РЕЗУЛЬТАТЫ АПРОБАЦИИ НОВОЙ АСЕПТИЧЕСКОЙ АБДОМИНАЛЬНОЙ ПОВЯЗКИ ДЛЯ ЗАЩИТЫ И УВЛАЖНЕНИЯ ЭВЕНТРИРОВАННЫХ ОРГАНОВ НА ЭКСПЕРИМЕНТАЛЬНОЙ МОДЕЛИ ОТКРЫТОЙ ТРАВМЫ ЖИВОТА

Abdominal injuries commonly seen in the military conflicts in Afghanistan and North Caucasus demonstrated hollow organ eventration rate of 10.8 %. Abdominal organs eventration is always complicated by abdominal cavity infection, which results in severe infectious complications. Infectious complications in 54.1 % of cases, and particularly peritonitis (43.3 %), are responsible for the lethal outcome when penetrating abdominal injuries occur. In Russia, multipurpose aseptic dressings to protect and hydrate eventrated abdominal organs are not available in both complete authorized equipment sets in Russian Army Medical Corps, and the emergency team supplies. Objective of the study was the development of the adequate experimental model of the open abdominal injury, accompanied by internal organs eventration, and assessment of the effectiveness of the developed aseptic abdominal dressing to protect and hydrate eventrated organs in the prevention of abdominal cavity infectious complications. Materials and methods. Assessment of the effectiveness of protective characteristics of AP-A aseptic dressing control samples used to protect and hydrate eventrated organs was carried out in seven heterosexual pigs weighing from 28.5 to 35.0 kg. 3 hours, 3, 4, 5 days later, following the use of AP-A, visual (gauze adhesion, the presence of peritonitis, adhesion process and other complications), laboratory (general blood test, microbiology testing), instrumental and morphological criteria were assessed. The device LAKK-M was used for assessment of microcirculation in the intestine. Results. AP-A maintained safe adhesive properties in 6 of 7 observations, gastrointestinal wall pellicles were noted in one case. Following 3, 4 or 5 days of monitoring during relaparotomy, 3 of 7 cases showed intestine edema, hyperemia and loose adhesions between its loops, isolated fibrinous pellicles. There were no signs of peritonitis found in any of 7 animals. Experimentally, basic blood test findings demonstrated minor variations, being compatible with reference values for this type of animals. The results of initial and repeated microbiology testing showed sterile gastrointestinal contents in 3 of 7 animals.  Blood culture taken on operation day in 3 animals and during relaparotomy in 2 animals demonstrated gram-negative bacteria, which was thought to be blood culture contamination, taking into account absence of definite signs of infectious inflammatory process in the skin and abdomen of animals. Basic microcirculation findings were: microcirculation – 18.4 [17.1; 19.0] perfusion units (p.u), σ – 1.1 [1.0; 1.7] p.u., Kv – 5.8 [5.0; 11.4] %. At the end of the experiment (3, 4, 5 days later), microcirculation reached 22.6 [8.0; 22.8] p.u. The morphological experiment of samples from the experimental (testing) group of animals (n = 7) as compared to the controls (n = 1), showed some insignificant reactive changes in cells of tessellated epithelium covering the serosa of small intestine.  Conclusion. The results show that aseptic dressing AP-A control samples maintain adequate humidity level and protect eventrated abdominal organs, demonstrate safe adhesion properties and prevent the development of local complications in the early postoperative period.