A method for integrated management of laparotomy access during abdominal surgery

Laparotomy is the most common approach for surgical procedures involving abdominal and pelvic organs. However, after surgery, patients often experience severe pain and a high risk of surgical site infection. These complications contribute to the development of hospital-acquired infections and can significantly increase patient mortality. Objective. The purpose of the study is to evaluate the efficacy of a new prophylactic method aimed at reducing the risk of developing surgical site infections and alleviating pain in the early postoperative period. Materials and Methods. A method for the prevention of surgical site infections was used in 10 patients. The method involves the use of two perforated micro-irrigators, which are placed at different levels of the wound surface. A 0.2 % ropivacaine anesthetic was continuously injected into the first catheter, inserted into the preperitoneal space, using a pump dispenser at a rate of 5 ml/hour for 3 days. A povidone-iodine solution was administered as an antiseptic via a bolus injection into the second micro-irrigator, inserted into the subcutaneous tissue, (20 ml t.i.d. at 8-hour intervals for 3 days). Pain after a laparotomy wound and the development of postoperative complications were assessed. Results. All patients experienced accelerated wound healing and absence of pain at the surgical site, which eliminated the need for narcotic analgesics. Furthermore, no postoperative complications associated with this method were reported. Conclusion. The use of the proposed method in clinical practice reduces the risk of infectious complications after elective laparotomy and provides effective pain relief.