Novosti
Khirurgii
This journal is
indexed in Scopus



Year 2016 Vol. 24 No 1

SCIENTIFIC PUBLICATIONS
EXPERIMENTAL SURGERY

DOI: http://dx.doi.org/10.18484/2305-0047.2016.1.5   |  

B.S. SUKOVATYKH, E.A. ELENSKAJA, E.B. ARTJUSHKOVA, A.I. ITINSON, A.A. ITINSON

EFFECTIVENESS OF IMMOBILIZED FORM OF SODIUM HYPOCHLORITE IN TREATMENT OF EXPERIMENTAL INFECTED PANCREATIC NECROSIS

SBEE HPE "Kursk State Medical University" 1,
RBME "Kursk City Clinical Emergency Hospital" 2,
The Russian Federation

Objectives. Experimental substantiation of using immobilized form of sodium hypochlorite in treatment of infected pancreatic necrosis.
Methods. The results of application of immobilized form of sodium hypochlorite in treatment of infected pancreatic necrosis were analyzed based on the experimental model in Wistar rats. Animals were divided into 3 groups, 96 rats per each. Infected pancreatic necrosis was created by moving the pancreas in intermuscular space in the anterior abdominal wall, a short-term cryodestruction of gland by liquid nitrogen followed by suspension of Staphylococcus aureus (1 billion microbial cells). Control group animals got no treatment; the comparison group received Levomecol unguent; the experimental group took the immobilized forms of sodium hypochlorite. Effectiveness of treatment was assessed according the leukocyte formula dynamics, bacterial contamination of purulent cavity, lethality rate, and histology.
Results. Anti-inflammatory activity of immobilized forms of sodium hypochlorite was higher than Levomecol unguent on the 3rd day in 1,2 fold, on the 5th day in 1,4, on the 7th day in 1,3 and on the 10th day in 1,1 fold. In the experimental group microbial contamination was lower than in control group on the 3rd day in 1,6, on the 5th day in 1,8, on the 7th day in 1,8 and on the 10th day in 1,6 fold. In the experimental group lethality rate was lower than in the control group on 3rd day by 10,4%, on 5th day by 8,4%, on 7th day by 3,1% and on 10th day by 1%. On the 5th day of the experiment Levomecol unguent application limited the dissemination of necrosis to pancreas, surrounding cellular tissue and the abdominal wall.
Conclusion. Treating infected pancreatic necrosis with immobilized form of sodium hypochlorite is considered to be an effective and pathogenetically grounded means of early complex therapy.

