Амбулаторная хирургия (Nov 2021)
Two-stage prevention of purulent-septic complications after surgery in patients with pararectal fistulas
Abstract
Introduction. In the treatment of patients with pararectal fistula, relapses of the disease are quite common, as well as postoperative complications in the form of suppression of a postoperative wound, anal incontinence, etc. The aim of the work is to improve the results of treatment of patients with pararectal fistula by reducing the number of purulent-septic complications in the postoperative period. Materials and methods. Analysis of 105 cases of treatment of patients was carried out. All patients were divided into 2 groups by random sampling: in group I, patients, in addition to standard preoperative training, underwent fistula sanitization with 1% dioxidin solution. In the postoperative period, patients underwent dressings with 5% dioxidin ointment, and also administered per rectum ointment from 1 postoperative day for 7 days. In the second group, standard preoperative training was carried out. All patients of the comparison groups were intraoperatively seeded on the flora from the fistula. Postoperative healing of postoperative wounds, subsidence of local and systemic inflammatory response were evaluated. Results. The results show a statistically significant improvement in treatment outcomes of patients in the major group. Conclusions. Application of two-stage prevention of postoperative complications makes it possible to improve results of treatment of patients with pararectal fistulas due to reduction of amount of pathogenic microflora in area of postoperative wound, faster stopping of local and systemic inflammatory reaction, and also due to increase of number of patients with primary healing postoperative wound.
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