27 февраля 2016г.
Achievement goals: during the investigation we wanted to use new modified methods of isolation the peritoneum cavity in the case of local peritonitis. Every patient during the operation had expiration of purulent effusion from an abdominal cavity in quantity from 10 to 100 ml. The major indication for the use of method was the existence of local peritoneal symptoms.
Investigation group of patients: on this method 52 patients were operated, including 38 patients with phlegmonous form and 14 patients with gangrenous form of sharp appendicitis.
Investigation methods: all patients had been operated in clinic and treated.
Procedure: first, rubber glove was taken; all fingers of rubber glove, except indicatory, are bandaged at founding; all fingers of rubber glove both with indicatory are cut off higher than ligature. A rubber sack is done. There is the only one opening in place of indicatory finger. During the operation, before dissection of abdominal cavity, the procured rubber glove is mortgaged in an operating wound and the peritoneum is taken out by a soft clamp through opening in a rubber glove, at section of abdominal cavity purulent effusion flows out in the cavity of rubber glove, the place there is cleaned. Borders of peritoneum are taken by the Mikulicz’ clamps together with a rubber glove and further appendectomy is executed by a typical method.
Results: in a postoperative period 1 patient that had been operated by this method has suppuration of wound (7.6%), while at the retrospective analysis of the cases report 24 patients had the destructive forms of sharp appendicitis. Before using this method there were 14 patients with wound infection.
Conclusion: the offered technical solution can reduce suppuration of postoperative wounds at the destructive forms of sharp appendicitis in 7.6 times.
Recommendations: the simple, accessible and effective method of isolation of abdominal cavity from an operating wound with the purpose of prophylaxis of suppuration at the destructive forms of sharp appendicitis had been offered.
List of references
1. Абдуллаев Ж.Н. Распознавание и лечение некоторых заболеваний органов брюшной полости.
2. Ротков И.Л. Острый аппендицит. «Медицина» М. 1988 г.
3. Гринберг А.А. Неотложная абдоминальная хирургия. М. 2000 г.
4. Кузин М.И./под редакцией/. Хирургические болезни: Учебник. М: Медицина. 2005 г.
5. Ибадильдин А.С. Хирургические болезни. Алматы. 2011 г.
6. Острый аппендицит: Руководство по неотложной хирургии органов брюшной полости / под редакцией Савельева В.С. М. 2005 г.
