Postoperative adhesions of the abdominal cavity (SPBP) and adhesive disease of peritoneum (PRSPs) are one of the major unsolved problems in modern surgical gastroenterologii. Over the past 20 years, the frequency of adhesive intestinal obstruction (JMC) has increased in 1,9 times and has no tendency to decrease (Zhenchevsky RA, 1989; Filenko BP, 2000). Increasing the number of patients is due, apparently increasing number of surgical interventions, the use of surgical treatments for categories of patients who previously received only conservative therapy (Chekmazov IA, 2002). SBB is a major cause of postoperative mortality (Vorobyev AA, Beburishvili AG, 2001). According to the International Society of adhesive on the SBB annually in surgical hospitals treated 1% of all the previously operated patients, relapse after surgical adgeziolizisa ranged from 32% to 71%; disease affects predominantly young, working age, causing disability, social maladjustment, and makes great material costs on ineffective conservative treatment (International Adhesion Society, 2001).
In recent years, increasingly have been used protivospaechnye funds through preventive action which is the separation of wound surfaces that result from surgical aggression (Wiseman DM, 1994; BhatiaD.S., Allen JE, 1997; Edwards GA, Glattauer V., Nash TJ, et al 1997; Strandell A., Thorburn J., Tronstad SE, et al, 1998).
For the prevention of postoperative adhesions, we proposed a method (priority number 2002105340 from 26.02.2002), which consists of intracavitary administration of gel methylcellulose (MC), water-soluble. The introduction of 3% MC gel into the abdominal cavity at the final stage of the operation due to gidroflotatsii wound surfaces prevented their consolidation, gluing fallen from peritoneal exudate and fibrin, respectively, the formation of adhesions.
This substance has good surfactant properties, non-toxic, biologically stable and physiologically inert (Tentsova LI, Alyushin MG, 1985; Pankrusheva TA, Surin, LV, Medvedev OA, 1997), in an experiment on parenteral administration does not affect the immunological reactivity (Razinkov SP, Hemp, AI, AI Lazarev, 1987).
Despite the fact that the spectrum of microorganisms, vysevyemyh of brand viagra peritoneal exudate has no tsellyulazoliticheskoy enzymatic activity and theoretically MC can not be a substrate for their activity, is still a potential possibility that cellulose ethers with intraperitoneal administration may contribute to and / or of peritonitis. In connection with this obvious need to exclude this possibility in experiments in vitro.
To study the effect of MC gel and Na-KMTS on growth and reproduction of bacteria, we used the culture of Staphylococcus aureus 25925, Staphylococcus aureus «Zhaev», Staphylococcus epidermidis, Escherichia coli 25922, Pseudomonus aeruginosa 1313.
From subsistence agar cultures of the above strains were prepared 1-billionth of a suspension in isotonic NaCl. In the test tube with 5 ml of sterile gels 3% concentration of MC and NaKMTs was added on 10 000 bacterial cells bacterial cultures. To determine the initial amount of microorganisms in the test cultures at once performed sowing 0,1 ml from each tube to a cup with a nutrient agar. As a control, tubes containing 5 ml isotonic NaCl, in which also contributes to 10,000 microbial strains tested.
Experimental and control tubes were placed in an incubator at 37.00 C and incubated for 24 hours. Next, the seeding material in the volume of 0.1 ml on the surface of nutrient agar at 8 and 24 hours of incubation followed by trituration inakulyata spatula. Cups with seedlings were incubated in an incubator for 18 hours and then counted the number of grown colonies. In the seeding of gels MC and NaKMTs immediately after the introduction of Cultures (prior to placement of tubes in a thermostat), there was an increase of bacterial population in the range of 150 to 200 colony-forming units per 0.1 cm
In the seeding of gels MC and NaKMTs after 8 and 24 hours of incubation, growing colonies of test cultures were found, while, as seeding of the test tubes at the same time gave a steady growth in average of 200 colony-forming units.
Thus, the results of the experiments in vitro, indicate that the gels MC and NaKMTs not promote the growth and reproduction of microorganisms, and therefore, infection of the abdominal cavity during their intraperitoneal use to prevent postoperative SPBP and adhesive complications.
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