No abstract

Background. Wounds inflicted by the teeth of animals and humans take a special place and have a number of characteristic features. There is still no generally accepted surgical tactics for the bite wounds treatment, and the issues of choosing the timing of wound closure, depending on their localization, remain unresolved. Aim. To analyze the clinical experience of bite wounds surgical treatment by applying primary and secondary sutures. Material and methods. From 2008 to 2018 409 patients with bite wounds of various localizations (289 female and 120 male) aged 16 to 84 years were under our supervision. The average age of the victims was 52.510.17 years. All patients were prescribed combined therapy, which was based on an urgent surgical care, since we attach a decisive role in the prevention and local treatment of wound infection to full primary or secondary surgical treatment. The analysis of the obtained data was performed using the statistical calculations in R 3.6.3 (R Foundation for Statistical Computing). To compare the average treatment time for primary and secondary sutures nonparametric MannWhitney test was used. Results. Analysis of the obtained clinical data showed that the largest number of bite wounds were dog bites (95%), which occured most often in spring (38%) and summer (38.1%), and, as a rule, at home (68%), these results were comparable with statistical data from other sources. The average duration of patients treatment with a primary suture was 13.2 days, and with a secondary suture 19.3 days. The authors proposed a differentiated approach to the choice of surgical tactics in the treatment of patients with bite wounds, depending on the timing of their admission to the hospital and the local status of the wound defect. Conclusion. The primary or primary delayed blind suturing should be used in the early stages (not later than in 12 hours after getting a bite), and secondary sutures are shown in late stages (more than 12 hours).

Background. The ultrasound method of examination is often used to detect liquid formations of a postoperative wound. For this reason, the search for new criteria for assessing the course of the wound process is currently relevant. Aim. To study the possibility of using the ultrasound method of research to determine the severity of postoperative wound complications according to the ClavienDindo classification and further optimal tactics, diagnosis and treatment. Material and methods. 255 patients after surgery for various urgent diseases of the abdominal organs, as well as patients with elective surgeries were examined. All patients underwent complex clinical, laboratory and instrumental studies. Continuous values that do not have a normal distribution were processed using non-parametric methods the values were presented in the format Me [Q1; Q3], the difference in unrelated groups was assessed by the MannWhitney U test, and in related groups, by the Wilcoxon test. Results. The postoperative period in 58 (22.7%) of 255 patients was complicated by postoperative wound complications, which had I, II, III severity according to the ClavienDindo classification. On the 5th day of ultrasound examination of the surgical site with the III degree of severity of postoperative wound complications, there was a statistically significant increase in the echogenicity width of tissues in the area of the wound defect compared with the III severity of complications. Conclusion. The ultrasound method of research allows to evaluate the effectiveness of reparative processes in damaged tissues and the development of complications, as well as to determine the severity of their course in the postoperative period for planning further surgical tactics.