Treatment of local purulent postoperative soft tissue complications in patients of older age groups with fractures of the proximal femur

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Abstract

BACKGROUND: Surgical treatment of fractures of the proximal femur in elderly patients makes it possible to put patients on their feet early and improve their quality of life. Local purulent complications in the postoperative period after hip fractures surgical treatment occur in 5–10% of cases.

AIM: To improve the treatment outcomes of patients with local postoperative purulent complications of soft tissues by a comparative analysis of treatment methods with various antibacterial, antiseptic hydrogels and physical methods of wound treatment.

MATERIALS AND METHODS: The article presents the nature of local purulent complications, their clinical picture, and diagnostic features. All the patients are divided into 2 groups. The main group included 53 patients, and the control group included 48. The patients of the main group underwent comprehensive treatment of local purulent complications using modern technologies (plasma scalpel) and dressings with hydrogel Argacol. The control group was treated with traditional bandages with dioxomethyltetrahydropyrimidine and chloramphenicol.

RESULTS: The use of surgical wound treatment using a plasma scalpel and dressings with multifunctional hydrogel allows to accelerate the wound healing process by 2–3 weeks compared with the use of traditional techniques.

CONCLUSIONS: The application of the proposed tactics of providing specialized care to elderly patients with a fracture of the proximal femur allows for a significant (p < 0.05) improvement in treatment results.

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About the authors

Stanislav A. Linnik

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: stanislavlinnik@mail.ru
ORCID iD: 0000-0002-4840-6662
SPIN-code: 3442-9930

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Saint Petersburg

Gennady E. Afinogenov

Saint Petersburg State University

Email: gennady-afinogenov@yandex.ru
ORCID iD: 0000-0003-1273-7651
SPIN-code: 7907-6990

MD, Dr. Sci (Medicine), Professor

Russian Federation, Saint Petersburg

Anna G. Afinogenova

Saint Petersburg Pasteur Institute

Email: pasteur.afinogenova@mail.ru
ORCID iD: 0000-0001-8175-0708
SPIN-code: 9188-3533

Dr. Sci. (Biology), Professor

Russian Federation, Saint Petersburg

Ivan O. Kucheev

Hospital for War Veterans

Email: 9513533@mail.ru
SPIN-code: 9494-9102

MD, Cand. Sci. (Medicine)

Russian Federation, Saint Petersburg

Giorgi Karagezov

North-Western State Medical University named after I.I. Mechnikov

Email: karagezov_87@mail.ru
ORCID iD: 0000-0002-5234-1697

assistant lecturer

Russian Federation, Saint Petersburg

Dmitry Yu. Korshunov

Federal Center of Traumatology, Orthopedics and Endoprosthetics

Email: dmi02041976@yandex.ru
SPIN-code: 2920-2594

MD

Russian Federation, Smolensk

Anatolii V. Polikarpov

Hospital for War Veterans

Email: multifisher@mail.ru
SPIN-code: 8122-2191

MD

Russian Federation, Saint Petersburg

Yaroslav B. Tsololo

North-Western State Medical University named after I.I. Mechnikov

Email: yaroslav.tsololo@gmail.com
ORCID iD: 0000-0001-7744-0002
SPIN-code: 5363-6020

assistant lecturer

Russian Federation, Saint Petersburg

Vladislav S. Gusev

North-Western State Medical University named after I.I. Mechnikov

Email: wwwgusakrus@mail.ru
ORCID iD: 0009-0006-5897-4598

resident

Russian Federation, Saint Petersburg

References

  1. Kucheev IO, Kabanov MYu, Linnik SA, et al. Optimization of treatment for patients of older age groups with osteoporosis with fractures of the proximal femur. HERALD of the North-Western State Medical University named after I.I. Mechnikov. 2023;15(1):97–106. doi: 10.17816/mechnikov209839
  2. Kucheev IO, Kabanov MYu, Linnik SA, et al. Optimization of trauma care to victims of older age groups with fractures of the proximal femur. Advances in gerontology. 2022;35(6):939–947. EDN: XUJGHC doi: 10.34922/AE.2022.35.6.017
  3. Grushko VI. Application of plasma flow in the complex treatment of purulent wounds [dissertation]. Moscow 2008. 127 p. (In Russ.)
  4. Shulutko AM, Osmanov EG. Plasma technology in the complex treatment of surgical infections of soft tissues in elderly patients. Clinical gerontology. 2009;15(4–5):13–17. EDN: KWVGRX
  5. Afinogenov GE, Panarin EF. Antimicrobial polymers. Saint Petersburg: Gippokrat; 1993. 264 p. (In Russ.)
  6. Riegels-Nielsen P, Espersen F, Holmich LR, Frimodt-Moller N. Collagen with gentamycin for prophylaxis of postoperative infection. Staphylococcus aureus osteomyelinis studied in rabbits. Acta Orthop Scand. 1995;66(1):69–72. doi: 10.3109/17453679508994644
  7. Madai DYu, Shamolina II, Ananyeva EP, Madai OD. Fibrous-porous materials from yeast polysaccharides. Uspekhi meditsinskoi mikologii. 2014;12:323–325. (In Russ.) EDN: TFXMAF
  8. Afinogenov GE, Afinogenova AG, Maday DYu, et al. Modern antiseptic hydrogel in the treatment of infectious complications of wounds in surgery. Grekov’s Bulletin of Surgery. 2016;175(3):26–31. EDN: VZUJLN

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