One of the main methods of treatment of locally advanced tumors of the small pelvis and soft tissues of the perineum is surgery, which consists of removing the tumor affecting the small pelvic organs, external genitalia, and rectum. For tumors of the distal parts of the rectum, abdominopelvic extirpation of the rectum was proposed by Miles in 1908, and somewhat later, in 1948, the American surgeon A. Brunschwig first published the results of pelvic extirpation. Modern medicine increasingly uses methods of surgical interventions using various materials or products capable of replacing or restoring the function of an organ or tissue damaged as a result of a pathological process or trauma. Depending on the purpose of its application, it can exist permanently in the body or be replaced by its own tissues. When used in the body, the implant must meet a number of requirements: not to emit harmful substances; to withstand sterilization conditions by standard methods; to be made of available materials using a fairly simple technology.
When using polymers as implants, their properties such as biological inertness, biocompatibility, biodegradation, biodegradation, and biosubstitution are taken into account. We bring to your attention the results of the first experience of using a biodegradable material based on a macroporous polyvinyl alcohol hydrogel combined with betadine in the treatment of patients with perineal wound suppuration after (EPO) Exenteration of the Pelvic Organs Surgery. This method of treatment was used in the complex treatment of 5 patients, operated on for locally advanced forms of pelvic cancer, 3 women of 56 to 71 years old. In two cases anterior, in two cases posterior and in one case total pelvic evisceration was performed. Four patients underwent laparotomy and one patient underwent laparoscopy, and the perineal wound suppuration was observed 3-7 days after the surgery. In all patients during the first two weeks local treatment was carried out according to the same scheme - daily washing of the wound with antiseptic solutions, drainage and wound tamponization with the use of Levomycol and Betadin ointments. Due to the low efficiency of local treatment of perineal wounds, a polyvinyl alcohol-based biodegradable implant was used. The scheme of material application was as follows: during the first week, the implant was placed for three days followed by replacement with sterile material cut to the size of the cavity; subsequently, replacement was usually performed on the seventh day. The average treatment period was 21±3 days. The patient was then discharged with the implant installed permanently.
Thus, the proposed method of using the biodegradable material based on cross-linked PVA combined with povidone-iodine (betadine) in the treatment of patients with perineal wound suppuration after (EPO) Exenteration of the Pelvic Organs Surgery can become an effective method in the complex of therapeutic measures.