A.A. Zaporozhets in 1963 discovered the phenomenon of infection of the abdominal cavity through intestine suture, and introduced the concept of biological tightness which was a stimulus for a number of research and studies. Biological tightness of intestinal suture is determined by bacteriological research area of anastomosis. Contamination of the abdominal cavity through a physically sealed suture occurs according to certain patterns:

a) intestinal wall in the area of the anastomosis becomes permeable to microorganisms in 7-8 hours after surgery; b) microbial penetration of intestinal suture reaches a maximum at 2-3 day after surgery; c) degree of infection of the abdominal cavity through the intestinal suture depends on the type of intestinal suture, its extent and concentration of microbes in the lumen of the operated organ (stomach or intestine). Analogues of biological tightness in the English-speaking foreign literature failed to reveal.

A somewhat different approach to the concept of biological tightness of intestinal wounds and methods of determination was described by Professor Yu. Mazur. Biological tightness of intestinal wounds experimentally studied by determining the number of test microbes introduced into the small intestine on the visceral surface of the wound.

The experiment was conducted on rabbits. Introduced organisms are not typical for the normal microflora of the used experimental animals (S.epidermidis – hemolytic strain, S.epidermidis – no hemolytic strain, E.coli, B.subtilis). This ensured the purity of the experiment.

Given the results of the experiment, it is stated that significant сontamination of the abdominal cavity with uncomplicated postoperative period is possible only in the first 3 hours after the section of intestine. Further penetration of microorganisms through the sutured intestinal wound was terminated.

We conducted an experiment determining biological tightness of intestinal wounds in rabbits which were administered with 0.15 ml of Nadroparinum of calcium njection before surgery. The experiment was performed on sexually mature male rabbits in the operating conditions of the vivarium and laboratory of Microbiology. Surgical intervention was carried out under the European Convention for the Protection of Vertebrate Animals used for experimental and other scientific purposes (Strasbourg, 1986), the Law of Ukraine “On protection of animals from cruelty” and were approved due to the local Ethics Committee.

In the operating room of vivarium, subject to the rules of aseptic and antiseptic, medium median laparotomy access was used. In wound segment of the small intestine was deduced. In enterotomy wound nodal joints were imposed using microsurgical instruments and atraumatic suture material prolen 6,0. In another enterotomy wound test microbes through katetr were administered. Determination of microbes was done every fifteen minutes. On hourly basis another microorganism was introduced. Removed material was sown on nutrient substrates and cultured in an incubator overnight. Counting colonies was conducted after cultivation. Laparotomy wound was sewn seams single node through all layers.

We found that Nadroparinum of calcium affects the process of fibrin formation – extends the time of biological leakage of intestinal wound. So, anticoagulation directly during operations on the intestine, requires consideration of the patient’s condition, duration and scope of operations, comorbidity as well as biological tightness of intestinal wound.

Ключові слова: biological tightness, intestinal wound, Nadroparinum of calcium

Повний текст: PDF (Ukr)