Keywords: infected pancreatic necrosis, treatment, omental sac sanation, Levomecol unguent, immobilized form of sodium hypochlorite
p. 5-11 of the original issue
References
  1. Ermolov AS. Smoliar AN, Shliakhovskii IA, Khrazhenkov MG. 20 let neotlozhnoi khirurgii organov briushnoi polosti v Moskve [20 years of emergency surgery of the abdominal cavity in Moscow]. Khirurgiia Zhurn im NI Pirogova.2014;(5):7-16.
  2. Litvin AA. Infitsirovannyi pankreonekroz [Infected pancreatic necrosis]. Moscow, RF: Integratsiia; 2011. 240 p.
  3. Beger HG, Buchler H. Acute pancreatitis: research and clinical management. London: Springer Limited; 2011. 412 p.
  4. Besselink MG, van Santvoort HC, Boermeester MA, Nieuwenhuijs VB, van Goor H, Dejong CH, et al. Timing and impact of infections in acute pancreatitis. Br J Surg. 2009 Mar;96(3):267-73. doi: 10.1002/bjs.6447.
  5. Bello B, Matthews JB. Minimally infasive treatment of pancreatic necrosis. World J Gastroenterol. 2012 Dec 14; 18(46): 68296835. doi: 10.3748/wjg.v18.i46.6829.
  6. Sleeman D, Levi DM, Cheung MC, Rahnemai-Azar A, Parisek S, Casillas V, et al. Percutaneus lavage as primary treatment for infected pancreatic necrosis. J Am Coll Surg. 2011 Apr;212(4):748-52; discussion 752-54. doi: 10.1016/j.jamcollsurg.2010.12.019.
  7. Martin RF, Hein AR. Operative management of acute pancreatitis. Surg Clin North Am. 2013 Jun;93(3):595-10.
  8. Miller SV, Vinnik IuS, Tepliakova OV. Rezul'tat standartizirovannoi taktiki lecheniia bol'nykh ostrym destruktivnym pankreatitom [The result of a standardized treatment strategy in patients with acute destructive pancreatitis]. Khirurgiia Zhurn im NI Pirogova. 2012;(5):24-30.
  9. Behrman SW, Bahr MH, Dickson PV, Zarzaur BL. The microbiology of secondary and postoperative pancreatic infections: implications for antimicrobial management. Arch Surg. 2011 May;146(5):613-9. doi: 10.1001/archsurg.2011.85.
  10. Freeman ML, Werner J, van Santvoort HC, Baron TH, Besselink MG, Windsor JA, et al. Interventions for necrotizing pancreatitis: summary of a multidisciplinary consensus conference. Pancreas. 2012 Nov;41(8):1176-94. doi: 10.1097/MPA.0b013e318269c660.
  11. Gostishchev VK, red. Infektsii v khirurgii [Infections in surgery]. Moscow, RF: Geotar-Med; 2007. 768 p.
  12. Werner J, Feuerbach S, Uhl W, Büchler M W. Management of acute pancreatitis: from surgery to interventional intensive care. Gut. 2005 Mar; 54(3): 426436. doi: 10.1136/gut.2003.035907.
  13. Zatevakhin II, Tsitsiashvilli MSh, Budurova MD, Altunin AI. Pankreonekroz (diagnostika, prognozirovanie i lechenie) [Pancreonecrosis (diagnosis, prognosis and treatment)]. Moscow, RF: Meditsina; 2007. 224 p.
  14. Savel'ev VS, Filimonov MN, Burnevich SZ. Pankreonekroz [Pancreonecrosis]. Moscow, RF: MIA; 2008. 264 p.
  15. Sukovatykh BS, Blinkov IuIu, Makienko KG. Vliianie immobilizirovannykh form natriia gipokhlorita na blizhaishie i otdelennye rezul'taty lecheniia bol'nykh s rasprostranennym peritonitom [Influence of immobilized forms of sodium hypochlorite on the immediate and long-term results of treatment of the patients with generalized peritonitis]. Vestn Khirurgii im II Grekova. 2014;173(2):47-51.
  16. Elenskaia EA, Sukovatykh BS, Artiushkova EB, Itinson AI, Itinson AA. Sposob modelirovanie ostrogo destruktivnogo infitsirovannogo pankreonekroza [Method of modeling of acute destructive infected pancreatic necrosis]. Patent RF 2547697 G09B 23/28. 10.04.2015.
Address for correspondence:
305041, Russian Federation,
Kursk, ul. K. Marksa, d. 3,
GBOU VPO Kurskiy gosudarstvennyiy meditsinskiy universitet,
kafedra obschey khirurgii,
tel. office 8(4712) 52-98-62,
e-mail: SukovatykhBS@kursksmu.net,
Sukovatykh Boris Semenovich
Information about the authors:
Sukovatykh B.S. MD, professor, a head of the general surgery chair of SBEE HPE "Kursk State Medical University".
Elenskaja E.A. A clinical intern of the surgery department of RBME "Kursk City Clinical Emergency Hospital", applicant for degree of the general surgery chair of SBEE HPE "Kursk State Medical University".
Artjushkova E.B. MD, a director of the Research Institute of the ecological medicine of SBEE HPE "Kursk State Medical University".
Itinson A.I. PhD, a clinical intern of the surgery department of RBME "Kursk City Clinical Emergency Hospital".
Itinson A.A. A clinical intern of the general surgery chair of SBEE HPE "Kursk State Medical University".
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