Experience with the combined method of air-plasma treatment in cardiac surgery
Abstract
Background. One of the most common and severe complications in cardiovascular surgery is postoperative infection. The most formidable wound complication is mediastinitis, the frequency of which varies from 1 to 3%. The mortality rate among the patients of this group currently ranges from 3.5 to 58.3%. In this regard, the relevance of developing new methods for the prevention and treatment of infectious wound complications is beyond doubt.
Aim – to study and evaluate the efficacy of the “PLAZON” device for the treatment of postoperative infectious complications in cardiac surgery.
Material and methods. The study included 40 patients, by 20 people in each group (26 males and 14 females, the average age in the 1st group was 61.15±5.284; in the 2nd group – 64.15±7.013). The 1st group included patients treated with conventional surgery, in accordance with the prescribed clinical recommendations. The 2nd group included cases with the original method of combined exposure to nitric oxide and air-plasma flow. Patients underwent planned surgical interventions, mainly coronary artery bypass grafting with cardiopulmonary bypass. In the early postoperative period all the patients included in the study showed clinical signs of infectious wound complications (sternomediastinitis).
Results. The average amount of bed-days before the repeated surgical debridement in the 1st group was 15.55±4.1days; in the 2nd group it was 5.8±1.0 days. Clinically in the 2nd group the exudative phase was reduced, which resulted in an earlier onset of the proliferative stage. This was the reason for the repeated surgical debridement and secondary suturing in earlier terms for the patients of the 2nd group. The average bed-day after the repeated surgical debridement in the 1st group was 21.1±11.2; in the 2nd group it was 14.3±0.6. Besides, the effectiveness of the method was evaluated according to the results of bacteriological studies. In the 1st group the culture-negative wound drainage test was on 11.35±2.5 bed-day; while in 2nd group it was on 3.6±1.1 bed-day.
Conclusion. Using the “PLAZON” device in accordance with the developed methodology allowed to accelerate tissue repair in the affected area, reduce the level of microbial contamination of the wound surface and completely eliminate the pathogen on the third day, as well as reduce the patient's hospital stay.
Keywords:nitric oxide, mediastinitis, wound infection, “PLAZON”
Conflict of interests. The authors declare no conflict of interests.
For citation: Kuznetsov M.S., Shipulin V.M., Kozlov B.N., Nasrashvili G.G., Panfilov D.S., Sonduev E.L., Kozhanov R.S., Pekshev A.V., Vagapov A.B., Sharapov N.A. Experience with the combined method of airplasma treatment in cardiac surgery. Clin Experiment Surg. Petrovsky J. 2020; 8 (2): 73–82. DOI: 10.33029/2308-1198-2020-8-2-73-82 (in Russian)
Received 20.12.2019. Accepted 26.03.2020.
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