METHOD FOR SURGICAL TREATMENT OF PYOINFLAMMATORY PROCESSES OF BONE AND SOFT TISSUE STRUCTURES OF PATIENT'S LOCOMOTOR SYSTEM USING SOFT SPACERS IMPREGNATED WITH ANTIBACTERIAL AGENTS
FIELD: medicine.SUBSTANCE: invention refers to medicine, namely to traumatology and orthopaedics, and can be used for surgical treatment of pyoinflammatory processes of bone and soft tissue structures of the patient's locomotor system. That is ensured by preoperative preoperative surgical treatment by standard X-ray imaging, fistulography and ultrasonic diagnostics of volume and border of pyoinflammatory process. Thereafter, an area of pyoinflammatory complications is accessed. Necrotically altered bone tissues are incised to support cortical layer with simultaneous removal of pathologically changed soft tissues. Flow-aspiration drainage of the formed cavity is ensured by antiseptic solutions. Then the bone cavity of the post-excision defect cleared from pathologically changed bone and soft-tissue structures is filled with a prepared soft spacer in form of macroporous cryogel based on polyvinyl alcohol with size of interconnected macropores from 2 to 10 mcm, made in the form of a set of spacers in the form of cubes, parallelograms, balls and irregular geometrical shape, impregnated as an antibacterial agent with aqueous solutions of tobramycin and/or dalbavancin with concentration of 10–50 mg/ml. Aqueous solution of the antibacterial preparation tobramycin in its mixture with an aqueous solution of dalbavancin is selected from 20 to 80 vol. %. Then the wound is closed in layers. In 40–60 days thereafter, the spacer is removed from the bone cavity of the post-excision defect.EFFECT: method provides reliable prevention of repeated occurrence of pyoinflammatory processes with simultaneous preservation of blood supply and innervation of tissues, reliable provision of bone defect filling with material with high antibacterial properties, ensuring the bone tissues and wound tissues closure with their own tissues, as well as reliable restoration of the anatomical, functional integrity and motor capabilities of the patient's extremity.1 cl, 5 exИзобретение относится к медици
