Dentistry

doi: 10.25005/2074-0581-2018-20-1-77-83
APPLICATION OF SORPTION TECHNOLOGIES IN COMPLEX TREATMENT OF PURULENT-INFLAMMATORY DISEASES OF THE MAXILLOFACIAL AREA

D.I. Tazin1, M.N. Shakirov1, I.D. Tazin1, R.I. Pleshko2

1Department of Dentistry, Siberian State Medical University, Tomsk, Russian Federation
2Department of Morphology and General Pathology, Siberian State Medical University, Tomsk, Russian Federation

Objective: To improve the results of treatment of patients with purulent-inflammatory diseases of the maxillofacial area by using the drainage sorbent "VitaVallis".

Methods: A total of 72 patients with odontogenic phlegmon of the maxillofacial region aged 18 to 78 years were examined, of which 39 were men (54.1%), women – 33 (45.9%). All patients were divided into two clinical groups: the main (36 patients, 50%) and the comparison group (36 patients, 50%). The sorbent material «VitaVallis» carried out drainage of the concerned cell spaces in the patients of the main group. Assessment of the local course of the wound process was based on the nature and volume of exudate; the timing of wound cleansing, the preservation of infiltration, the appearance of granulations and marginal epithelization, as well as the application of secondary sutures and the length of hospitalization. The nature of the course of the wound process was evaluated based on cytological examination of smears-prints taken from different parts of the wound on the first, 3rd, 5th and 7th day of the postoperative period.

Results: The use of sorption-application therapy has made it possible to reduce the duration of treatment of patients with odontogenic phlegmon of the maxillofacial region by 4.35±1.41 days (p<0.05). The use of the dressing material already for the first day of the study led to the predominance of previously destructive forms of neutrophils, which can speak of the enhanced effector function of these cells in conditions of sorption from the wound of microorganisms. On the 7th day of observation, neutrophil granulocytes (88.6%) prevailed in the smear from the bottom of the wound drained by the sorbent, including destructive changes (50.7%), but macrophophagal elements (7.7%) and phagocytic forms (3.5%), which indicated an active process of cleansing from microflora and detritus. Analysis of the control group showed that all over the monitoring the share of neutrophilic granulocytes remained almost unchanged throughout the observation period (94%, 94.3%, 94%, 93.3%, respectively), the macrophages reaction was noted only on the 5th day and was weakly expressed.

Conclusions: The use of the sorption material "VitaVallis" was given in local treatment of the phlegmon of the maxillofacial area promotes to the rapid improvement of the overall condition of the patient and the cupping of local signs of a purulent-inflammatory process, which allows reducing the duration of hospital treatment of patients by 4.35±1.41 days (p<0.05). Developed draining sorbent is a highly effective means of the new generation for the local treatment of purulent wounds.

Keywords: Sorbent "VitaVallis", odontogenic phlegmon, maxillofacial area.

