Saratov JOURNAL of Medical and Scientific Research

drain

The experience of using biodegradable drainage in combination with traditional sinustrabeculectomy

Year: 2018, volume 14 Issue: №4 Pages: 633-638
Heading: Ophtalmology Article type: Original article
Authors: Krasyuk E.Yu., Noskova O.G., Akulov S.I., Strelnikova N.V., Tokareva E.G.
Organization: Tambov Ophthalmological Clinical Hospital, S. Fedorov Eye Microsurgery Federal State Institution
Summary:

Purpose: analysis and comparison of the degree of intraocular pressure (IOP) compensation, the presence and nature of postoperative complications in traditional sinustrabeculectomy (STE) and STE using biodegradable drainage. Material and Methods. Surgical intervention — sinustrabeculectomy (53 — traditional, 53 — using drainage, DDA drainage type) was performed with stationary diagnosis (106 patients) with a verified diagnosis of "primary open-angle glaucoma" (106 eyes). A comparative analysis was carried out for the stages of glaucoma, the degree of compensation of IOP, the presence and nature of postoperative complications. Results. In the course of sinustrabeculectomy with the use of drainage, a high level of the degree of IOP compensation and a low level of postoperative complications were noted in comparison with traditional sinustrabeculectomy. Gradual resorption of drainage prevents sharp decrease in ophthalmotonus, which allows to significantly reduce the risk of postoperative complications. At the same time, the presence of drainage interferes with the adhesion of the scleral flap and contributes to the gradual formation of a filtration pillow, which, accordingly, leads to a prolonged hypotensive effect. Conclusion. Sinustrabeculectomy with the use of drainage is pathogenetically grounded, which does not complicate the operation, it allows to achieve a persistent and prolonged hypotensive effect and to reduce the risk of postoperative complications.

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Modern surgical aspects in blood loss management in total knee arthroplasty

Summary:

The frequency of knee arthroplasty in knee arthritis is forcing the orthopedic community to take measures to optimize this surgical intervention. Despite the fact that this is a routine operation, it is often accompanied by significant blood loss. Large intraoperative blood loss leads to the development of postoperative post-hemorrhagic anemia which is an extremely unfavorable effect in the course of wound healing, moreover, it affects the length of stay of a patient in clinic and the cost of treatment. The analysis of the literature on the issue of patient blood loss management tells of divergent efforts of experts in related fields of medicine and complex multi-disciplinary research on this topic, often — with contradictory conclusions. It can be noted that nowadays there is no accurate, reliable and scientifically proven sound algorithm of blood loss management in primary total knee arthroplasty in modern Russian and foreign literature.

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