposed by certain foreign states.

Functional problems after surgical treatment of spine fractures

Introduction: Despite the large amount of research on the spine injuries themselves and on methods of their treatment, there are only a few reports of functional problems faced by patients after surgical treatment of these injuries. Aim: The aim of the study was to demonstrate the occurrence of functional problems and determine their type in patients after surgical treatment of spinal injuries, to determine the impact of the severity of the injury on the occurrence of dysfunctions, to determine the impact of patients' health and fitness on the occurrence of functional problems and coping with them, to demonstrate the relationship between the mental state and the occurrence of dysfunction, determination of the impact of pain on the occurrence of functional problems, assessment of the degree of coping with dysfunctions. Materials and methods: The study included a group of 20 people (13 men and 7 women) treated surgically at the Department of Neurosurgery, Nicolas Copernicus University Collegium Medicum in Bydgoszcz, due to a spine injury. The average age of the respondents was 44.6 years. The research consisted of patient answering the questions included in the patient's questionnaire, subjective descriptive test of pain intensity, modified Barthel scale and determination of pain intensity on the VAS scale. The investigator also completed an additional questionnaire in order to obtain additional information about the patient's health. Results: Research results indicate pain as the main cause of postoperative dysfunction. They concern self-service activities, travel, sleep and social life. As it has been shown on the basis of research, the quality of coping with functional problems depends on factors such as physical fitness, the activity of daily life before the injury, the presence of comorbidities, mental attitude and the severity of the injury.

Complications of surgical treatment of injuries and diseases of the cervical spine at the subaxial level

Complications of surgical treatment of injuries and diseases of the cervical spine at the subaxial level

Dog bites and diabetic peripheral neuropathy: a dangerous combination

All animal bites have the potential to cause significant infection. In the UK, dogs are the most common source of bites. Incidence of hospital attendances attributable to dog bites has...

Хирургическая тактика при закрытой дуоденальной травме

Relevance Among closed injuries of the abdominal cavity trauma duodenum (KDP) holds a special place due to the rare, large traumatic severe complications in 50-70% of operated patients. To date, there is a high mortality rate (30 to 60%) due to develop complications and failure at the seams or phlegmon - up to 100%. The purpose of the study The aim of the study was choice of the method of surgical treatment and analysis results of surgical treatment in patients with closed trauma of the KDP. Materials and methods The paper analyzes results of treatment 35 patients with a closed duodenal injury. The most common cause of damage KDP was closed to road traffic injury (17 pers. - 48.6%), resulting in katatravmy in 6 (17.1%) patients. In 5 (14.3%) patients injury was received in the workplace, in 1 - sports injury in 6 - home injury. Results and their discussion Depending on the timing of the victims to the hospital after the injury, the size of the defect duodenal wall, level of injury, associated injuries pancreatoduodenal zone defines the principles of surgical treatment for injuries of the duodenum. For the prevention and treatment of retroperitoneal phlegmon used 5% glucose solution ozonated, which reduced the number of complications from 52.3% in the control group to 33.3% - in the main group and reduced the risk of an adverse outcome, ie, reduce mortality C60% to 33.3%. Conclusion 1. The volume of surgery at closed duodenal injury must be selected individually, depending on the severity of the injury and status of victim. 2. In the postoperative period is mandatory drug suppression of secretion digestive tract and the appointment of broad-spectrum antibiotics against background of infusion-transfusion therapy. Key words Closed duodenal trauma, surgical technique, complications, mortality

ОСЛОЖНЕНИЯ ВЕНТРАЛЬНОЙ МЕЖТЕЛОВОЙ ФИКСАЦИИ ШЕЙНЫХ ПОЗВОНКОВ ДИНАМИЧЕСКИМИ ПЛАСТИНАМИ

Dynamic cervical plates, due to their constructive features, provide more proportional load sharing on interbody support that optimizes interbody healing after anterior cervical interbody fusion in the surgical treatment of injuries and diseases of the cervical spine. However, complication rate after their application remains sufficiently high. Analysis of complications of anterior interbody fusion with dynamic cervical plates was performed with respect to their constructive features and the option of interbody support restoration. Complications specific to each type of dynamic cervical plate were determined.

