Introduction. Diseases that are accompanied by significant cutaneous-subcutaneous-fascial defects during surgery in children include: pilonidal cyst (PC), spinal hernia (SH), Fournier’s gangrene and wounds. Various methods of surgical treatment of PC consist of the stages: removal of the cyst and covering the wound surface with suturing or leaving the wound surface open. The existing methods of covering a defect in SH in children cannot satisfy surgeons, because they are accompanied by significant tissue tension, which causes complications. Fournier’s gangrene in children is a rare disease with a large area of soft tissue damage. Initial surgical debridement of wounds in childhood requires an individual approach with the choice of the correct method to close the defect. Purpose. To study the possibilities of using the rotation of vascularized cutaneous-subcutaneous-fascial flap (CSFF) for the surgical treatment of superficial defects in children. Materials and methods. The surgical treatment of superficial defects in 73 children in a City Children’s Hospital (Chernivtsi) with PC (29 children), SH (20 children), wounds of the face, limbs and trunk (23 children), Fournier gangrene (1 child) was analyzed. We compared the performing of traditional methods of treatment and rotational methods of using CSFF. Recovery time and postoperative complications were analyzed. Results. By using traditional methods of treating PC, complications were observed in 50%, when using the proposed plastic surgery with rotational CSFF in 6.67%; in case of SH – in 44.44% and 18.18%, with wounds – in 27.27% and 8.33%, respectively. Plastic reconstruction in Fournier’s gangrene recovered on the 40th day of the postoperative period. Conclusion. The use of cutaneous-subcutaneous-fascial rotational flap with perforating vessels surgery allows to reduce the amount of complications after operations for PC, SH, initial surgical debridement of wounds, Fournier’s gangrene. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. Key words: cutaneous-subcutaneous-fascial flaps, superficial defects, children.
Introduction. Small intestine atresia is one of the most common causes of low bowel obstruction in newborns. Mortality in this pathology ranges from 5 to 60%, depending on the country. Modern views about surgical correction are rather contradictory. Purpose. To analyze the surgical treatment of small intestine atresia in the surgical department of the City Children’s Hospital No. 1 ССH) (Chernivtsi, Ukraine) and the surgical department Saint Damien Pediatric Hospital NPH (SDH) (Port-o-Prence, Haiti). To determine the best methods of surgery. Materials and methods. The surgical treatment of 15 children under the conditions of SDH (Haiti) and 12 children under conditions of the city children’s clinical hospital (CCH, Chernivtsi) with atresia of the small intestine was analyzed. Determined the effectiveness of closed (oblique «end-to-end» anastomosis, taping with «end-to-end» anastomosis, Denis-Brown and Louw anastomoses), discharging (U- and T-shaped, taping with anostomosing and suspended proximal enterostoma), anastomoses and stomas (end, double, according to Mikulich). Mortality with limited parenteral nutrition was 40% (SDH), with the presence of parenteral nutrition – 33.33% (ССH, Chernivtsi). Results. According to the analyzed data, we believe that the use of the method of surgical treatment should correspond to the type of atresia, the distance of the blind proximal end from the Treitz ligament, the difference in the diameters of the adducting and abducting sections, the possibility of parenteral nutrition, and the threat of short bowel syndrome (SCS). Conclusions. Y-shaped discharging anastomosis «side-to-side» with the removal of the proximal area in the form of a stoma, can be the method of choice in case of significant difference between the intestinal diameters. It provides a wide area of the small bowel junction, chyme abduction until the fistula heals, and can be used for different types of small bowel atresia. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. Keywords: small intestine atresia, surgical treatment, children.
Огляди Читайте нас на сайті: http://med-expert.com.ua О.Б. Бодн ар, Р.Ю. Рандюк, Б.М. Боднар, Л.І. Ватаманеску, А.В. Бочаров Епітеліальний куприковий хід у дітей: характеристика, особливості, методи лікування ВДНЗУ «Буковинський державний медичний університет», м. Чернівці Висвітлено епідеміологічні, клінічні та діагностичні аспекти епітеліальних куприкових ходів. Проаналізовано сучасні методи діагностики та лікування даної патології. Розкрито проблемні питання рецидивів даного захворювання. Ключові слова: епітеліальний куприковий хід, хірургічне лікування, колопроктологія.
результати хірургічних способів лікування пілонідального синусу у 25 дітей, віком від 13 до 18 років. Вивчено перебіг післяопераційного періоду при його висіченні з використанням підшивання шкіряних країв до дна рани (n=14) та шкірно-підшкірно-фасціальної лоскутної пластики (n=11). Шкіряно-підшкірно-фасціальна лоскутна пластика у власній модифікації є оптимальним способом хірургічного лікування пілонідального синусу у дітей, зменшує тривалість післяопераційного періоду та кількість ускладнень, прискорює загоєння рани при зменшенні інтенсивності больових відчуттів. Ключові слова: пілонідальний синус, шкірно-підшкірно-фасціальна лоскутна пластика, діти.
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