OBJECTIVE

To develop a method to improve the reparative potential of laparotomy wound tissues in patients who have undergone open surgical interventions in conditions burdened with peritonitis.

MATERIAL AND METHODS

90 operated patients with acute appendicitis complicated by peritonitis were examined, divided into 3 groups of patients: the first group (n=30, control) — patients with uncomplicated acute appendicitis. The second group (n=30) — patients with acute appendicular peritonitis. The third group (n=30) is similar to the second, where are included laser therapy and remaxol in the treatment. The tissue healing process was evaluated by the cytological picture of wound exudate and microcirculation of laparotomy wound tissues. At the organizational level, indicators of endogenous toxemia, lipid peroxidation, activity of the coagulation-lytic system were determined. Follow—up period: — 1st, 4th, 8th postoperative day.

RESULTS

In conditions burdened with acute peritonitis, in the early stages after surgery, the inflammation phase is prolonged in the tissues of the laparotomy wound, the inhibition of the reparative phase occurs, which largely determines the development of various kinds of wound complications. The process of reparative regeneration of laparotomic wound tissues is associated with a violation of homeostasis: endogenous intoxication, peroxidation of membrane lipids, the state of the coagulation-lytic system. The inclusion of laser therapy and remaxol in complex treatment leads to correction of homeostasis disorders, improvement of microcirculation, which improves the characteristics of the reparative process.

CONCLUSION

Complex therapy, acting on aggravated factors of the repair process in conditions of peritonitis, improves the course of healing of a laparotomic wound and reduces the number of wound complications.