Optimization of the Cardiosurgical Services of the Voronezh Region, Providing an Example of High-Tech Medical Care to the Patients of Older Age Group


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Abstract

Relevance Enteroparesis and perifocal edema in the zone of anastomosis lead to the rise of pressure in the intestinal lumen, the enlargement of its diameter, the stretching of its wall, the proportional increase of the distance among sutures, which may contribute to the rupture of the sutures and interfere with the reparative process in the zone of anastomosis. The purpose of the study The objective is to develop the pathogenetically justified method of a single-row continuous Z-shaped suture by using microsurgical techniques. Materials and methods Experimental research was performed on 70 adult albino rats of the line «Vistar» in two stages. At the first stage, distinctive features of the healing of intestinal wounds were compared. The anastomosis was performed using a single-row penetrating interrupted suture in the 1st series and a single-row continuous locking serous-muscular-submucous stitch in the 2d series. At the second stage, we focused on the development of the pathogenetically justified method of the single-row continuous serous-muscular-submucosal Z-shaped suture, practiced the application of this suture on 100 fresh gastrointestinal conglomerates of pigs and 10 adult albino rats of the line «Vistar». Results and their discussion In the early postoperative period, we observed the tendency towards the development of more durable sutures of the anastomosis in the second series than in the first one. The new single-row continuous Z-shaped suture has a higher strength, hermeticity and large fixing area of serous membranes. Conclusion Within the proposed use of the technique of the single-row continuous serous-muscular-submucosal Z-shaped suture, there is the distribution of the multi-vector tensile force that can prevent hyperextension of tissues and anastomotic leak.

About the authors

Voronezh Regional Clinical Hospital №1, 151 Moskovskii Ave., Voronezh, 394066, Russian Federation

Author for correspondence.
Email: author@vestnik-surgery.com
 MD, Professor, Deputy Director of the Scientific Centre of cardiovascular surgery named after A.N. Bakulev scientific-organizational work

Voronezh Regional Clinical Hospital №1, 151 Moskovskii Ave., Voronezh, 394066, Russian Federation

Email: author@vestnik-surgery.com
MD, Professor, head. CTD. surgery for coronary heart disease and cardiac rhythm Voronezh regional clinical hospital №1

Voronezh Regional Clinical Hospital №1, 151 Moskovskii Ave., Voronezh, 394066, Russian Federation

Email: Nazarov8481@mail.ru
cardiovascular surgeon of the Voronezh regional clinical hospital №1

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