EXPERIENCE IN THE USE OF THE SERRATA IN COMPLEX TREATMENT OF PATIENTS WITH TRAUMATIC OSTEOMYELITIS OF THE LOWER JAW

Voloshyna L. I., Rybalov О. V., Skikevych M. G., Sokolova N. A.

CONTENTS

Scentific article

According to native and foreign authors the number admitted to hospitals with injuries of the maxillofacial area grows. Fractures of the lower jaw are always accompanied by injuries of soft tissue, breaks and bruising and hematomas. Frequency traumatic osteomyelitis is up to 10-20%. For traumatic osteomyelitis characterized by the development of purulent-necrotic process in primary intact bone tissue. As a result of deceleration regeneration of blood vessels and violations of vascularisation fracture zone slows resorption of bone tissue. For traumatic osteomyelitis of the lower jaw is dominated periosteal type of osteogenesis due to tissue hypoxia. Development of traumatic osteomyelitis contribute to :later treatment of the patient in hospital, infection of the bone through the crack fracture; rupture of the mucous membrane of the alveolar process; the presence of teeth (roots) in the fracture line; teeth with chronic odontogenic center; detachment of soft tissues from the ends of the bone fragments; the formation of abscesses around the jaw in the soft tissues; violation of regional blood circulation and tissue trophism in the area of damage; untimely and insufficient effective immobilization of the fracture of the jaw; decrease of immunological the reactivity of the organism. Traumatic osteomyelitis more likely to develop in persons with combined trauma. The aim of the research was to examine the impact on local and general reactions of the organism «Serrata». Under the supervision were 38 patients in maxillofacial department with traumatic osteomyelitis of the mandible. 15 of them were with phlegmon around the lower jaw. The greatest number of observed (18 people – 65,78%), aged between 21 and 40 years. In the first day was the disclosure of purulent, prescription of antibacterial therapy and «Serrata». «Serrata» – product «Kusum Heltkher » (India), contains a proteolytic enzyme nonpathogenic intestinal bacteria Serratia E 15 (10 mg in one tablet). Clinical research has established anti-inflammatory, fibrinolytic, decongestants properties of the tablets. The drug reduces the painful symptoms. The drug is рrescribed in a dose of 10 mg (1 tablet) 3 times a day for 8 – 10 days. All patients have carried out the analysis of the results of the studies of general indicators of the urine and blood of coagulation. 2-3 days after the opening of a purulent focus was exudation, declined or stopped on the 4-5 day of observation. Pain in the area of the wound decreased or disappeared on 2 – 4 day, infiltration of tissues in the inflammation decreased from 2 days. In most patients by day 5 infiltration of the limited size of the wound. The wound edges by this time started to granulate. In the analysis of urine all patients revealed from 1 to 3 erythrocytes, on 10-12 days is the norm. Content of protein in the urine by 10-12 day almost all of the patients came to normal. The results of blood tests, the number of erythrocytes was not significantly changed. Hemoglobin slightly decreased, the number of leukocytes in the blood is significantly decreased. All patients cleansing of purulent wounds came on the average 1-2 days earlier. This did affect the period of consolidation of bone fragments. We ascertained the positive dynamics of the flow of the postoperative purulent wounds, no patients undesirable collateral general and local reactions. We can conclude that the «Serrata» can be recommended as the tablets of choice in treatment of patients with acute purulent inflammatory processes in maxillofacial area and traumatic osteomyelitis in particular.

traumatic osteomyelitis of the lower jaw, Serrata

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«Bulletin of problems biology and medicine» Issue 2 part 1 (107), 2014 year, 075-078 pages, index UDK 616. 716. 4-002-001-085. 828