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https://doi.org/10.14300/mnnc.2018.13051

Effect of negative pressure drainage with irrigation on peculiarities of microstructure of parapancraetic tissue and the dynamics of microflora in patients with infected necrotizing pancreatitis

[Surgery]
Vladimir Beschastnov; Andrey Leontyev; Oleg Mokeev; Maksim Кyabkov;

The effect of the drainage method on the features of the morphological microstructure of parapancreatic fatty tissue, on the dynamics of the microbial landscape and the severity of the syndrome of the systemic inflammatory response was studied in 37 patients with infected pancreatic necrosis. It was revealed that in the postoperative period in 92 % of
patients with infected pancreatonecrosis the initiating microflora changes to antibiotic-resistant hospital strains, represented mainly by Gram-negative microorganisms. Active drainage changes the structure of parapancreatic fatty tissue, which by 3.5 times (p<0.05) reduces the risk of transformation of tissue contamination into the infectious process in the source of destruction. The introduction of active drainage into the practice of surgical treatment of purulent-necrotic parapancreatitis allowed to reduce the incidence of systemic inflammatory reaction and local purulent complications in the postoperative period.

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Keywords: infected pancreatic necrosis, drainage, мicrobiota