Roganov G.G., Kushnir K.G., Nepreluk O.A.

Crimea state medical university named after S. I. Georgievsky, Simferopol.

 

Modern complex methods of treatment the osteomyelitis of mandible

     It was passed complex treatment of 55 patients with traumatic osteomyelitis of mandible. During the operation and postoperative period tissues are saturated by mixture of Erbisol in isotonic sodium chloride solution in correlation 1:5. In the dynamics of treatment was realized a control of indexes of cytobiochemical activity of peripheric blood neutrophils. Application of preparation  Erbisol directes  to manifestation of expressed protector and medical effect.

     The number of patients with damages in maxillofacial field significantlly became high last years because the increase of  level of traumatism.The problem of prophylaxis and treatment of traumatic osteomyelitis The problem of prophylaxis and treatment of traumatic osteomyelitis  one of the most actual and complicated in surgical stomatology. It justified by the complicate mechanism of development of suppurative and destructive process in the bone.

      Nowadays the investagators develop  the next main directions: the learning the issue of etiology and pathogenesis of disease, the improvement the methods of diagnosis , development and introduction modern methods of treatment and prophylaxis.

      The cause of growth the number of patients suffering from traumatic osteomyelitis of mandible are: the late call in the doctor, errors during the before hospital period of treatment, self-medication, the decrease the

 immunity  of the body, not right tactics of treatment.  The specialist have good reviews to remidies , which used in first phase of inflammation and to preparations, demonstrating multidirectional effect.

Such group of preparations includes Erbisol. Esrbisol has effect of activation  the recovery processes and non-specific immunity, increases the functional activity of organs and tissues.

Materials and methods

    Carried out 55 patients in age from 20 to 45 years, which seen a doctor in maxillofacial department of clinical hospital named after Semashko with diagnosis :chronic traumatic osteomyelitis of mandible. Were formed 2 groups , comparable by clinical issues , prevalence and sevirity of process.

     First group included 25 people (18 male and 7 female), which had the surgical operation and( sequestration) and treatment in postoperative period conducted by traditional method. In second (main) group were 30 people( 22 male and 8 female), which had   during the operation  the places of tissue, adjacent to sequestration  focus saturated with a mixture of Erbisol and isotonic sodium chloride 0.9%.

    Also by cytochemical method determined the activity of dehydrogenases complex:  SDH – activity and  LDH-activity.

    Results and discussion

    The analysis of cytobiochemical indexes of periphic blood neutrophils had showed the changes with different level of reliability. The patients had the decrease of aerobic oxidation(SDH-activity) by 31,07% and the increase of anaerobic glycolysis(LDH-activity) by 24,54 %, that testified about tension of metabolism and anoxaemia. The was in control group  till 7th day.

In the main group, where used preparation Erbisol  observed the decrease of SDH-activity .LDH -activity  increased.

Conclusions

     1. The identified dynamics of aerobic oxidation and growth of anaerobic glycolysis  is reflection of structures changes , developing during the osteomyelitis of mandible.

2.     Identified the significant protector and therapeutic effect of antioxidant “Erbisol”(the recovery of activity of cytobiochemical indexes of perepheric blood  neutrophils  in traditional method of treatment noticed on 14-21 day, and in our developed method – on 10-14 day.

3.     The used method of comparable estimation of cytobiochemical indexes activity of  peripheric blood  neutrophils in patients with osteomyelitis of mandible can be recommended as diagnostic criterion for control the course of postoperative period