METHOD FOR SURGICAL TREATMENT OF CHRONIC INFLAMMATION OF THE EPITHELIAL COCCYGEAL PASSAGE. Russian patent published in 2022 - IPC A61B17/00 A61K33/40 A61P31/04 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to coloproctology. Preoperative sanitation of fistulas, excision of the epithelial coccygeal passage, purulent fistulas and infiltrates, hemostasis and wound closure are performed. At the same time, preoperative debridement of the wound is carried out with a 3% solution of hydrogen peroxide, ozonated saline at a concentration of 2.5 mg/l. Wherein the length and distribution of the epithelial coccygeal passage are additionally preliminarily specified by probing. Then the skin and subcutaneous tissue of the epithelial coccygeal passage is dissected by two semi-oval incisions of the leaf-like type with an indent from the intergluteal fold at a distance of 2 cm and 2 cm above and below the primary opening of the passage with the capture of secondary fistulous passages without opening their lumen. At the same time, the excision of the pathological focus is carried out within healthy tissues without damaging the periosteum in such a way that in its middle part the excision depth is maximum, in the upper and lower edges of the incision it is minimal, forming a navicular shape. Closure of the resulting wound is carried out from the bottom up, and the subcutaneous tissue is sutured to ½ of the depth of the wound with interrupted sutures from absorbable suture material, the ends of the threads are cut off, on each side of the reduced wound, retreating from the skin down, and from the previously applied interrupted sutures upward, wedge-shaped in in the form of an equilateral triangle with a height equal to the depth of the wound and a base located towards the wound, the subcutaneous tissue is excised from both sides. Threads are inserted intradermally, parallel to the wound edge, to a depth of 5 mm, the ends of which are directed towards the wound, while the ends of the threads alternately capture the subcutaneous tissue with the thread passing at the level of the bottom of the wound sutured with the first row of sutures. The ends of the threads are brought to the skin 1.5 cm from the skin edge of the wound. Then the threads are tied together, reducing the skin edges of the wound to its bottom with the formation of an intergluteal fold to a flat configuration of the buttocks.

EFFECT: method allows to simplify and reduce the time of the operation and reduce the duration of postoperative recovery.

1 cl, 8 dwg, 5 ex