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15THE FEATURES OF SURGICAL TREATMENT OF PSEUDOFURUNCULOSIS OF THE HEAD AND
NECK IN NEWBORNS
Shamsiev A.M.,
Department of pediatric surgery №1, MD, professor Samarkand State Medical Institute Shamsiev J.A.,
Department ofpediatric surgery, anesthesiology and intensive care ofpostgraduate education, head of the
department, MD, professor Samarkand State Medical Institute Atakulov J.O.,
Department of pediatric surgery №1, MD, professor Samarkand State Medical Institute
Mahmatqulov H.G., Department of pediatric surgery №1, assistant Samarkand State Medical Institute
Shamsiev B.M.
Department of Humanities of Physical Education and Sport, docent
Samarkand State Medical Institute 140100, 18, Amir Temur st. Samarkand, Republic of Uzbekistan
Abstract
One of the most urgent problems in newborns is purulent-inflammatory diseases, which occupy the second place in the structure of the morbidity of newborns, after hypoxia. Pseudofurunculosis is most common in this category of patients, and the latter has a tendency to rapid abscission and the development of sepsis. In the 2-clinic of the Samarkand State Medical Institute for the period from 2016 to 2020, 136 newborns with localization of purulent elements on the head and neck received inpatient treatment. All patients underwent complex surgical treatment. In addition to traditional methods of treatment, the drug Baneocin (zinc bacitracin with neomycin sulfate) and Tyrosur (tyrotricin) were used as local treatment. The use of baneocin and tyrosur in the complex of local treatment had a positive effect on the results of the treatment, which allowed to reduce the time of normalization of body temperature and the time of stay of patients in the hospital.
Keywords: pediatric surgery, pseudofurunculosis, newborns, complex treatment, perinatal infection
Relevance. Currently, there is an increase in the frequency of intrauterine infections in newborns, which is associated with an increase in the number of infected women. According to the literature, the prevalence of intrauterine infections reaches 22.0% [1]. The main etiological causes of intrauterine infections are cytomeg-alovirus, chlamydia, mycoplasma, herpes, toxoplasma, and others. Conditionally pathogenic microflora and bacteria are also important, which is associated with the suppression of aerobic flora when using antibiotics [2, 3]. Intrauterine infections affect the health of newborns, lead to high mortality, but also disability [4]. One of the most urgent problems in newborns is purulent-inflammatory diseases, which occupy the second place in the structure of the morbidity of newborns, after hypoxia. Pseudofurunculosis is most common in this category of patients, and the latter has a tendency to rapid abscission and the development of sepsis [5].
Purpose of the research. To analyze the results of surgical treatment of psedofurunculosis of the head and neck in newborns.
Materials and methods of the research. In the 2-clinic of the Samarkand State Medical Institute for the
period from 2016 to 2020, 136 newborns with localization of purulent elements on the head and neck received inpatient treatment. There were 57 urban areas (41.9%), and 79 rural areas (58.1%). The gender distribution was almost equal - 70 (51.5%) male patients and 66 (48.5%) female patients. In the age aspect, they were distributed as follows: 21 (15.4%) patients were under 28 days of age, 67 (49.3%) patients were under 3 months of age, and 48 (35.3%) patients were over 3 months of age. All patients received appropriate treatment, which consisted in opening purulent foci, rational antibiotic therapy, vitamin and immunostimulating treatment, physiotherapy procedures, if necessary, infusion - detoxification therapy, as well as post-syndrome treatment.
Such treatment tactics were carried out in all sick newborns treated in the period from 2016 to 2017, from 2018 to 2019, in addition to traditional methods of treatment, the drug Baneocin (zinc bacitracin with neo-mycin sulfate) was used as a local treatment, and in the period from 2020 to 2021, Tyrosur (tyrotricin) was used locally (table 1).
Table 1
Distribution of patients depending on the treatment method
Age
Groups Boys Girls city countryside Up to 28 days 28 days-3 months Older than 3 months
Traditional treatment 37 32 27 42 (60,9%) 11 32 26
(n=69) (53,6%) (46,4%) (39,1%) (15,9%) (46,4%) (37,7%)
Traditional 22 (48,9%) 23 (51,1%) 20 (44,4%) 5 (11,1%) 21 (46,7%) 19 (42,2%)
treatment+baneocin (n=45) 25 (55,6%)
Traditional 11 (50,0%) 11 (50,0%) 10 (45,5%) 5 (22,7%) 14 (63,7%) 3 (13,6%)
treatment+ tyrosur (n=22) 12 (54,5%)
Total (n=136) 70 (51,5%) 66 (48,5%) 57 (41,9%) 79 (58,1%) 21 (15,4%) 67 (49,3%) 48 (35,3%)
As can be seen from the table above, the ratio by age, place of residence and gender in the groups was almost the same. It should be noted that about half of the patients were aged from 28 days to 3 months - 67 (49.3%), less often were aged over 3 months - 48 (35.3%) and up to 28 days - 21 (15.4%).
Results of the research and their discussion. During the complex treatment of this pathology, a bacteriological study of the contents of purulent foci was carried out in parallel to correct the antibacterial therapy. При этом наиболее часто высеивался золотистый стафилококк - в 102 (75,0%) streptococcus - 21 (15.4%), escherichia coli - 9 (6.7%), klebsiella-4
Terms of reducing body temperature
(2.9%) cases. The seeded flora was most sensitive to cephalosporins, aminoglycosides, and macrolides. Given this, the starting drugs were cephalosporins, if necessary, aminoglycosides were added to the complex of antibacterial therapy in age-related dosages.
One of the results of the treatment is the timing of a decrease in body temperature, the absence of new purulent foci, the phenomena of intoxication of the body, which are manifested in the improvement of the general condition of the sick child and serves as indications for discharge from the hospital. Table 2 below shows this data by group.
Table 2
and finding patients in the hospital
Groups Terms of reducing body temperature (day.) Bed days (days)
Traditional treatment 6,7±0,6 16,6±0,5
Traditional treatment+baneocin 5,8±0,4 13,5±0,2
Traditional treatment+ tyrosur 5,1±0,8 12,8±0,3
As can be seen from table 2, on average, normalization of body temperature occurred 4-5 days after hos-pitalization of patients, the time spent in the hospital was 16-17 days. It should be noted that the use of bane-ocin and tyrosur in the complex of local treatment had a positive effect on the results of the treatment, which allowed to reduce the time of normalization of body temperature and the time of stay of patients in the hospital.
After comprehensive treatment in the hospital, all patients were sent for outpatient observation by a pedi-atric surgeon at their place of residence.
Conclusions. Thus, pseudofurunculosis of newborns is a formidable disease and requires urgent hospitalization of patients in a hospital. Treatment of this pathology should be comprehensive, including in addition to surgical treatment, antibiotic therapy, immunomodulators, vitamins and physiotherapy. The inclusion of modern drugs in the complex of local treatment allows to improve the results of the therapy.
References
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