FIELD: medicine.
SUBSTANCE: invention relates to traumatology and orthopedics and may be applicable to the surgical treatment of periprosthetic infection of large joints. In the area of endoprosthetics of the damaged joint, the focus of purulent-inflammatory complications is approached. Necrotically altered tissues are incised with the removal of pathologically altered soft tissues, including from the cavity of the metal endoprosthesis, exposing the surface of the metal endoprosthesis. Metal endoprosthesis is disassembled and its head and polyethylene liner are removed. Surface of the wound cavity and exposed surfaces of the disassembled metal endoprosthesis are washed with a 3 % povidone-iodine solution using a pulsatile lavage system. Surface of the wound cavity and exposed surfaces of the disassembled metal endoprosthesis are washed with a 1 % lavatept solution using an ultrasound lavage. New head of the endoprosthesis and a new polyethylene insert are placed in the metal endoprosthesis and the integrity of the endoprosthesis is restored. Surface of the wound cavity and surface of the assembled metal endoprosthesis are washed with a 1 % lavatept solution using ultrasound lavage. gel "Phagodent" with bacteriophages is applied to the surface of the wound cavity and to the surface of the assembled metal endoprosthesis, evenly distributing along the entire surface of the wound cavity and the surface of the assembled metal endoprosthesis, providing a thickness of the gel layer from 1 to 3 mm. Porous sponge made of a hydrophilic polyurethane base, impregnated with a 1 % solution of the preparation "Phagodent" with bacteriophages is applied immediately to the wound surface of the wound cavity and the surface of the metal endoprosthesis, as a wound filler, and the open wound surface of the operated patient is immediately covered with a rectangular or diamond-shaped biocompatible, optically transparent elastic vacuum-tight polymer film insulator with self-adhesive edges, ensuring a tight fit of the film insulator to the patient's body in the process of isolating the patient's wound surface from the environment atmosphere. Film insulator with self-adhesive edges placed on the operated patient is equipped with a vacuum system for removing ambient air from beneath the internal volume of the film insulator, communicating through a cut in the film insulator and fixed to the upper outer surface of the film insulator using a self-adhesive film. 3-4 postoperative days involve 1-2 vacuum drainages of inflammation products of the involved bone and soft tissues through the pre-laid porous sponge.
EFFECT: method provides minimum damage during surgery, reduced risk of recurrent surgery.
3 cl
Title | Year | Author | Number |
---|---|---|---|
METHOD FOR SURGICAL TREATMENT OF LARGE JOINTS PERIPROSTHETIC INFECTION USING POLYVALENT BACTERIOPHAGE FAGODERM AND VACUUM DRAINAGE OF INFLAMMATION PRODUCTS | 2016 |
|
RU2631052C1 |
METHOD FOR SURGICAL TREATMENT OF PERIPROSTHETIC INFECTION OF LARGE JOINTS USING POLYVALENT PHAGODENT BACTERIOPHAGE | 2017 |
|
RU2676403C2 |
METHOD FOR SURGICAL TREATMENT OF LARGE JOINT PERIPROSTHETIC INFECTION USING POLYVALENT FAGODERM BACTERIOPHAGE | 2016 |
|
RU2631109C1 |
METHOD FOR SOFT TISSUE INFECTION CONTROL IN THIGH-JOINT REPLACEMENT SURGERY | 2018 |
|
RU2697989C1 |
METHOD FOR TREATMENT OF DEEP PERIPROSTHETIC INFECTION OF HIP JOINT IN PRESENCE OF PERIPROSTHETIC FRACTURE | 2021 |
|
RU2766816C1 |
METHOD OF PROLONGED ULTRASONIC SANATION WITH EARLY DEEP PERIENDOPROSTHETIC HIP INFECTION | 2018 |
|
RU2712010C1 |
METHOD OF SURGICAL MANAGEMENT OF CHRONIC INFLAMMATION OF PILONIDAL CYST | 2015 |
|
RU2602680C1 |
METHOD OF TREATING EARLY PARAPROSTHETIC INFECTION | 2011 |
|
RU2478343C1 |
METHOD FOR PREPARATION OF INFECTED PERIARTICULAR WOUND FOR IMPLANTATION OF PERMANENT OR TEMPORARY STABILIZING DEVICE | 2018 |
|
RU2712013C1 |
METHOD OF TREATING THE PERIOPROSTHETIC INFECTION AFTER REPLACEMENT ARTHROPLASTY | 2019 |
|
RU2712806C1 |
Authors
Dates
2018-12-28—Published
2017-03-10—Filed