Novosti
Khirurgii

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Year 2018 Vol. 26 No 6

TRAUMATOLOGY & ORTHOPEDICS

A.N. TKACHENKO 1, L.B. GAIKOVAYA 1, EHSAN ULHAQ 1, A.A. KORNEENKOV 2, I.I. KUSHNIRCHUK 2, D.S. MANSUROV 1, A.I. ERMAKOV 1

PREDICTION POSSIBILITIES OF LOCAL INFECTIOUS COMPLICATIONS AFTER METAL OSTEOSYNTHESIS OF LIMB LONG TUBULAR BONES

North-West State Medical University named after I.I. Mechnikov1,
Military Medical Academy named after S.M. Kirov 2, Saint Petersburg,
The Russian Federation

Objective. To improve the results of osteosynthesis of long tubular bones on the basis of working out and application of the mathematical forecast model to prevent the surgical site infection (SSI).
Methods. A retrospective analysis of data of 179 patients who underwent osteosynthesis of long tubular bones after the diaphyseal fractures was performed. The data were compared on patients who underwent osteosynthesis without SSI (the 1st group — 144 observations) with the data of the operated ones, where SSI was observed (the 2nd group — 35 cases). A prospective analysis included 117 cases of diaphyseal fractures of long tubular bones.
Results. 18 prognostic criteria for the development of SSI have been identified and evaluated in quantitative terms (gender, age, information about comorbidities, the type and location of a fracture, the type of metal construction, the operation theatre list, etc.). The developed method of SSI prognosis made it possible, on the basis of the total prognosis index, to single out among the patients with fractures of long tubular bones the risk group in respect of whom individual preventive measures were taken. In the study of immunological parameters, it is advisable to consider T/NK cells as a prognostic criterion for the development of SSI, the preoperative indicators of which in patients with SSI exceeded those in the group without SSI and amounted to 2.213×109/l and 1.397×109/l, respectively (p<0.01).
Conclusions. The developed method of SSI prediction and the use of individual preventive measures can significantly reduce the incidence of SSI compared with the group of retrospective studies.

Keywords: long tubular bones, diaphyseal fracture, osteosynthesis, surgical site infection, prognosis, risk factors
p. 697-706 of the original issue
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Address for correspondence:
195067, The Russian Federation,
Saint-Petersburg, Piskarevsky Ave., 47,
North-West State Medical University
Named after I.I. Mechnikov,
Department of Traumatology,
Orthopedics and Military Field Surgery,
тel.: +7-911-215-19-72,
e-mail: altkachenko@mail.ru,
Aleksandr N. Tkachenko
Information about the authors:
Tkachenko Aleksandr N., MD, Professor of the Department of Traumatology, Orthopedics and Military Field Surgery, North-West State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0003-4585-5160.
Gaikovaya Larisa B., MD, Professor of the Department of Biological and General Chemistry, North-West State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0003-1000-1114.
Ehsan Ulhaq, Post-Graduate Student of the Department of Traumatology, Orthopedics and Military Field Surgery, North-West State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0002-9647-052X.
Korneenkov Aleksei A., MD, Professor of the Department of Medical Service Management Automation with Military Medical Statistics, Military Medical Academy named after S.M. Kirov, Saint Petersburg, Russian Federation
https://orcid.org/0000-0001-5870-8042.
Kushnirchuk Igor O., PhD, Associate Professor of the Department of Medical Service Management Automation with Military Medical Statistics, Military Medical Academy named after S.M. Kirov, Saint Petersburg, Russian Federation
https://orcid.org/0000-0002-6926-5360.
Mansurov Djalolidin Sh., Post-Graduate Student of the Department of Traumatology, Orthopedics and Military Field Surgery, North-West State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0002-1799-641X.
Ermakov Aleksei I., Physician of the Central Clinical and Diagnostic Laboratory, North-West State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russian Federation.
https://orcid.org/0000-0003-3435-5881.
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