EFFECTIVENESS OF HERBAL MEDICINES FOR THE TREATMENT OF POSTOPERATIVE PERINEAL WOUNDS

AIM. The problem of treatment of postoperative wounds of the anal canal and perineum does not lose its relevance to the present time. Operated surgeons are concerned about finding new drugs for conservative treatment of postoperative perineal wounds. In the State Scientific Center of Coloproctology, from December 2015 to January 2017, a study was conducted to evaluate the effectiveness of the Gem drug for the treatment of postoperative crotch injuries and anal canal. METHODS. The study included 82 patients diagnosed with a chronic anal fissure, hemorrhoids, fistulas of the rectum. The main group (1) consisted of 40 patients who were treated with Gem, control (2) - 42 patients treated with water-soluble ointments for topical application. The evaluation methods included clinical examination, profilometry, cytological examination of print smears, quality of life of patients on the QoL SF-36 scale before surgery, at discharge and on the 28th day after surgery. In each group, patents were included, homogeneous in terms of key indicators. RESULTS. The quality of life and the intensity of the pain syndrome in the early postoperative period did not have statistically significant deviations in the patients of the main and control groups. Clinical evaluation of the course of the wound process with the use of the Gem drug showed that the duration of hyperthermia already decreases on the second day of the postoperative period from 35.7 % in the control patients to 10 % in the patients of the main group (p<0,05). In the patients of the main group, in a cytological study, a significant decrease in the inflammatory wound reaction was revealed from 59.5 % to 10 % as early as the 15th day after surgery (p<0.001). Compared with patients of the control group, statistically significant clinical acceleration of wound surface healing was observed on the 15th and 28th days after the operation (by 34 % and 40 %, respectively) against the background of administration of the Hem preparation (p<0,05). Hem demonstrated itself as a safe drug - no side effects or allergic reactions were observed in any observation against its background. In patients of the main group on day 28 after the operation, a significant improvement in the quality of life as a physical from 36.7 ± 0.56 to 44.9 ± 0.42 and a mental state from 35,6 ± 0,5 to 44,8 ± 0,37, (p<0,001).

Local treatment of postoperativel perineal wounds, a plant preparation, methods for assessing the course of the wound process

1. Багдасарян, С.Л. Хирургическое лечение анальной трещины с пневмодевульсией анального сфинктера: Дисс.. канд. мед. наук, М. - 2010.

2. Винник, Ю.С. Современные методы лечения гнойных ран. / Ю.С. Винник, Н.М. Маркелова, В.С. Тюрюмин // Сибирское медицинское обозрение. - 2013. - № 1. - с. 18-24.

3. Липатов, В.А. Патогенез раневого процесса и подходы к лечению гнойных ран. / В.А. Липатов // Хирургия. - 2005. - № 10. - с. 22-25.

4. Мохова, О.С. К вопросу регионального лечения гнойных ран. Научное обозрение. / О.С. Мохова, А.П. Остроушко // Медицинские науки. - 2016. -№ 5. - с. 72-74.

5. Светухин, A.M. Гнойная хирургия: современное состояние проблемы. 50 лекций по хирургии (под ред. акад. Савельева B.C.). / A.M. Светухин, Ю.А. Амирасланов // М., «Медиа Медика». - 2003. -с. 335-344.

6. Филипс, Р.К.С. Колоректальная хирургия. / Р.К.С. Филлипс // 2009. - с. 281-286, 295-297.

7. Koscinski, T. Obstetric damage to the perineum and the anal sphincters. Reconstruction surgery. / T.Koscinski // Ginekol. Pol. Review. Polish. - 2014 Aug. - № 85 (8). - р. 624-8.

8. La Greca, G. Perineo-ano-rectal injuries: clinical experience. / G. La Greca, S. Gagliardo, M. Sofia et al. // Chir. Ital. Review. Italian. - 2008 Jan-Feb. -№ 60 (1). - р. 91-101.

9. Lewis S. Pilcher. The Treatment of Wounds. / S. Lewis // 2015. - с. 10-15.