EGORKIN MIKHAIL ALEKSANDROVICH,Егоркин Михаил Александрович,GORJUNOV SERGEJ VITALEVICH,Горюнов Сергей Витальевич
申请号：
RU2014106133/14
公开号：
RU0002550048C1
申请日:
2014.02.19
申请国别(地区):
RU
年份:
2015
代理人:
摘要：
FIELD: medicine.SUBSTANCE: preoperative patient preparation involves urinary catheterisation and rectal drainage. That is followed by radical surgical d-bridement of a purulonecrotic centre and wide opening of the involved site. The pus pockets are drained, and the necrotic tissues are excised to form a vast wound surface. The radical surgical d-bridement of the purulonecrotic centre leaves a sphincter muscle of anus and a serous-muscular layer of the rectal walls preserved. On the 3rd-4th postoperative day, after multiple necrectomies of the wound surface and intensive infusion, detoxification and antibacterial therapy, the vast wound surface is covered with a porous sponge and/or a gauze bandage as a wound filler. The sponge is made of a hydrophilic polyurethane base impregnated with activated carbon. The gauze bandage is impregnated with a colloidal solution of zerovalent metal silver Ag0 particles having a silver nanoparticle size from 2 to 25 nm. The patient is anaesthetised adequately and placed in a plastic air-tight transparent isolator chamber configured as cut down trousers with the vast wound surface covered with the wound filler. The 3-5 postoperative days involve 3-4 continuous vacuum drainage of inflammation products of the involved soft tissues through the porous sponge and/or gauze bandage coverage. The vacuum drainage does not require the dressings to be changed and uses a negative pressure of 85-130 mmHg. After each procedure of the vacuum drainage of the wound surface and every time the isolator chamber is opened, the wound is visually inspected, examined for bacterial contamination and explored. Necrectomy is performed if needed. After the inflammation is arrested completely and the wound surface is clean, whereas the wound surface is decreased considerably, a bacterial swab test is conducted. That is followed by the stages of skin repair of the wound defect with the use of local tissues. The vacuum drainage of the necrotic putrid inflammation pr
