The effectiveness of the implementation of new technologies in the prevention of purulent complications of repeated surgеries for complications of fractures of the proximal femur of patients
DOI:
https://doi.org/10.14739/2310-1210.2016.3.76992Keywords:
Biomedical Technology, Femoral Fractures, Secondary Prevention, Suppuration, ReoporationAbstract
Despite the latest achievements of modern traumatology, remains quite high percentage of unsatisfactory results of treatment of fractures of the proximal femur (fPf). According to the literature repeated surgery increases the risk of postoperative purulent complications in several times.
The authors of the article developed the innovations introduced in practice based on the use of thrombocytopoiesis fibrin gel, which has a high antibacterial activity due to preservation of leukocytes (local antibiotic effect), together with bone shavings during the performing of the operations when performing reactioneze and TEP after performing osteosynthesis, and also at persons of senile and elderly, for prevention of postoperative purulent complications in fPf.
A comprehensive clinical study of 120 patients with fPf complications (false joints, aseptic necrosis of the femoral head, axial deformation) after osteomyelitis who underwent re-operative intervention was provided. Patients were divided into two groups, first (control) group consisted of 60 patients with consequences fPf who underwent total endoprosthesis (TEP) of the hip joint (30 patients) and locked intramedullary nailing (LIN) (30 patients) by conventional methods. The second (experimental) group consisted of 60 patients with consequences fPf who underwent TEP of the hip joint (30 patients) and LIN (30 patients) with use developed by authors of innovations. Effectiveness of prevention of septic complications in both groups of observation was evaluated. The observation period was 1 year. There was statistically significant (p≤0.01) decrease in the number of early (4 times) and late (3 times) postoperative complications in patients of the experimental group in comparison with patients of control group. The new technologies use allows to increase in 8.4% the efficiency of preventive maintenance of purulent complications of surgical treatment of patients with complications after performing osteosynthesis in the treatment of fPf.
The introduction of the proposed new technologies will allow to carry out effective prevention of purulent complications of repeated surgical interventions in the fPf treatment, which distinguishes the proposed method from the accepted methods of prevention of postoperative purulent complications fPf treatment.
References
Haiko, H. V., Korzh, M. O., Kalashnikov, A. V., Herasymenko, S. I., & Polishko, V. P. (2008). Analiz stanu travmatolohichno-ortopedychnoi dopomohy naselenniu Ukrainy v 2006–2007 rr. [Analysis of the state of traumatologic and orthopaedic care to population of Ukraine in 2006–2007]. Kyiv: Volia. [in Ukrainian]
Akhtyamov, I. F., & Tikhilov, R. M. (2009) Eˊndoprotezirovanie v Rossii [Endoprosthesis replacement in Russia]. Moscow: Medicinskaya kniga. [in Russian].
Girshin, S. G. (2004) Klinicheskie lekcii po neotlozhnoj travmatologii [Clinical lectures on emergency traumatology]. Moscow: Azbuka. [in Russian]
Hrytsai, M. P., & Sulyma, V. S. (2014) Kistkovo-plastychne likuvannia khvorykh na khronichnyi osteomiielit [Osteoplastic treatment of patients with chronic osteomyelitis]. Ivano-Frankivsk: Talia. [in Ukrainian]
Duplenko, Yu. K. (1985) Starenie. Ocherki razvitiya problemy [Aging. Essays on development issues]. Leningrad: Nauka. [in Russian]
Zubenko, A. H. (2011) Optymizatsiia perebihu reparatyvnoho osteohenezu pry perelomakh velykohomilkovoi kistky (eksperymentalno-klinichne doslidzhennia) (Avtoref. dis…kand. med. nauk) [Optimization of the course of reparative osteogenesis at fractures of the tibia (experimental clinical research)] (Extended abstract of candidate’s thesis). Kyiv: DU AMN Ukrainy «Instytut travmatolohii ta ortopedii». [in Ukrainian]
