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EVALUATION OF THE RESULTS OBTAINED BY VARIOUS METHODS
IN TRADITIONAL SURGICAL PRACTICE AND THE USE OF OPTIMAL
SUTURE MATERIALS.
Kurbanov Khasan Askarovich
assistant of the department of faculty and hospital surgery
Andijan State Medical Institute
https://doi.org/10.5281/zenodo.14266811
Summary.
The article discusses the results obtained by various methods in
traditional surgical practice and the use of optimal suture materials. The study is
based on the results of surgical treatment of 481 (100.0%) patients with various
pathologies of the abdominal organs who were treated in the surgical
department of the Andijan Regional Multidisciplinary Medical Center in 2020-
2023. Before surgical treatment, the condition of the patients was assessed not
only visually, but also through additional examinations. The influence of suture
materials on recovery time and the level of functional state of organs and tissues
after surgery was studied.
Keywords.
Suture material. Surgery. Regeneration.Relevance of the topic.
Relevance.
In surgical practice, the main emphasis on focusing on the
seroma causes the wound to suppurate, open the sutures, or remove the sutures.
Puncture methods are often used in the treatment of seromas[1]. Large seromas
affect the general condition of patients, causing not only a local but also a
general disorder.
Methods of identifying risk factors and prevention of postoperative
purulent-inflammatory complications in emergency surgery, the frequency of
their occurrence is much higher, from 2.8% to 23.5%, and after emergency
cases, this indicator increases to 26.1%[2].
For example, local purulent-inflammatory complications during gall
bladder surgery occur in 9.3% of surgical procedures for diseases of abdominal
organs; on the pancreas in 26%; y in the colon in 23.5% ; 21.1% with intestinal
obstruction; 15.8% with acute appendicitis; with gastric operations can be
observed from 1.6 to 15.8%. According to other authors, post-appendectomy
wound suppuration occurs from 2.5 to 60.7%. Complications after colon surgery
can be observed in 11.1-60.0%[4].
The problem under consideration is that the frequency of purulent-septic
complications after urgently performed surgical operations is 23.5-71.2%, and
in planned operations, this indicator is 0.29%-30%[3]. This situation is
described as follows: in urgent surgical pathologies, patients often present with
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symptoms of intoxication, which in turn is due to the fact that the protective
function of the div is in a decompensated state . It should also be noted that
urgent surgery is performed in conditions of high contamination of organs and
tissues, and in the group of "conditionally dirty" and "dirty" operations, with a
high risk of post-diagnosis purulent complications[6,7].
Much research is being done to develop various interventions to prevent
surgical site infection. Antibacterial therapy, as well as local application of low-
intensity laser rays, are included in the scope of secondary preventive measures.
Also, the prevention of surgical site infection is considered one of the
insufficiently studied methods, but the use of various (usually antimicrobial)
biologically active suture materials during surgery is considered one of the
solutions to this problem[5].
Purpose of the study.
Study of the results obtained by various methods in
traditional surgical practice and the use of optimal suture materials.
Research materials and methods.
This study is based on the results of
surgical treatment of 481 (100.0%) patients with various abdominal pathologies
treated in the surgical department of Andijan regional multidisciplinary medical
center in 2020-2023. The patients included in the study were completed by us
during the primary and repeated examinations in the clinic according to the
specially developed questionnaire "Protocol of examination of patients after
abdominal examination". Before surgical treatment, the condition of patients
was evaluated not only visually, but also through additional examinations . The
effects of suture materials on recovery periods and levels of the functional state
of organs and tissues after the operation were studied.
Research results.
In traditional surgical practices, the study of the results
obtained from different methods allows the use of optimal suture materials. It
should also be taken into account that the obtained results depend on the
general surface of the wound and the level of complexity of the performed
operation. Let's study the characteristics of dependence on the inspection area
with the help of table 1.
Table 1
A comparative analysis of the direct effect of suture materials on the
results depending on the inspection area
Cursors
Plastic methods
Total
E
H
G
R
X
E
I
R
S
E
B
Patients in the
9
3
8
1
2
7
241
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comparable group
1
6
9
6
(100%)
Positive results
Small
4
4
2
46
Medium
1
5
2
0
4
9
6
2
3
95
Big
1
5
8
2
7
6
2
58
General
7
4
2
8
7
6
1
2
2
5
197
(82.8%)
Negative results
Small
3
3
Medium
5
2
5
2
1
15
Big
9
6
8
2
1
26
General
1
7
8
1
3
4
2
44
(18.2%)
Explanation: * - EH – elimination of hernia; GR-gastric resection; XE-
cholecystectomy; BR-bowel resection; SE-splenoectomy; B-general type of
operations.
Good results of abdominal surgery were observed in small and large areas.
Good direct results in small and large surgical procedures were observed in 141
(71.6%) of 197 patients. In the case of large sizes, this indicator was only 58
(29.4%). 44 negative results were observed in 59.1% of large-field surgical
operations. This can be explained as follows. As mentioned above, large-scale
surgical operations are directly related not only to the cavity or parenchymatous
organ and tissue, but also to the thickness of the used suture material, its effect
on the tissues, the restoration of intestinal peristalsis, and the regeneration of
the intestinal loop.
