Assessment of the severity of inflammatory changes in the surgical wound after closing preventive intestinal stoma
Abstract Introduction. Closing preventive intestinal stoma – frequently performed operation in modern colorectal surgery and for this kind of interventions are frequent inflammatory complications of the surgical wound. However, currently there is no objective evaluation system of severity of inflammatory complications in the surgical wound in these patients.
Aim. Develop a rating scale severity of inflammatory changes in the surgical wound after closing preventive intestinal stoma.
Material and methods. In single center, prospective, randomized study comparing the incidence of wound infection when closing preventive intestinal stoma using antibiotic prophylaxis (ABP) and without it (WABP) was included 195 patients (group WABP – 99 patients; group ABP – 96 patients). The degree of inflammation was assessed in the period up to 30 days after surgery. In State Scientific Centre of Coloproctology (SSCC) was developed scale to assess the severity of inflammatory changes in the surgical wounds. It differs 5 inflammation ascending degrees of severity.
Results. Normal wound healing (Grade I) was registered in 87 (87.8%) patients of group WABP and 85 (88.6%) patients in the ABP group (p>0.05). Grade II wound inflammation was observed in 6 (6.1%) patients WABP, and in 8 (8.3%) patients ABP group (p>0.05). Of all the patients studied, only 1 (1%) patients in the ABP group noted early signs of suppuration (Grade III). In 6 (6.1%) patients of WABP and 2 (2.1%) patients of ABP group reviewed Grade IV of inflammation. The most severe complications of the surgical wound (Grade V) did not develop in any of the studied patients. Analysis of the data showed no statistically significant differences in the incidence of wound infection between the two groups (p=0.35).
Conclusion. We have developed a SSCC scale allowed to review a rate of inflammatory complications and also to determine it's degree.
Keywords:antibiotic prophylaxis, inflammation of wound, closing stoma, preventive stoma
Clin. Experiment. Surg. Petrovsky J. 2016. № 2. Р. 89–95.
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