METHOD AND RETRACTOR FOR INTRAOPERATIVE ANTIBACTERIAL PREVENTION OF PERIPROTHETIC INFECTION DURING FALLOPROTHETIC SURGERY

摘要

FIELD: medicine. ;SUBSTANCE: group of inventions relates to medicine. The retractor used for intraoperative antibacterial prophylaxis of periprosthetic infection during falloprosthetics consists of two rings, outer and inner, connected by a sheath made of synthetic biopolymer material, which is evenly fixed along the inner circumference of the rings. The inner ring is made hollow, and through holes are made along the entire length of its inner circumference, located relative to each other at an equal distance. The retractor is additionally equipped with a tube for supplying an antibacterial drug, rigidly connected with the lower end to the inner ring of the retractor, and the upper end with a cannula for connection with a dropper. The method of intraoperative antibacterial prophylaxis of periprosthetic infection during a falloprosthetics operation consists in using the above retractor. 30 minutes before the operation, a broad-spectrum antibacterial solution is injected intravenously. Access is performed with dissection of the subcutaneous tissues, creating space for implantation of the inner ring of the retractor. The outer ring is placed over the skin, the outer ring of the retractor is gripped, onto which the sheath of synthetic biopolymer material is screwed from the outside to the inside until it is in tension around the circumference of the wound. Cavernous bodies are isolated, cavernotomy is performed, then an antibacterial solution of rifampicin with gentamicin is initially introduced, supplying the above solution into through holes made along the entire length of the inner circumference of the inner ring of the retractor through a tube for supplying an antibacterial drug, rigidly connected by the lower end to the inner ring of the retractor, and by the upper ring - with a cannula connected to a dropper. Then the corpora cavernosa are sequentially bougienated. Next, a bougie test is carried out. Then, the aforementioned antibacterial solution is injected for the second time using a female Nelaton catheter, irrigating the corpora cavernosa with further implantation of prostheses into the right and left cavernous body. The tunica albuginea is sutured with absorbable suture material. Active drainage is established and hemostasis is controlled. Then, starting from the inner ring, the retractor is removed. The surgical wound is sutured in layers with absorbable suture material, and cold and aseptic pressure bandage are applied to the surgical site.;EFFECT: inventions provides opportunity not to interrupt the operation during irrigation of the surgical wound with an antibacterial solution of rifampicin with gentamicin, to ensure a uniform and controlled supply of an antibacterial solution of rifampicin with gentamicin, excluding irrigation of the surgical wound with a syringe by a nurse and the possibility of irrigation of the corpora cavernosa after cavernotomy.;2 cl, 1 dwg, 1 ex