FIELD: medicine.
SUBSTANCE: two-flap fascioplastic amputation is performed under spinal anesthesia. During dissection of muscle massifs, fascial leaves, nerves and vessels, the argon-plasma flow (APF) is used in the cutting-coagulation mode. The proximal end of the truncated nerve is treated with APF in the mode of close-focus coagulation until a coagulation scrap is formed at the end of the nerve. The surgical wound is treated at all stages of stump formation by APF in the therapeutic mode with spiral or linear scanning movements of the plasma torch. Prior to soft tissue dissection, circular tumescent infiltration of all soft tissues to the bone is performed by ozonized saline chilled to 4-5°C with ozone concentration of 4-5 mg/l. Before crossing the femoral and sciatic nerves, ozonized saline chilled to 4-5°C with ozone concentration of 4-5 mg/l is injected under the epineurium and into the perineural cell space.
EFFECT: decreased severity of postoperative pain syndrome in the lower limb stump, rapid regression of postoperative stump edema, reduced postoperative blood loss and the number of wound complications due to the protective, hemostatic, antimicrobial, antioxidant, anti-inflammatory and analgesic effects of the cooled ozonized saline introduced through the hip soft tissue dissection line, as well as in the trunk of the nerve and perineural space.
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Authors
Dates
2018-02-01—Published
2017-05-30—Filed