Therapeutic management of patients with chronic stenosis of the larynx and trachea
The treatment of patients with chronic stenosis of the larynx and trachea is a laborious long process that requires special attention to the choice of surgical tactics and conservative therapy. The effectiveness of the performed surgical treatment largely depends on the course of the postoperative w...
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| Format: | Article |
| Language: | Russian |
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Remedium Group LLC
2020-11-01
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| Series: | Медицинский совет |
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| Online Access: | https://www.med-sovet.pro/jour/article/view/5842 |
| _version_ | 1797841951399084032 |
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| author | E. A. Kirasirova A. A. Gurov E. V. Kulabuhov N. V. Lafutkina M. I. Usova |
| author_facet | E. A. Kirasirova A. A. Gurov E. V. Kulabuhov N. V. Lafutkina M. I. Usova |
| author_sort | E. A. Kirasirova |
| collection | DOAJ |
| description | The treatment of patients with chronic stenosis of the larynx and trachea is a laborious long process that requires special attention to the choice of surgical tactics and conservative therapy. The effectiveness of the performed surgical treatment largely depends on the course of the postoperative wound process, which explains the need for an individual approach to patient management in order to prevent the development of bacterial complications. One of the factors contributing to the occurrence of these complications are transient microorganisms that colonize the mucous membrane of the respiratory tract, represented mainly by Streptococci, Staphylococci and Neisseria, as well as Acinetobacter, Moraxella, Corinebacterium, Escherichia, Klebsiella. In order to prevent postoperative complications, it is necessary to carry out antibacterial prophylaxis with I–II generation cephalosporins (cefazolin, cefuroxime) or inhibitor-protected aminopenicillins (amoxicillin/clavulanate, ampicillin/sulbactam) during clean surgical interventions. In cases where a bacteriological examination reveals hospital strains of microorganisms, it is necessary to carry out antibacterial therapy aimed at eradication of the bacterial pathogen. In case of “dirty” surgical interventions in patients in cases where a bacteriological examination does not reveal pathogenic strains of microorganisms, it is recommended to carry out antibacterial therapy with broad-spectrum antibiotics, within 7–10 days after the surgery. Irrigation and inhalation therapy occupies a special place in the treatment of patients with chronic stenosis of the larynx and trachea. At the final stages of the operation, irrigation of the surgical area with solutions of glucocorticosteroids and anesthetics is used, and inhalation therapy is used starting from the early postoperative period, continuing throughout the entire period of inpatient treatment, as well as at the outpatient stage. Among the inhalation drugs used topic antibiotics, glucocorticosteroids, mineral water, mucolytics, and bacteriophages are most often used. |
| first_indexed | 2024-04-09T16:39:48Z |
| format | Article |
| id | doaj.art-1cd898b0d03845feb837acf4f64b2184 |
| institution | Directory Open Access Journal |
| issn | 2079-701X 2658-5790 |
| language | Russian |
| last_indexed | 2024-04-09T16:39:48Z |
| publishDate | 2020-11-01 |
| publisher | Remedium Group LLC |
| record_format | Article |
| series | Медицинский совет |
| spelling | doaj.art-1cd898b0d03845feb837acf4f64b21842023-04-23T06:56:44ZrusRemedium Group LLCМедицинский совет2079-701X2658-57902020-11-01016364210.21518/2079-701X-2020-16-36-425310Therapeutic management of patients with chronic stenosis of the larynx and tracheaE. A. Kirasirova0A. A. Gurov1E. V. Kulabuhov2N. V. Lafutkina3M. I. Usova4Pirogov Russian National Research Medical University; Sverzhevsky Scientific and Research Otolaryngology Clinical InstitutePirogov Russian National Research Medical University; Sverzhevsky Scientific and Research Otolaryngology Clinical InstitutePirogov Russian National Research Medical UniversitySverzhevsky Scientific and Research Otolaryngology Clinical InstituteSverzhevsky Scientific and Research Otolaryngology Clinical InstituteThe treatment of patients with chronic stenosis of the larynx and trachea is a laborious long process that requires special attention to the choice of surgical tactics and conservative therapy. The effectiveness of the performed surgical treatment largely depends on the course of the postoperative wound process, which explains the need for an individual approach to patient management in order to prevent the development of bacterial complications. One of the factors contributing to the occurrence of these complications are transient microorganisms that colonize the mucous membrane of the respiratory tract, represented mainly by Streptococci, Staphylococci and Neisseria, as well as Acinetobacter, Moraxella, Corinebacterium, Escherichia, Klebsiella. In order to prevent postoperative complications, it is necessary to carry out antibacterial prophylaxis with I–II generation cephalosporins (cefazolin, cefuroxime) or inhibitor-protected aminopenicillins (amoxicillin/clavulanate, ampicillin/sulbactam) during clean surgical interventions. In cases where a bacteriological examination reveals hospital strains of microorganisms, it is necessary to carry out antibacterial therapy aimed at eradication of the bacterial pathogen. In case of “dirty” surgical interventions in patients in cases where a bacteriological examination does not reveal pathogenic strains of microorganisms, it is recommended to carry out antibacterial therapy with broad-spectrum antibiotics, within 7–10 days after the surgery. Irrigation and inhalation therapy occupies a special place in the treatment of patients with chronic stenosis of the larynx and trachea. At the final stages of the operation, irrigation of the surgical area with solutions of glucocorticosteroids and anesthetics is used, and inhalation therapy is used starting from the early postoperative period, continuing throughout the entire period of inpatient treatment, as well as at the outpatient stage. Among the inhalation drugs used topic antibiotics, glucocorticosteroids, mineral water, mucolytics, and bacteriophages are most often used.https://www.med-sovet.pro/jour/article/view/5842chronic stenosislarynxtracheareconstructive surgeryantibioticprophylaxistherapy |
| spellingShingle | E. A. Kirasirova A. A. Gurov E. V. Kulabuhov N. V. Lafutkina M. I. Usova Therapeutic management of patients with chronic stenosis of the larynx and trachea Медицинский совет chronic stenosis larynx trachea reconstructive surgery antibiotic prophylaxis therapy |
| title | Therapeutic management of patients with chronic stenosis of the larynx and trachea |
| title_full | Therapeutic management of patients with chronic stenosis of the larynx and trachea |
| title_fullStr | Therapeutic management of patients with chronic stenosis of the larynx and trachea |
| title_full_unstemmed | Therapeutic management of patients with chronic stenosis of the larynx and trachea |
| title_short | Therapeutic management of patients with chronic stenosis of the larynx and trachea |
| title_sort | therapeutic management of patients with chronic stenosis of the larynx and trachea |
| topic | chronic stenosis larynx trachea reconstructive surgery antibiotic prophylaxis therapy |
| url | https://www.med-sovet.pro/jour/article/view/5842 |
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