Surgical treatment of injuries caused by fishing gear in the intracoelomic digestive tract of sea turtles

We report the surgical techniques used to remove accidentally ingested hooks and branchlines localized in different parts of the digestive tract of 129 loggerhead sea turtles Caretta caretta, together with the characteristics and localization of lesions, and final outcome related to their severity. Hooks were removed from the cervical esophagus via the ventral surface of the neck, while the supraplastron approach was performed for hooks wedged in the intracoelomic portion of the esophagus. An approach through the left axillary region was preferred for fishhooks in the stomach, while hooks and long branchlines in the intestine or pyloric area were removed by approaching the coelomic cavity through the right or left prefemoral fossa. The ingestion of fishhooks, and/or longlines, often induces severe injuries in the digestive tract that could lead to the death of the turtles, with the extent of damage engendered by lines often more severe than that caused by hooks, leading to strangulation, intussusception, and tears that require resection of long tracts of intestine. Spontaneous expulsion of hooks, even where possible, involves long waiting times, with the possible impairment of the turtle's clinical condition, and should be avoided when the line is evident or suspected. The development of diversified surgical techniques enabled us to approach the coelomic cavity with minimally invasive and easy-to-perform methods, and survival rates proved very satisfactory.

The Use of Adipose Tissue–Derived Stem Cells within a Dermal Substitute Improves Skin Regeneration by Increasing Neoangiogenesis and Collagen Synthesis

Surgical treatment of injuries with loss of skin tissue has improved significantly with the advent of regenerative medicine and tissue bioengineering, and the use of stem cells and dermal substitutes. The success of tissue regeneration depends on optimal local vascularization and the successful integration of the artificial skin. The present study combines the use of autologous adipose-derived stem cells with a commercially available dermal substitute (Integra) for skin regeneration. Adipose-derived stem cells were isolated from the inguinal region of eight Sprague-Dawley adult rats, seeded onto a piece of dermal substitute for 48 hours, and then implanted into the same rat, followed by comparison of the evolution with a contralateral implant without adipose-derived stem cells. After 1, 2, and 3 weeks of regeneration in vivo, implants were removed for histologic evaluation. Adipose-derived stem cells adhere properly to the dermal matrix, and autologous tissue integration in the rat was good. The histologic evaluation showed that adipose-derived stem cells significantly increased microvascular density (7.7 ± 0.6 percent versus 5.3. ± 0.5 percent, as assessed by immunohistochemical staining of factor VIII) and the synthesis of collagen type I (24 ± 3 percent versus 16 ± 2 percent, as assessed by Sirius red staining). Although there was greater epithelialization on the side treated with adipose-derived stem cells (2530 ± 939 μm versus 1911 ± 763 μm), as assessed by anticytokeratin immunohistochemistry staining 34βE12, this difference was not statistically significant. The authors' data suggest that the seeding of adipose-derived stem cells onto a dermal substitute improves skin regeneration and tissue integration by increasing vascularity and collagen synthesis. Further studies are necessary to achieve complete epithelialization with the use of adipose-derived stem cells.

Surgical treatment of injuries in the capsular-ligamentous apparatus on the lateral part of the ankle joint (a review of literature)

Treatment of injuries in the capsular-ligamentous apparatus on the lateral part of the ankle joint remains an urgent problem at present. This is owing to a high rate of such injuries, their incomplete diagnosis during an acute period of the injury and a high level of unsatisfactory results of treatment. Despite a significant umber of works, still there is no common opinion concerning recommendations to surgical or conservative treatment depending upon the injury severity, instability degree and time periods since the moment of injuring. The article examines different techniques of surgical treatment for fresh and neglected injuries in the ligamentous apparatus on the lateral part of the ankle joint. Advantages and shortcomings of the main surgical techniques for treating the above injuries, their early and remote results are analysed on the basis of Ukrainian and foreign scientific sources, as well as indications for using each of them in the presence of fresh and neglected injuries in the ligamentous apparatus on the lateral part of the ankle joint are clearly grounded.

The surgical treatment for injuries in the cervical spine

The tactics of the surgical treatment of 1,300 patients with injuries of the cervical vertebrae during the period from 1972 to 2008 was analysed. In 80 % of cases the injuries resulted from traffic accidents. Eight hundred and five patients were admitted during the acute and early periods of the injury; other cases had neglected damages. Neurological vertebrogenic syndromes were present in the majority of observations; their absence was registered only in 50 patients. All the casualties were operated on with help of the anterior access. During the acute and early periods of the injury, the dislocated vertebrae were reduced. Failures of the reduction, as well as fractures and dislocations fractures served as indications for the transcorporal decompression of the spinal cord. This operation is regarded by the authors as the method of choice for the late period of the injury. The vertebral column was stabilized with a carbon graft (900 patients), bone allograft (400 patients), in combination with a utilized autobone (960 patients) or GAP-containing material CollapAn (340 patients). The results were assessed as follows: good – 1,110 cases, satisfactory – 180 cases, bad – 10 cases. One hundred and twenty patients were followed up for more than 25 years after the operation. No reassessment of the treatment results took place. A solid bone or bone-carbon block was registered in all the cases.

