Вестник хирургии имени И.И. Грекова (Apr 2023)

Features of the tissue repair process in urgent surgical abdominal pathology in combination with COVID-19

  • A. P. Vlasov,
  • O. V. Markin,
  • V. V. Shchapov,
  • I. I. Sitdikov,
  • A. A. Zakharov,
  • V. G. Shindakov,
  • M. O. Babiker

DOI
https://doi.org/10.24884/0042-4625-2022-181-4-36-42
Journal volume & issue
Vol. 181, no. 4
pp. 36 – 42

Abstract

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The OBJECTIVE was to study the process of wound healing after surgical interventions in patients with urgent surgical diseases in combination with a new coronavirus infection.METHODS AND MATERIALS. We observed for 80 patients with urgent abdominal diseases. Group I – 48 patients with various urgent diseases of the abdominal organs, group II – 32 patients with similar diseases occurring against the background of coronavirus infection. Stages of postoperative examination: 2, 4 and 7 days after surgery. The nature and rate of wound regeneration was assessed by cytological examination of wound exudate. In the tissues along the suture line, trophic indicators and microcirculation were recorded.RESULTS. The number of neutrophilic leukocytes in the wound exudate in group II exceeded the values of group I by 38.7–116.8 % with a slowed down dynamics of recovery. In the II group of patients, the number of tissue polyblasts was reduced at all stages of observation in comparison with the control group by 34.2–41.9 %. The number of lymphoid polyblasts in the main group was increased in comparison with the control group on days 2, 4, 7 of observation by 33.1 %, 63.2 %, 354.9 %, respectively. The indices of microcirculation in the tissues of the laparotomic wound in the group II of patients changed to a greater extent. The redox potential and oxygen diffusion coefficient in the group II were lower than the control figures by 9.8 – 37.2 % and 35.3 – 38.1 %, respectively. The number of complications according to the Clavien – Dindo classification in the group II of patients compared to the group I was more than 6 times higher.CONCLUSION. In patients with urgent diseases of the abdominal organs with concomitant coronavirus infection, the process of incomplete reparative tissue regeneration of the wound area slows down, which increases the risk of complications. The main factors that reduce the rate of tissue healing are disorders of microcirculation and bioenergetics.

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