Ultrasound method for assessing the severity of local wound complications after surgical interventions on the abdominal organs

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Abstract

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 Clavien–Dindo 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 Mann–Whitney 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 Clavien–Dindo 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 I–II 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.

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About the authors

Alexander G. Izmailov

Kazan State Medical University

Author for correspondence.
Email: izmailov_alex@mail.ru
ORCID iD: 0000-0001-9559-550X

M.D., Cand. Sci. (Med.), Assoc. Prof., Depart. of General Surgery

Russian Federation, Kazan, Russia

Sergey V. Dobrokvashin

Kazan State Medical University

Email: gsurgery1@yandex.ru
ORCID iD: 0000-0002-9817-9816

M.D., D. Sci. (Med.), Prof., Head of Depart., Depart. General Surgery

Russian Federation, Kazan, Russia

Sergey G Izmailov

City Clinical Hospital No. 7 of the Leninsky District of Nizhny Novgorod named after E.L. Berezova

Email: izi28082009@yandex.ru
ORCID iD: 0000-0001-7998-9277

M.D., D. Sci. (Med.), Prof.

Russian Federation, Nizhny Novgorod, Russia

Andrey E. Leontiev

City Clinical Hospital No. 7 of the Leninsky District of Nizhny Novgorod named after E.L. Berezova

Email: leontjeff@mail.ru
ORCID iD: 0000-0001-6510-3391

M.D., Cand. Sci. (Med.), Assoc. Prof.

Russian Federation, Nizhny Novgorod, Russia

Dmitry E. Volkov

Kazan State Medical University

Email: gsurgery1@yandex.ru
ORCID iD: 0000-0002-7253-3370

M.D., Cand. Sci. (Med.), Assoc. Prof., Depart. of General Surgery

Russian Federation, Kazan, Russia

Egor E. Lukoyanychev

City Clinical Hospital No. 7 of the Leninsky District of Nizhny Novgorod named after E.L. Berezova

Email: egor-lukoyanychev@yandex.ru
ORCID iD: 0000-0001-6392-2692

M.D., Cand. Sci. (Med.), Assoc. Prof.

Russian Federation, Nizhny Novgorod, Russia

Oksana S. Kolchina

City Clinical Hospital No. 7 of the Leninsky District of Nizhny Novgorod named after E.L. Berezova

Email: kolchinaoksana190493@mail.ru
ORCID iD: 0000-0002-9448-8590

M.D.

Russian Federation, Nizhny Novgorod, Russia

Mikhail D. Romanov

National Research Mordovian State University named after N.P. Ogarev

Email: MDRomanov@yandex.ru
ORCID iD: 0000-0002-7348-1242

M.D., D. Sci. (Med.), Prof., Depart. of Hospital Surgery with courses in Traumatology and Orthopedics, Eye Diseases

Russian Federation, Saransk, Russia

Tatiana V. Vadyaeva

National Research Mordovian State University named after N.P. Ogarev

Email: vadyaeva2011@yandex.ru

M.D., Clin. Resident, Depart. of outpatient Therapy

Russian Federation, Saransk, Russia

Anna O. Firsova

Kazan State Medical University

Email: Hanna.shon@mail.ru
ORCID iD: 0000-0002-2026-7269

student

Russian Federation, Kazan, Russia

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Supplementary files

Supplementary Files
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1. JATS XML
2. Рис. 1. Ультразвуковая картина передней брюшной стенки живота пациента К. 42 лет на 3-и сутки после лапаротомии. Определяется гипоэхогенная зона шириной 12,5 мм в области апоневроза белой линии живота

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3. Рис. 2. Ультразвуковая картина передней брюшной стенки живота того же больного (см. рис. 1) на 5-е сутки после лапаротомии. Гипоэхогенная зона в области апоневроза белой линии живота по сравнению с 3-м днём наблюдения уменьшилась до 6 мм

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4. Рис. 3. Ультразвуковая картина передней брюшной стенки живота пациента Б. 52 лет на 3-и сутки после лапаротомии. Гипоэхогенная зона в области апоневроза белой линии живота составляет 11,7 мм

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5. Рис. 4. Ультразвуковая картина передней брюшной стенки живота того же больного (см. рис. 3) на 5-е сутки после лапаротомии. Гипоэхогенная зона в области апоневроза белой линии живота уменьшилась до 5,7 мм

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6. Рис. 5. Ультразвуковая картина передней брюшной стенки живота того же больного (см. рис. 3, 4) на 7-е сутки после лапаротомии. Гипоэхогенная зона в области белой линии живота отсутствует. Определяются гиперэхогенные участки

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