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References
  1. Nesterov AV, Lebedev MV, Zakharova IYu. Chastota i struktura gnoyno-vospalitel'nykh zabolevaniy chelyustno-litsevoy oblasti (po materialam otdeleniya chelyustno-litsevoy khirurgii Penzenskoy oblastnoy klinicheskoy bol'nitsy im. N.N. Burdenko) [Frequency and structure of pyoinflammatory diseases of maxillofacial region (based on materials of unit of maxillofacial surgery of Burdenko Regional Clinical Hospital)]. Vestnik Penzenskogo gosudarstvennogo universiteta. 2017;17(1):65-7.
  2. Timofeev AA. Profilaktika gnoyno-vospalitel'nykh oslozhneniy v khirurgicheskoy stomatologii i chelyustno-litsevoy khirurgii [Prevention of pyo-inflammatory complications in oral and maxillofacial surgery]. Stomatologpraktik. 2015;4:34-6.
  3. De Angelis AF, Barrowman RA, Harrod R, Nastri AL. Review article: Maxillofacial emergencies: oral pain and odontogenic infections. Emerg Med Australas. 2014;26(4):336-42. Available from: https://doi.org/10.1111/1742-6723.12266.
  4. Dorzhiev TE, Khitrikheev VE, Saganov VP, Radnaeva LD. Optimizatsiya diagnostiki i lecheniiya flegmon chelyustno-litsevoy oblasti (obzor literatury) [Optimization of diagnostics and treatment of phlegmones of maxillofacial region (Literature review). Byulleten’ VSNTS SO RAMN. 2015;102(2):111-4.
  5. Dragostin OM, Samal SK, Dash M, Lupascu F. New antimicrobial chitosan derivatives for wound dressing applications. Carbohydrate Polymers. 2016; 141(4):28-40.
  6. Kharitonov YuM, Frolov IS. Novye tekhnologii v lechenii bol'nykh odontogennoy infektsii [New technologies in the patient treatment of odontogenic infection]. Fundamental’nye issledovaniya. 2014;7:582-5.
  7. Nedoseykina TV, Glukhov AA, Korotkikh NG. Sovremennye napravleniya kompleksnogo lecheniya bol'nykh s flegmonami chelyustnolitsevoy oblasti i shei [Modern tendencies of complex treatment of patients with phlegmones of maxillofacial region and neck]. Fundamentalnye issledovaniya. 2014;4:641-6.
  8. Mokhova OS. Sovremennye metody lecheniya gnoynykh ran [Modern methods of treatment of septic wounds]. Zhurnal anatomii i gistopatologii. 2013; 2(4):15-21.
  9. Medvedev YuA, Gyunter VE, Kharnas PS. Primenenie elasticheskikh retraktorov pri lechenii bol'nykh s flegmonami chelyustno-litsevoy oblasti [The using of elastic retractors in treatment phlegmon of maxillofacial area]. Rossiyskiy stomatologicheskiy zhurnal. 2013;4:40-3.
  10. Glass GE, Murphy RF, Nanchahal GJ. Does negative pressure wound therapy influence subjacent bacterial growth? A systematic review. J Plast Reconstr Aesthet Surg. 2017;70(8):1028-37.
  11. Kabisova GS. Sravnitel'nyy analiz effektivnosti sovremennykh form dreniruyushchikh sorbentov v mestnom lechenii gnoynykh ran litsa i shei [Comparative analysis of efficiency of modern forms of sorbing agents in local treatment of septic wounds of face and neck]. Vestnik RGMU. 2011;4:75-8.
  12. Lutsenko VD, Shaposhnikov АА, Krut UA, Magolin GF, Lukhanina EV, Ivanckikova KN, i dr. Obosnovanie primeneniya bioaktivnykh sorbtsion-no-gelievykh kompozitsiy pri lechenii gnoynykh ran [Substantiation of us-ing bioactive sorption gel formulations for treatment of pyogenie wounds]. Novosti khirurgii. 2016;24(3):222-6.
  13. Vinnik YuS, Markelov NM, Tyuryumin VS. Sovremennye metody lecheniya gnoynykh ran [Modern methods of treatment of septic wounds]. Sibirskoe meditsinskoe obozrenie. 2013;1:18-24.
  14. Smotrin SV, Oslavskiy AI, Melamed VD, Grakovich PV. Sorbtsionno-drenazhnye ustroystva v kompleksnom lechenii gnoynykh ran i abstsessov myagkikh tkaney [Sorption-drainage devices in complex treatment of purulent wounds and abscesses of soft tissues]. Novosti khirurgii. 2016;24(5):457-64.
  15. Abaev YuK. Khirurgicheskaya povyazka [Surgical dressing]. Minsk, RB: Belarus; 2005. 150 p.
  16. Fomenko AN, Pekhenko VG, Tikhonova IN, Bakina OV. Otsenka biologicheskogo deystviya perevyazochnogo materiala na osnove polimernoy matritsy i nanostrukturnykh chastits oksigidroksida alyuminiya [Biological evaluation of wound dressing based on polymer matrices and nanostructured particles of aluminum oxyhydroxide]. Sibirskiy meditsinskiy zhurnal. 2013;2:103-7.
  17. Serova AN, Pekhenko VG, Tikhonova IN, Glazkova EA, Bakina OV, Lerner MI, i dr. Antimikrobnaya aktivnost' perevyazochnogo materiala, impregnirovannogo kolloidnym serebrom [Antimicrobial activity of dress-ings impregnated with colloidal silver]. Sibirskiy meditsinskiy zhurnal. 2012;3:137-41.

Authors informations:

Tazin Dmitry Ivanovich, Assistant of the Department of Dentistry, Siberian State Medical University

Shakirov Mukhamedzhan Nigmatovich, Doctor of Medical Sciences, Professor of the Department of Dentistry, Siberian State Medical University

Tazin Ivan Dmitrievich, Doctor of Medical Sciences, Professor of the Department of Dentistry, Siberian State Medical University

Pleshko Raisa Ivanovna, Doctor of Medical Sciences, Professor of the Department of Morphology and General Pathology, Siberian State Medical University

Address for correspondence:

Shakirov Mukhamedzhan Nigmatovich

Doctor of Medical Sciences, Professor of the Department of Dentistry, Siberian State Medical University

634034, Russian Federation, Tomsk, str. Sovetskaya 84, apt. 50

Tel.: (+7) 913 1175700

E-mail: shakirov1948@mail.ru

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