Expression of inflammatory process and wound healing rate after regional conduction anesthesia in surgical treatment of the lower extremities: a prospective study
https://doi.org/10.17238/2072-3180-2023-4-15-21
Abstract
Introduction. Conduction anesthesia under ultrasound control of nerve plexuses and peripheral nerves should be recognized as the most optimal type of anesthesia during surgeries on the upper and lower extremities. However, the effect of the used anesthesia tactics and various anesthetic aids on wound healing has not been clearly proved.
The aim – comparative analysis of inflammatory process expression and wound healing rate in patients with shrapnel wounds of the lower extremities after using different tactics of conduction anesthesia during surgical treatment.
Materials and methods of research. An observational prospective cohort study of 147 patients who underwent surgery for shrapnel wounds of the lower extremities was carried out. The patients were observed in 4 groups depending on the anesthesia tactics. Data analysis was performed using descriptive statistical methods, comparative analysis using Wilcoxon and Mann-Whitney criteria.
Treatment results. Intergroup analysis of one of the main indicators of the efficacy of the treatment, which characterizes the rate of wound healing, showed a significant difference in the group of patients who received conductive anesthesia of the sciatic nerve branches at the level of the fossa of the hamstrings according under ultrasound control during surgery (p< 0.05 by Mann-Whitney test), when compared to the groups that underwent surgery with conductive anesthesia of the sciatic nerve through gluteal access with blockade of the femoral nerve under ultrasound control, with conductive anesthesia of the femoral nerve under ultrasound control, as well as with local anesthesia, respectively.
Conclusion. The anesthetic aid developed during the study has a positive effect on tissue proliferation and regeneration after surgical treatment of shrapnel wounds of the lower extremities.
About the Authors
D. E. Agafonov
Central Military Clinical Hospital named after P. V. andryka of the Ministry of Defense of the Russian Federation
Russian Federation
Russian Federation
Agafonov Dmitry Evgenievich – Head of the Department
Bolshaya Olenya str., 8, Moscow, 107014
P. E. Kraynyukov
Central Military Clinical Hospital named after P. V. andryka of the Ministry of Defense of the Russian Federation;
Federal State Autonomous Educational Institution of Higher Education "Peoples Friendship University of Russia"
Russian Federation
Russian Federation
Krayniukov Pavel Evgenievich – MD, PhD, Associate Professor. Professor of the Department of Hospital Surgery with a course of pediatric Surgery of the Medical Institute of the Peoples’ Friendship University of Russia of the Ministry of Education and Science of the Russian Federation, Miklukho-Maklaya str., 6, Moscow 117198;
Head
Bolshaya Olenya str., 8, Moscow, 107014
M. Yu. Yakovlev
National Medical Research Center of Rehabilitation and Balneology;
I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
Yakovlev Maxim Yuryevich – Doctor. Sci. (Med.), deputy director for strategic development of Medical Activities;
Associate Professor, Department of General Hygiene
32 Novy Arbat, Moscow, 121099
E. A. Valtseva
National Medical Research Center of Rehabilitation and Balneology
Russian Federation
Russian Federation
Valtseva Elena Alekseevna – Cand. Sci. (Biol.), leading researcher
32 Novy Arbat, Moscow, 121099
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Review
For citations:
Agafonov D.E., Kraynyukov P.E., Yakovlev M.Yu., Valtseva E.A. Expression of inflammatory process and wound healing rate after regional conduction anesthesia in surgical treatment of the lower extremities: a prospective study. Moscow Surgical Journal. 2023;(4):15-21. (In Russ.) https://doi.org/10.17238/2072-3180-2023-4-15-21
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