Prevention of purulent-necrotic inflammation of thoracotomy wound tissues in the treatment of purulent mediastinitis with programmed rethoracotomy

The need to develop new therapeutic methods for diffuse purulent mediastinitis is still an urgent problem in surgery. The purpose of the study is to evaluate the effectiveness of temporary rib fixation in programmed rethoracotomy while treating diffuse purulent mediastinitis. Materials and Methods. The study involved 49 patients with diffuse purulent mediastinitis. All patients underwent programmed rethoracotomy and sanitation of pyogenic sources in the mediastinum. The subjects were divided into 2 groups: group 1 included 19 patients without preventive measures against wound complications; 30 patients of group 2 underwent temporary rib fixation, which contributed to the decrease of wound complications. To reduce trauma and infection of the thoracotomy wound tissue, a special device was created (RF patent No. 2474389). It consists of staples and locks that appose wound edges after rethoracotomy. During the study, we used V.B. Gavrilov and M.K. Mishkorudnaya's spectrophotometric method; modified Stoke method; N.I. Gabrielian's spectrophotometric method. Statistical assessment of parameters was carried out using variation statistics. Statistical significance of differences (t) was calculated by Student's t-test. Results. Measures to prevent purulent-necrotic complications from a thoracotomic wound significantly contributed to their reduction. The indicators of the effectiveness of these measures were changes in the coefficient of lipid peroxidation, antioxidant activity and midmolecule peptides in the blood serum, the sum of infectious complications and wound complications. Conclusion. Temporary rib fixation contributes to a significant decrease in the number of patients with purulent-necrotic inflammation of thoracotomy wound tissues (p function show_eabstract() { $('#eabstract1').hide(); $('#eabstract2').show(); $('#eabstract_expand').hide(); }