SURGICAL MANAGEMENT METHOD OF CHRONIC INFLAMMATION OF EPITHELIAL COCCYGEAL PASSAGE Russian patent published in 2020 - IPC A61B17/00 A61K35/19 A61P17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to coloproctology, and can be used for surgical management of chronic inflammation of epithelial coccygeal passage. After excising the epithelial coccygeal opening, the outer fistulous orifices are excised by enclosing incisions at the skin depth. In the upper and lower angles of the wound, perpendicular to it, additional incisions are made on both gluteal regions with their length equal to 1/3 of the buttock height plus a wound width from the middle line to its edge. Skin with subcutaneous fat is mobilized for this length to pre-excised external fistulous holes. Mobilized flap with subcutaneous fat is turned, pathologically changed tissues are removed with previously isolated external fistulous holes, wound in a wall administered platelet-rich plasma with platelet 10⁶/mcl, using a syringe with injection needle 1.0 BogMark 0.5 × 16. Wound is closed from the bottom up by suturing with a double synthetic suture; the sacrococcyceal ligaments are grasped with a stitch length of 1.0–1.5 cm. Ends of the first suture at 2/3 of the wound depth are used to suture the subcutaneous tissue of one of the wound walls in the form of P-shaped seam. Second suture is similar to the other wound wall. Nasal sutures are fastened. Then by ends of the first suture at both sides, wound edges are intracutaneously grasped, which are brought down and fixed to bottom of sutured to 2/3 of wound depth by binding ends of this thread, similarly performed with the ends of the second suture, obtaining two nodal intracutaneous sutures at distance of 1.0 to 1.5 cm from each other with subsequent repetition with the filaments of all superimposed required for suturing, with the possibility of forming an intergluteal fold and a path in the form of a narrow strip with a width of up to 0.5 cm with the possibility of an outflow of a wound discharge, and additional incisions on the buttocks are closed with an intracutaneous suture.

EFFECT: method enables simplifying surgical intervention, reducing the length of operation and the length of postoperative recovery ensured by simultaneous complete removal of fistulous holes.

1 cl, 6 dwg, 4 ex