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

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

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.

Full Text

Restricted Access

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

References

  1. Belokonev VI, Ponomareva YuV, Pushkin SYu, Melentieva ON, Gulyaev MG. Potential predictors and morphological aspects of seroma deve¬lopment after plastic surgery of the anterior abdominal wall hernia. Novosti khirurgii. 2014;22(6):665–670. (In Russ.)
  2. Sharafislamov IF, Klyushkin IV, Klyushkina JuA, Mikhaylova ON, Badretdinova AR. Spontaneous hematoma of the anterior abdominal wall in emergency surgery clinic. Sonographic aspects. Vestnik sovremennoy klinicheskoy meditsiny. 2018;11(5):149–153. (In Russ.) doi: 10.20969/VSKM.2018.11(5).149-153.
  3. Belokonev VI, Ponomareva YuV, Pushkin SYu, Kovaleva ZV, Gubsky MV, Terekhin AA. Prospects of combined anterior prosthetic hernia repair in treatment of large and giant ventral hernias. Khirurgiya. Zhurnal im. N.I. Pirogova. 2018;(5):45–50. (In Russ.) doi: 10.17116/hirurgia2018545-50.
  4. Izmaylov SG, Bodrov AA, Lazarev VM, Trifonov RV. Ultrasonic method of monitoring the course of the wound process in the anterior abdominal wall. Khirurgiya. Zhurnal im. N.I. Pirogova. 2002;(6):41–45. (In Russ.)
  5. Vlasov AV. The prediction of the probability of seroma development in case of endoprosthesis replacement of ventral hernias. Sovremennye problemy nauki i obrazovaniya. 2013;(2):11. (In Russ.)
  6. Diomidova VN, Valeeva OV, Voropaeva LA, Kon'kova MV. Catheter technologies with ultrasound monitoring in modern surgery. Healthcare of Chuvashia. 2012;(4):40–45. (In Russ.)
  7. Zatevakhin II, Pasechnik IN, Gubaydullin RR, Reshetnikov EA, Berezenko MN. Accelerated postoperative rehabilitation: multidisciplinary issue. Part 2. Khirurgiya. Zhurnal im. N.I. Pirogova. 2015;(10):4–8. (In Russ.)
  8. Dobrokvashin SV, Izmaylov AG, Volkov DE, Pyrkov VA, Zakirov RF. Clinical and instrumental control over the course of the wound process in acute diseases of the abdominal organs. Prakticheskaya meditsina. 2014;(5):38–41.(In Russ.)
  9. Imangazipov SB, Kairkhanov EK, Kazangapov RS. Postoperative ventral hernia. Surgery and prevention of wound complications. Literature review. Nauka i zdravookhranenie. 2019;21(1):29–41. (In Russ.)
  10. Larichev AB, Chistyakov AL, Klochikhin AL. Healing of the postope¬rative wound using a local flap in surgery of tumors of the skin of the head and neck. Vestnik Sankt-Peterburgskogo universiteta. Meditsina. 2015;(1):46–55. (In Russ.)
  11. Loginov VI, Parshikov VV, Nasimov RR. Current mechanical methods of intraoperative prevention of surgical site infections. Novosti khirurgii. 2015;23(5):559–565. (In Russ.) doi: 10.18484/2305-0047.2015.4.559.
  12. Malkov IS, Filippov VA, Shaymardanov RSh, Korobkov VN, Gubaev RF, Erhu EE. Experience in perfor¬ming posterior separation plasty in giant postoperative ventral hernias. Kazan Medical Journal. 2017;(4):636–640. (In Russ.) doi: 10.17750/KMJ2017-636.
  13. Parshikov VV, Loginov VI, Baburin AB, Kasimov RR. 50-year's path of development of postoperative wound infectious complications prophylaxis. Meditsinskiy vestnik Bashkortostana. 2017;12(1):82–93. (In Russ.)
  14. Sergeev AN, Morozov AM, Askerov EM, Sergeev NA, Armasov AR, Isaev YuA. Me¬thods of local antimicrobic prophylaxis of surgical site infection. Kazan Medical Journal. 2020;101(2):243–248. (In Russ.)
  15. Kharitonov SV, Zinyakova MV. The ultrasound semiotics of uncomplicated wound healing after inguinal mesh plastics. Khirurgiya. Zhurnal im. N.I. Pirogova. 2012;(12):27–33. (In Russ.)
  16. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–213. doi: 10.1097/01.sla.0000133083.54934.ae.
  17. Parshikov VV. Inflammatory complications of the abdominal wall prosthetic repair: diagnostics, treatment, and prevention (review). Modern technologies in medicine. 2019;11(3):158–178. doi: 10.17691/stm2019.11.3.19.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
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

Download (14KB)
Indexing metadata
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

Download (15KB)
Indexing metadata
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

Download (15KB)
Indexing metadata
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

Download (17KB)
Indexing metadata
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

Download (22KB)
Indexing metadata

© 2022 Eco-Vector