Injuries: the neglected burden in developing countries

Injuries: the neglected burden in developing countries

071 Connective Tissue Growth Factor (CTGF) Content and Bioactivity of Small Intestinal Submucosa (SIS)

Bioactive, resorbable materials can be useful in the treatment of surgical injury where biomaterial incorporation followed by tissue-specific remodeling is desired. Bioactive growth factors may be useful in the treatment of chronic ulcerative wounds, shifting the static wound environment to a more active acute phase. Small intestinal submucosa (SIS) is a naturally occurring extracellular matrix used as a biomaterial for the treatment of soft tissue injury, as well as pressure, venous, and diabetic ulcers. Preclinical and clinical studies have demonstrated that SIS induces host tissue infiltration, site-specific remodeling, and repair. Although SIS consists primarily of collagen, the presence of other proteins, glycosaminoglycans, proteoglycans, and the growth factors FGF-2, VEGF, and TGF-β have been reported. Recent experiments have demonstrated the presence of connective tissue growth factor (CTGF) in SIS. Immunohistochemical staining for CTGF was positive in mechanically isolated, disinfected, and ethylene oxide (EO) sterilized SIS. Lyophilized SIS samples were ground in ice cold PBS and CTGF concentration was measured using ELISA. The results are summarized in the following table: Sample [CTGF](ng/g) Mechanically isolated SIS 39.88 ± 5.4 Disinfected SIS 11.31 ± 7.2 Ethylene oxide sterilized SIS 7.96 ± 1.3 CTGF, secreted by fibroblasts after activation with TGF-β, stimulates cell proliferation and extracellular matrix synthesis. In vitro cell culture bioactivity experiments are planned. This work was supported by Cook Biotech Incorporated.

Modern aspects of posterior fusion for surgical treatment of injuries and disorders of the cervical spine

Modern aspects of posterior fusion for surgical treatment of injuries and disorders of the cervical spine

Development of large vein surgery in Europe

Surgery of the great veins inevitably began with the surgical treatment of injuries, often involving the femoral vein. Because of the famous case presented by Roux in 1813, the prevailing opinion until almost the end of the nineteenth century was that ligation of the vein made death inevitable, but that the only way to control severe hemorrhaging from a vein was to ligate the femoral artery. Zaufal's principle (1880) consisted in the ligation and resection of great veins of the body and limbs in order to prevent sepsis in suppurative processes. This surgical method was still being used in the first half of the twentieth century in patients with perforated appendicitis or puerperal fever. In the limb, the congestion induced in the vein had a positive effect on the healing process. The surgical treatment of leg and pelvic deep vein thrombosis was initially (1931) aimed at achieving decompression in compartment syndromes. The first thrombectomy was performed in 1937, but several operations with a successful outcome were reported at the 61st annual meeting of the German Society of Surgery in the following year.

Microbiological decontamination of natural honey by irradiation

Abstract Degree of microbiological decontamination, organoleptic and physico-chemical properties of natural honeys were investigated after radiation treatment. Seven kinds of honeys were irradiated with the beams of 10 MeV electrons from a 10 kW linear accelerator “Elektronika 10-10” at the dose 10 kGy. It was shown, that after irradiation, the total count of aerobic and anaerobic bacteria and moulds decrease by 99%. The antibiotic value in investigated honeys increased in turn from 1.67 to 2.67 after irradiation. Such factors and parameters of investigated honeys as their consistency, content of water and saccharose, acidity, the diastase and 5-HMF values were not changed significantly after irradiation. Decontamination by irradiation is a process which allows us to obtain high microbiological purity of honeys. It is especially needed, when honeys are used in surgical treatment of injuries and in nutrition of babies with food deficiency.

Surgical treatment of injuries and diseases of the spine using the steffee and luque systems

The experience of treatment using the Steffee transpedicular system and the Luque sublaminar system in 33 patients with spinal fractures (20), spondylolisthesis (11), spinal tuberculosis (1) and cauda equina root cavernous angioma (1) is presented. The indications for various types of operations for traumatic injuries and diseases of the spine are substantiated, depending on clinical neurological manifestations and data from special research methods (X-ray, myelography, computed and magnetic resonance imaging). Schemes of operations are given. It has been shown that the use of the Steffee and Luque systems in combination with adequate neuroorthopedic correction makes it possible to eliminate various types of spinal deformities, provides rigid fixation of it, creating an opportunity for early activation and rehabilitation treatment of patients.