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8MEDICAL SCIENCES
METHOD OF TREATMENT WITH TITANIUM NICKELIDE DILATOR TO IMPROVE DRAINAGE OF SURGICAL WOUNDS IN CASES OF MANDIBULAR FRACTURES WITH INFLAMMATORY
COMPLICATIONS
Vitkovskyi O.
Bukovinian State Medical University Department of Childhood Dentistry, Assistant
Abstract
The paper offers data on treatment characteristics for mandibular bone fractures with purulent and inflammatory complications. New and up-to-date treatment methods have been explored. A comparative analysis of dynamic indicators of the efficacy of the traditional treatment of purulent and inflammatory processes and the treatment that uses titanium nickelide dilatators has been performed. Clinical efficacy of titanium nickelide dilatators has been proved demonstrating its supremacy in surgery wound drainage over the traditional drainage procedure.
Keywords: titanium nickelide dilatators, mandibular bone, fracture, drainage, abscess.
Fractures of the mandibular bone range from 75 to 89% of the total number of injured patients with damaged facial bones. The urgency of this issue is associated with the increasing number of injuries of maxillo-facial area, their morbidity due to a significant amount of damaged tissues, combination with the injuries in adjacent areas and in vital organs, prolonged treatment and development of post-traumatic complications. Several authors mention the annual increase in the number of facial fractures by 10-15% and increase in rehabilitation terms by half (in case of complications) [1, 3]. Moreover, the rate of complications in mandibular fractures reaches, based on references, 40% [2]. Therefore, early diagnosis and correct choice of treatment of mandibular fractures with post-traumatic complications remain important and pending.
Repair processes in mandibular fracture area and healing of purulent and inflammatory events in patients were assessed by the common clinical and radiographic studies. The digital results obtained in the course of this research were processed using Microsoft Excel included in Microsoft Office package.
A TH-10 titanium nickelide retractor was used. The dilatator is crown-shaped and consists of 4-8 wire turns. Production of the TH-10 titanium nickelide device allows for an easy reduction of the dilatator diameter by over 20 times when cooled (0-5 ° C). It facilitates device introduction in a surgery wound and reduces trauma after fixing it. Affected by tissue
temperatures, the device performs self-fixing in the wound by gradually taking its original shape and thus dilates the wound.
24 patients with mandibular bone fractions were included. The main inclusion criteria: both sexes with a confirmed diagnoses of mandibular bone fractures with purulent-inflammatory complications, no severe concomitant diseases of internal organs and a signed informative consents. After the patient had been admitted to the hospital, the abscess was lanced, we introduced the dilatator in the surgery wound and let it self-fix. The following day, reposition of fragments and splinting of jaws were performed.
The patients with mandibular fractures were divided into two groups. The study group (16 people) were treated with the additional introduction of titanium nickelide dilatators in the post-surgery wound, and the control group (18 people) were subjected to traditional treatment. To assess clinical efficacy, the following indicators were considered: reduction of swelling of soft tissues (day), cessation of discharge from the wound (day), resorption of infiltration (day), first signs of granulation and epithelialization of the wound (day), radiographic signs of the primary callus formation (day).
The first signs of callus formation were evaluated radiologically.
Table 1.
The treatment results of the patients from the study and control groups
Indicator Study Group (DilatationTreatment) (n=16) Control Group (Traditional Treatment) (n=18)
Swelling Recovery 3,8±0,3 5,7±0,4
Cessation of Exudation 5,1±0,4 7,3±0,7
Resorption Of Infiltration 5,3±0,4 8,3±0,9
First Signs of Granulation and Epithelialization of the Wound 7,8±0,5 10,6±0,8
Radiographic Signs of the Primary Callus Formation 14,2±0,9 16,5±0,6
The clinical and radiological studies have demonstrated that introduction of a titanium nickelide dilatator in a post-surgery wound accelerates wound drainage, prevents late post-traumatic complications, improves treatment outcomes, accelerates rehabilitation terms, reduces incapacity time by 3-4 days [6].
The results of the clinical studies show the reliable efficacy of titanium nickelide dilatators as part of the complex treatment of purulent and inflammatory processes caused by mandibular fracture complications. Such treatment of patients can prevent post-traumatic osteomyelitis and normalize regeneration of bone tissue.
