METHOD FOR CLOSING POSTOPERATIVE WOUND DEFECT OF SACROCOCCYGEAL AREA Russian patent published in 2021 - IPC A61B17/00 A61B17/04 

FIELD: medicine; surgery.

SUBSTANCE: invention relates to medicine, namely to surgery, it can be used in the surgical treatment of the epithelial coccygeal passage (ECC). With the condition of preserving the gluteal muscle, the gluteal fascia is dissected with the mobilization of fascial leaves. A perforated single-lumen drainage is placed on the wound bottom, the ends of which are removed through the counterpertures from the right of the upper wound corner and from the left of the lower wound corner. The drainage is fixed to the skin with a monofilament thread of size 3/0 according to USP. Then, a blocking thread is passed through by retracting from the upper wound corner by 2-4 cm, making an injection with a needle with a monofilament non-absorbable thread of size 8 according to USP, which is removed at the wound bottom, and applying clamps-holders to the blocking thread ends. After that, the mobilized fascial flaps are stitched over the perforated drainage with monofilament non-absorbable threads of size 1 according to USP. Then, on each monofilament non-absorbable thread of size 1 according to USP, the first knot is made, then, the second knot is tied, thus forming a loop through which the blocking thread is passed. Then, the second knot is tightened until the loop is fixed around the blocking thread. After fixing the node of the last monofilament non-absorbable thread on the blocking thread, the blocking thread is removed through the subcutaneous tissue and skin at a distance of 2-3 cm from the right at the level of the lower wound edge. Monofilament threads tied on the fascia are removed through the skin wound edge, the ends of each thread are connected to each other, forming a knot at a distance of 5 cm from the skin, free thread ends 6 cm long are left above the knot, and the skin is stitched. The free ends of the blocking thread are tied over the wound, thus forming a loop-handle, on which the free ends of monofilament threads of size 1 according to USP are fixed. The wound fluid is evacuated by layer-by-layer drainage: the subfascial layer is drained by perforated single-lumen drainage, the epifascial layer is drained between the edges of the stitched wound by shifting the monofilament threads of the fascia while dressing. On the 21-24 day, the removable stitches are removed.

EFFECT: method reduces tension, improves the formation of stitches and evacuation of wound fluid by preserving the gluteal muscle, dissecting the fascia with the mobilization of fascial leaves, followed by stitching the fascia with removable stitches and skin-subcutaneous-fat tissue, applying removable stitches and layer-by-layer draining the wound.

1 cl, 5 dwg, 2 ex