Authors
Sukovatykh B.S., Mosolova A.V., Zatolokina M.A., Blinkov Yu.Yu.
Kursk State Medical University, Kursk
Abstract
Mortality in generalized peritonitis ranges from 16% to 30%.
Aim: to compare the effectiveness of immobilized forms of sodium hypochlorite and miramistin in the treatment of experimental generalized peritonitis
Materials and methods. The experimental study was carried out on 288 male Wistar rats, divided into 3 groups of 96 animals each. Animals of the 1st group (control), 24 hours after the introduction of fecal suspension into the abdominal cavity under aseptic conditions, performed laparotomy and lavage of the abdominal cavity with saline. Animals of the 2nd group (comparison) at the same time, at the first stage, were initially sanitized with saline with the removal of purulent effusion and fibrin films, and at the second stage, 5 ml of immobilized sodium hypochlorite were injected into it.
In the 3rd (experimental) group, after laparotomy and sanitation of the abdominal cavity with saline solution, 5 ml of 0.01% miramistin gel was evenly distributed over the entire surface of the peritoneum. The anti-inflammatory activity of the dosage forms was assessed by the dynamics of leukocytosis and the leukocyte index of intoxication, and the antimicrobial activity was assessed by the dynamics of the number of microorganisms in the abdominal exudate. The lethality of animals in each group was calculated. Sections of the parietal and visceral peritoneum were taken for histological examination.
Results. On the 1st day, compared with the first group, the number of leukocytes in the second group was less by 1.1, and in the third by 1.3; and respectively on the 3rd day at 1.7 and 1.8; on the 7th day, 1.4 and 1.5 times. In a bacteriological study, the number of microorganisms in 1 ml of exudate from the abdominal cavity on the 1st day after surgery in the comparison group was 2.3 times, and in the experimental group — 2.2 times; on the 3rd day of the experiment, respectively, 8.3 and 7.9 times; on the 7th day, 6.3 and 6.7 times less than in the control. On the 1st day of the experiment, the lethality in the comparison group was 2.3 times, and in the experimental group, 2.2 times; on the 3rd day, respectively, 1.7 and 2 times; on the 7th day 2.2 and 1.8 times lower than in the control group. On the first day, the morphological picture of peritonitis in the experimental and comparison groups testified to the continuation of the inflammatory process. On the 3rd day in the second and third groups, the intensity of peritonitis began to decrease, and by the 7th day it was completely eliminated.
Conclusion. There were no statistically significant differences between the immobilized forms of sodium hypochlorite and miramistin in the course of experimental generalized peritonitis.
Keywords: experimental widespread peritonitis; sanitation of the abdominal cavity; immobilized form of sodium hypochlorite; immobilized form of 0.01% miramistin solution.
References
1. Ostryj peritonit. Klinicheskie rekomendacii Rossijskogo obshchestva hirurgov. M.: Medicina, 2017. 98 р. (In Russ).
2. Aliev SA, Aliev ES. Abdominal’nyj sepsis sostoyanie problemy, integral’nye ocenki sistemy tyazhesti techeniya i kriterii prognoza iskhoda.Vestnik hirurgii im.I.I.Grekova. 2018; 177(5): 108–112. (In Russ).
3. Savel’ev VS, Gel’fand BR, Filimonov MI, Podachin PV, Sergeeva M.A. Kriterii vybora effektivnosti taktiki hirurgicheskogo lecheniya rasprostranennogo peritonita.Annaly hirurgii. 2013; 2: 48–54. (In Russ).
4. Malkov IS, Filipov VA, Korobkov VN, Tagirov MR. Rasprostranennyj peritonit: evolyuciya metodov hirurgicheskogo lecheniya.Prakticheskaya medicina. 2017; 107(6): 46–49. (In Russ).
5. Budamala S, Penugonda A, Prakash GV, Ramaniah NV, et al. Evaluation of Various Prognostic Factors in Perforative Peritonitis Management. Journal of Evidence based Medicine and Healthcare. 2015; 2(38): 6027–6035.
6. Sukovatyh BS, Konoplya AI, Blinkov YUA, Blinkov YuYu. Sravnitel’naya effektivnost’ vodnyh i immobilizirovannyh form gipohlorita natriya v lechenii rasprostranennogo peritonita. CHelovek i ego zdorov’e. 2012; 1: 118–124. (In Russ).
7. Sukovatyh BS, Blinkov YuYu, Makienko KG. Vliyanie immobilizirovannyh form gipohlorita natriya na blizhajshie i otdalennye rezul’taty lecheniya bol’nyh s rasprostranennym peritonitom.Vestnik hirurgii im. I.I.Grekova. 2014. 173(2): 647–51. (In Russ).
8. Patent RUS №2338265. Blinkov YuYu, Lipatov VA, Sukovatyh BS, Eshtokin SA, Kostin SV, Besedin AV, Okunev OA, Efremenkov AM, Zajcev OV, Nenahov AA, Skorikov DV, Starodubceva EV. Sposob modelirovaniya ostrogo peritonita № 2007119763/14 (In Russ).
9. Patent RUS №2715922. Mosolova AV, Sukovatyh BS, Zatolokina MA, Pashkov VM, Pankrusheva TA, CHekmaryova MS. Sposob lecheniya rasprostranennogo peritonita № 2019124361. (In Russ).
10. Sukovatyh BS, Blinkov YuYu, Eshtokin SA, Frolova OG. Eksperimental’no-klinicheskoe obosnovanie primenenie immmobilizirovannyh form gipohlorita natriya v lechenii rasprostranennogo peritonita. Vestnik hirurgii im. I.I. Grekova. 2008; 167(6): 44–47. (In Russ).