The long-term results of the surgical procedures performed in the
pathologies of the abdominal organs were determined after 6-12 months by
reorganizing the patient's visit to the clinic. According to this, the long-term
results, both functional and cosmetic, were made according to the criteria
presented in chapter 2, according to the types of operations included in the
comparative group and the condition of the wound area. The analyzes show that
the location, area and depth of the scar deformation, its size and depth are
considered to be one of the reasons for the reduction of the immediate result. In
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addition, according to the instructions, abdominal organs were examined by
ultrasound, and in some cases, X-rays were performed. The distribution of the
long-term results showed that in the long-term after the examination,
complications such as dome formation, expansion and non-swelling of the scar
were observed (Table 2).
Table 2
Frequency of outcomes after practice by type of practice
Cursors
Plastic methods
Total
E
H
G
R
X
E
I
R
S
E
B
Patients in the
control group
9
1
3
6
8
9
1
6
2
7
241
(100%)
Complications:
1
7
9
1
1
7
3
50
(20.7%)
The
dome
is
scarred
6
3
2
1
12
(24%)
Scar enlargement
2
3
3
1
9
(18%)
A lump under the
skin
5
3
3
1
1
13
(26%)
A draining wound
2
2
3
1
8
(16%)
A
contagious
disease
2
1
2
5
(10%)
Explanation: * - EH – elimination of hernia; GR-gastric resection; XE-
cholecystectomy; SE-splenoectomy; B-general type of operations.
As can be seen from this table, the number of complications in the
early result was 44, while in the long term this indicator increased to 50, that is,
from 18.2% to 20.7%. The average is 19.1±0.7, Pearson's χ
2
test is 19.712 ; d
f
=4; R = 0.0012. The most common complication is the feeling of a nodule under
the skin, depending on these two criteria. If the results are based on the results
after 6 months after the examination, the period of absorption of the used
polyfilament is low, the other side of the issue is characterized by the low div
weight of the patients and the rough examination. Large scars accounted for 5%
of 12 patients, which is evaluated by the fact that patients did not receive
comprehensive preventive treatment aimed at absorption of scars during the
postoperative rehabilitation phase.
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When assessing the functional state of patients, the state of the patients
during the satisfaction of their needs without physical movements is considered,
while the cosmetic aspects, the effect of each performed procedure on the
psycho-emotional state of the person was studied. These patients are expected
to acquire skills in relation to the practice, early employment, activeness in
finding their place in the surrounding society, and other criteria. This directly
affects the quality of life . In the assessment of cosmetic and functional condition,
3 main criteria were evaluated: good, satisfactory and unsatisfactory . We can
see this in Table 3.
Table 3
Analysis of remote results based on the type of survey conducted
Types
of
operations
A distant result
Number
of
patients
(%)
Good
Conical
Without
cones
n
%
n
%
N
%
N
%
EG
2
2
24.
2
5
2
57.
1
17
18.
7
9
1
37.
8
GR
8
22.
2
1
9
52.
8
9
25
3
6
14.
9
XE
2
1
23.
6
5
7
64.
0
11
12.
4
8
9
36.
9
IR
3
18.
8
6
37.
5
7
43.
8
1
6
6.6
SI
1
50
1
50
2
0.8
B
2
28.
6
2
28.
6
3
42.
9
7
2.9
Total
5
7
23.
7
1
37
56.
8
47
19.
5
2
41
100
.0
Explanation: * - EG – elimination of hernia; OR-gastric resection; XE-
cholecystectomy; SE-splenoectomy; B-general type of operations.
Analysis of the results for all parameters shows that the best long-term
result is the result after cholecystectomy. Despite the fact that the majority of
operative procedures of this type were performed in traditional ways,
unsatisfactory results were achieved in only 12.4% of cases. In the operation of
hernia removal, the highest good result was achieved in 22 (24.2) patients. The
average relative error in the analysis of the results should be below R ≥0.0012 ,
according to Pearson's χ
2
test-8.932 ; d indicates
f
=6. The best and conic distant
ACADEMIC RESEARCH IN MODERN SCIENCE
International scientific-online conference
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result was observed in 78 (87.6%) of 89 patients. We found it necessary to
express this situation as it should. The use of absorbable monofilaments of
suture materials based on the criteria established in the mid-range studies has a
significant effect on the time of thread absorption, the regeneration process, the
reduction of the rehabilitation period, and the quality of life , which occupies an
essential place .
Summary.
Thus, the use of traditionally used suture materials, including
absorbable polyfilaments, in abdominal procedures depends on the size of the
wound, its location, adhesion to the underlying tissues, and the degree of
limitation. The results of the study showed that conventional absorbable
polyfilaments increase the number of positive results without side effects on the
surrounding healthy tissue in small, medium and large surgical procedures.
Despite the fact that polyfilaments used in traditional surgical practice have
several advantages, we found it necessary to improve the use of polyfilaments
and develop new ones due to high complications in long-term results.
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