Purpose of the study: to assess the patho-histological changes in the intact pancreas and parietal peritoneum against the background of the directed ozone gas flow.Material and methods. The prospective study was conducted in 54 adult male Wistar rats. In 1st and 2nd groups (n = 24, each) the left pancreatic lobe and parietal peritoneum, respectively, was treated with a 40 mg/L ozone gas stream at a rate of 2 L/min for 1.5 minutes. 1, 3, 30 and 120 days after the first operation 6 animals of each groups were sacrificed and tissue specimens were collected for histological analysis. In the control group (6 sham operated animals), tissue samples were collected 120 days after laparotomy.Results. A day after treatment with ozone gas stream, the pancreatic specimens of 1st group differed from the control in moderate and mild perivascular infiltration and edema. In the period from 3 to 120 days after exposure, the pancreatic specimens of 1st group and control did not differ significantly. Specimens of 2nd group differed from the control degree of edema and infiltration in the first 3 days, the level of proliferation of fibroblast-like cells and fibrosis in 120 days after treatment of the parietal peritoneum with a directed ozone gas stream.Conclusion. Local use of the directed ozone gas flow at a concentration of 40 mg/L at a rate of 2 L/min is accompanied by the same type of patho-histological changes from the intact pancreas and parietal peritoneum in the form of mild to moderate edema, perivascular polymorphic cell infiltration in the early period after exposure. Late parietal peritoneum reaction (moderate events fibroblast-like cell proliferation and fibrosis) requires additional safety studies of intraabdominal use of ozone-oxygen mixture.
Introduction. Search for new means and methods of sanitation of the abdominal cavity remains significant related to growing antibiotic resistance of bacterial pathogens in surgical infection. This challenge is of particular relevance in the development of purulent complications of acute pancreatitis due to the complexity of radical control of the inflammation source.The aim of the study was to evaluate outcomes of microbiological examination of peritoneal exudate, biopsies of the pancreas, arterial blood in the topical application of gaseous ozone for the treatment of experimental infected pancreatic necrosis.Methods. This prospective experimental study included 43 laboratory animals - Soviet Chinchilla rabbits. Group 1 consisted of 13 animals, groups 2 and 3 consisted of 12 animals each. All animals were infected with pancreatic necrosis simulated using a clinical strain of A. baumannii. Sanitation relaparotomies were performed in 24 hours and 60 hours under anesthesia: with 0.9% sodium chloride solution in animals of group 1, with 0.02% aqueous solution of chlorhexidine bigluconate in animals of group 2, with ozone-oxygen gas mixtures in animals of group 3. The control group included six sham-operated animals. Animals were withdrawn from the experiment in 96 hours with taking samples for microbiological investigations.Results. Animals of group 1 showed an increased frequency (from 23.1 to 100.0%, p=0.003) and degree (from 3.5 (3.0; 4.5) to 7.0 (5.5; 7. 5) lg COE/ml, p0.001) of bacterial contamination of peritoneal exudate within 24 to 96 hours. Most parameters in animals of group 2 were not significantly different from those achieved in animals of group 1. Notably, the bacterial count of A. baumannii in the peritoneal exudate in 60 hours (6.0 (5.7; 6.7) lg COE/ml), and the degree of secondary (enterogenic) contamination of the pancreas (5.5 (5 .0; 6.7) lg CFU/g) and peritoneal exudate in 96 hours (7.7 (7.0; 8.0) lg CFU/ml) in animals of group 2 significantly exceeded those in animals of group 1 (p 0.010). Intraperitoneal application of a directed flow of gaseous ozone in 24 and 60 hours allowed achieving elimination of A. baumannii in 80.0% of pancreatic biopsy samples by the end of the fourth day (p=0.002 and p=0.007 when compared with results of groups 1 and 2, respectively), prevent its spread into the peritoneal exudate and systemic circulation. The treatment with gaseous ozone was also accompanied by the decreased bacterial count of A. baumannii and the degree of secondary (enterogenic) contamination by other opportunistic microorganisms in the analyzed samples.Conclusion. Perspectives for translating the results obtained into clinical practice determine the relevance of studying modern molecular methods of bacteriological analysis. This should be combined with an adequate assessment of the safety of various targeted treatment options of the abdominal tissues and organs with an ozone-oxygen gas mixture.
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