Meckel diverticulum is a congenital abnormality of the intestinum appearing due to the failure of the vitelline duct closure. Meckel diverticulum may have no clinical signs however in 20-25% its complications may cause different acute surgical conditions demanding surgical interventions. These complications may appear with the symptoms of abdominal pain, intestinal hemorrhage and intestinal obstruction. The aim of the study was to analyze the results of treatment of Meckel diverticulum complications in children. We have analyzed the results of diagnostics and treatment of 69 children aged between 10 months and 13 years. All the children were admitted to the surgical department of Samara Regional Clinical Hospital named after V.D. Seredavin between 2013 and October 2020. The presented complications of Meckel diverticulum were: diverticulitis (37), intestinal bleeding (17), intestinal volvulus (9), intestinal obstruction (3), intussusception (3). Most frequently the complications were present in infants and preschool children. All the patients underwent clinical, laboratory, ultrasound, X-Ray (when necessary) and intraluminal endoscopic (when necessary) examinations. However, in most cases complications were diagnosed during laparoscopy. All the children underwent surgical treatment. Most of the surgeries were laparoscopic (54, 35 of them were video assisted mini laparotomies). Two patients presented postoperative complications: anastomotic leaks; both of the children required repeated surgeries. The reasons of complications were underestimation of the paients’ conditions at the moment of surgical interventions and significance of the inflammatory process in the abdominal cavity. We employed ileostomies to those children which we closed 3 weeks after that when the general conditions were appropriate. We had no lethal cases. The average hospital stay was 11,6 days.

The results of treatment of 57 children with wound defects of soft tissues that have appeared at the background of surgical infections of various origins have been analyzed. The causes of the wound defects formation were analyzed according to the T.I.M.E. system.[7,8,9]. While treating the wound defects the strategy of creating the conditions close to the ones in an acute wound was followed («Wound bed preparation») [7,8,11]. We used several types of debridement aimed at shortening the phases of the wound process with the following closure of the wound defects by different methods [1,2,5,7]. The assessment of the effectiveness of local treatment was carried out taking into account the nature and severity of the phases of the wound process by the method of clinical observation of the state of the wound (the severity of symptoms of inflammation, the nature and amount of exudate, the presence and appearance of granulations, the presence of signs of wound epithelialization and scarring, the size of the wound), microbiological, cytological and histology and research [10]. The study revealed factors that disrupt wound healing during primary surgical treatment, in the management of foci of surgical infection, in the management of postoperative wounds, in the treatment of pressure ulcers in children with neurological pathology. During the initial surgical treatment of the received wounds, its inadequacy was noted - the abandonment of necrotic, defective tissues, foreign bodies, the presence of an undiagnosed infection, the absence or inadequate antibiotic therapy, constant tension of the skin edges, impaired blood flow and innervation, inadequate sanitation and drainage. The use of modern innovative technologies in wound management reduces hospital stay, reduces the duration of the use of antibiotics and other medications, contributes to a good cosmetic effect. Application of the current innovative technologies in wounds treatment shortens the hospital stay, decreases the duration of the use of antibiotics and other medicines, and contributes to better cosmetics effects [1,4,6]. The current trends in wounds treating with the choice of local treatment according to the phases of the wound process are presented in this article. The methods of active wound defects therapy and different types of debridement considering their pros and cons are analyzed.