References
1. Baronov A.I. Peace Time Jaw Fractures and Relevant Treatment: Abstr. Med. Doct. Dis.: 14.00.21/KGMI. - Krasnodar, 1986. - 32 p.
2. Leontiev V.K. Dentistry in XXI century. Prediction Attempt/V.K. Leontiev, V.M. Bezrukov//Den-tistry. - 2000. - No. 6. - P. 4-5.
3. Malanchuk V.A. Immunologic and Biochemical Indicators in Patients with Mandibular Fractions Immediately after the Injury/V.A. Malanchuk. S.A. Usenko, A.V. Kopchak//Expert Clinical Dentistry Issues. - Kharkov.- 2001. - Abst. 4. - P. 141-143.
4. Pankratov A. S. Analysis of the Relevant Epi-demiologic Pattern of Mandibular Fractions/A. S. Pankratov//Russian Dentistry Journal. - 2001. - No. 4.- P. 26-30.
5. Shargorodskiy A.G. Facial Soft Tissue and Bone Injuries/A.G. Shargorodskiy, N.M. Steph-antsov.//M., VUNMTs,- 2000. - P. 239.
6. Bailey B.J. Principles and preferences in mandibular reconstruction/B.J. Bailey//Surgery of mandible. - New York., 1987.- P. 173-209.
ПОКАЗАТЕЛИ СТАБИЛИЗАЦИИ ЛИКВОРОДИНАМИКИ НА ЭТАПАХ ЛЕЧЕНИЯ НЕОНАТАЛЬНОЙ ГИДРОЦЕФАЛИЙ
Волкодав О.В.,
доцент кафедры нервных болезней и нейрохирургии Медицинской академии имени С.И. Георгиевского (структурное подразделение), ФГАОУ ВО «КФУ им. В.И. Вернадского», к. м. н., Симферополь,
Россия
http://orcid.org/0000-0001-9662-5731 Зинченко С.А.
доцент кафедры нормальной физиологии Медицинской академии имени С.И. Георгиевского (структурное подразделение), ФГАОУ ВО «КФУ им. В.И. Вернадского», к. м. н., Симферополь, Россия
http://orcid. org/0000-0002-5222-2110
INDICATORS OF STABILIZATION OF CEREBROSPINAL FLUID DYNAMICS AT THE STAGES OF TREATMENT OF NEONATAL HYDROCEPHALUS
Volkodav O.,
Associate Professor of the Department of Nervous Diseases and Neurosurgery of the Medical Academy named after S.I. Georgievsky (structural unit), Federal State Autonomous Educational Institution of Higher Education "KFU named after V.I. Vernadsky ", Ph.D., Simferopol, Russia
http://orcid.org/0000-0001-9662-5731 Zinchenko S.
Associate Professor of the Department of Normal Physiology of the Medical Academy named after S.I. Georgievsky (structural unit), Federal State Autonomous Educational Institution of Higher Education "KFU
named after V.I. Vernadsky ", Ph.D., Simferopol, Russia http://orcid. org/0000-0002-5222-2110
Аннотация
Проанализирован клинический материал по лечению гидроцефалии у 480 новорожденных по данным Республики Крым за период 2000-2018гг. Недоношенными родились 327 детей (1 группа), доношенными 153 ребенка (2 группа). Стандартное лечение, включающее люмбальные пункции, вентрикуло-субгалеальное дренирование и вентрикуло-перитонеальное шунтирование, выполнено в 1 группе у 184 детей, во второй группе у 107 детей. При окклюзии желудочков с блоком субарахноидального пространства у 143 детей 1 группы и 46 детей 2 группы в лечение включались опции коронаро-транслябдовидная субарахновентрикулостомии и вентрикуло-субарахноидального стентирования. Этапное включение предложенных опций в стандартный лечебный протокол позволило обеспечить повышение компенсации гидроцефалии (р < 0,001) с устранением внутричерепной гипертензии и снижения перивентрикулярной плотности мозга, стабилизации размеров желудочков, что может служить объективным показателем стабилизации ликвородинамики.
Abstract
The clinical material on the treatment of hydrocephalus in 480 newborns was analyzed according to the data of the Republic of Crimea for the period 2000-2018. 327 children were born prematurely (group 1), 153 children