Lazarev, A. F. (2004) Novye podkhody k lecheniyu perelomov proksymalˊnoho otdela bedrennoj kosti [New approaches to the treatment of fractures of the proximal femur]. Vestnik travmatologii i ortopedii, 1, 27–31. [in Russian]
Lapach, S. N., Chubenko, A. V., & Babych, P. N. (2000) Statisticheskie metody v biologicheskikh issledovaniyakh s ispolˊzovaniem Excel [Statistical methods in biological research using Excel]. Kyiv: Morion. [in Ukrainian]
Mintser, O. P., Voronenko, Yu. V., & Vlasov, V. V. (2003) Informatsiini tekhnolohii v okhoroni zdorovia i praktychnii medytsyni [Informacin Aharon technology in the health Fund medical prakticni], (Book 5: Obroblennia klinichnykh i eksperymentalnykh danykh u medytsyni [Obramleny clinic I have eksperimentalnih difference Fund medical]. Kyiv: Vyshcha shkola. [in Ukrainian]
Parvizi, D., & Herke, T. (2016) Rekomendatsii mizhnarodnoi pohodzhuvalnoi konferentsii z peryproteznoi infektsii. Konsensus [The recommendations of the international consensus conference on pariprasna infection. The consensus]. Kharkiv: Kolehium. [in Ukrainian]
Korzh, N. A., Gerasimenko, S. I., Klimovickij, V. G., Loskutov, A. E., Romanenko, K. K., Gerasimenko, A. S., & Kolomiec, E. N. (2010) Rasprostranennostˊ perelomov kostej y rezulˊtate ikh lecheniya v Ukraine (kliniko-eˊpidemiologicheskoe issledovanie) [The prevalence of bone fractures and results of their treatment in Ukraine (clinical-epidemiological study)]. Ortopediya, travmatologiya i protezirovanie, 3, 5–14. [in Ukrainian]
Haiko, H. V., Kalashnikov, A. V., Malyk, V. D., & Kalashnikov, O. V. (2014) Sposib profilaktyky hniinykh uskladnen pry vykonanni totalnoho endoprotezuvannia kulshovoho suhloba u khvorykh pislia poperednoho vykonannia osteosyntezu z vykonanniam metalevykh konstruktsii [Method of prevention of septic complications when performing total hip replacement in patients after a preliminary run of osteosynthesis with the implementation of metal structures]. Zhurnal Natsionalnoi akademii medychnykh nauk Ukrainy (dodatok), 37, 198. [in Ukrainian]
Haiko, H. V., Kalashnikov, A. V., Malyk, V. D., & Kalashnikov, O. V. (2014) Sposib profilaktyky hniinykh uskladnen (PHU) pry vykonanni osteometalosyntezu pry perelomakh proksymalnoho viddilu stehna (PVS) u khvorykh pislia poperednoho vykonannia osteosyntezu z vykonanniam metalevykh konstruktsii (MK) [Method of prevention of septic complications (PSС) when you run osteomyelitis for fractures of the proximal femur (PF) patients after prior execution of osteosynthesis with the implementation of metal structures]. Zhurnal Natsionalnoi akademii medychnykh nauk Ukrainy (dodatok), 37, S. 202. [in Ukrainian]
Haiko, H. V., Kalashnikov, A. V., Malyk, V. D., & Kalashnikov, O. V. (2014) Sposib profilaktyky hniinykh uskladnen (PHU) pry vykonanni totalnoho endoprotezuvannia kulshovoho suhloba u khvorykh pokhyloho ta starechoho viku (KhPSV) [Method of prevention of septic complications (PSC) when performing total hip replacement in patients of elderly and senile age (HPES)]. Zhurnal Natsionalnoi akademii medychnykh nauk Ukrainy (dodatok), 37, 196-197. [in Ukrainian]
Sulyma, V. S. (2002) Suchasni kliniko-diahnostychni aspekty khronichnoho osteomiielitu (ohliad) [Modern clinical and diagnostic aspects of chronic osteomyelitis (review)]. Ukrainskyi medychnyi chasopys, 5(31), 23–28. [in Ukrainian]
Yuriichuk, L. M. (2009) Endoprotezuvannia kulshovoho suhloba u khvorykh pokhyloho ta starechoho viku z cherez- ta mizhvertliuhovymy perelomamy stehnovoi kistky. (Avtoref. dis…kand. med. nauk). [Hip replacement in patients of elderly and senile age with through - and intertrochanteric fractures of the femur] (Extended abstract of candidate’s thesis). Kyiv: DU AMN Ukrainy «Instytut travmatolohii ta ortopedii». [in Ukrainian]
Kato, T., Kawaguchi, H., Hanada, K., Aoyama, I., Hiyama, Y., Nakamura, T., et al. (1998) Single local injection of recombinant fibroblast growth factor-2 stimulates healing of segmental bone defects in rabbits. J. Ortop. Res., 16, 654–659. doi: 10.1002/jor.1100160605.
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)