actabiomedicaActa Biomedica ScientificaActa Biomedica Scientifica2541-94202587-9596Scientific Centre for Family Health and Human Reproduction Problems10.29413/ABS.2021-6.6-2.13actabiomedica-3149Research ArticleХИРУРГИЯSURGERYПерспективы профилактики спаечного процесса при оперативных вмешательствах на сердцеProspects for prevention of adhesion process during cardiac surgical interventionshttps://orcid.org/0000-0001-5921-0318ШурыгинМ. Г.ShuryginM. G.

 доктор медицинских наук, заведующий научно-лабораторным отделом

664003, г. Иркутск, ул. Борцов Революции, 1, Россия

 Dr. Sc. (Med.), Head of the Scientific Laboratory Department

Bortsov Revolyutsii str. 1, Irkutsk 664003, Russian Federation

shurygin@rambler.ruhttps://orcid.org/0000-0003-3980-050XШурыгинаИ. А.ShuryginaI. A.

 доктор медицинских наук, профессор РАН, заместитель директора по научной работе

664003, г. Иркутск, ул. Борцов Революции, 1, Россия

 Dr. Sc. (Med.), Professor of Russian Academy of Sciences, Deputy Director for Science

Bortsov Revolyutsii str. 1, Irkutsk 664003, Russian Federation 

irinashurygina@gmail.comФГБНУ «Иркутский научный центр хирургии и травматологии»РоссияIrkutsk Scientific Centre of Surgery and Traumatology Russian Federation20212812202166-2125132Copyright © Шурыгин М.Г., Шурыгина И.А., 20212021Шурыгин М.Г., Шурыгина И.А.Shurygin M.G., Shurygina I.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.actabiomedica.ru/jour/article/view/3149

Статья посвящена проблеме профилактики спаечного процесса в кардиохирургии. Определено, что проблема актуальна в связи с ростом кардиохирургической активности. Известно, что спайки образуются при любом хирургическом вмешательстве, затрагивающем серозные оболочки. Однако чрезмерный рост соединительной ткани в условиях хирургических вмешательств на сердце может иметь крайне негативные последствия: страдает центральная гемодинамика, резко осложняется техническое выполнение оперативных вмешательств при повторных операциях.Показано, что в настоящее время для профилактики спаечного процесса исследователи склоняются к использованию биодеградируемых барьерных материалов, обладающих биосовместимостью и способностью рассасываться после выполнения барьерной функции. Основными противоспаечными средствами, применяемыми в кардиохирургии, являются мембраны и гели. Определены требования к «идеальному» средству для профилактики спайкообразования: биосовместимость, отсутствие раздражающего действия, отсутствие влияния на заживление раны, подавление роста соединительной ткани в перикарде.Выводы. До настоящего времени ни одно из средств не обладает всеми необходимыми качествами для предотвращения спаечного процесса в перикарде. Поэтому поиск эффективных методов профилактики послеоперационных спаечных процессов остаётся актуальным для кардиохирургии.

The article is devoted to the problem of prevention of adhesions in cardiac surgery. It was determined that the problem is urgent due to the increase in the number of heart surgeries. The formation of adhesions is a reaction of the body after surgery, which is a stage of healing and partly performs a protective function. Nevertheless, the presence of adhesions violates the mechanical properties of the heart, negatively affects central hemodynamics, complicates the surgeon’s task during repeated surgical interventions and increases the risk of repeated operations.It has been shown that at present, for the prevention of adhesions, researchers tend to use biodegradable barrier materials with biocompatibility and the ability to dissolve after performing the barrier function. The main anti-adhesion agents used in cardiac surgery are membranes and gels. The requirements for an “ideal” agent for the prevention of adhesion were determined: biocompatibility, no irritating effect, no effect on wound healing, suppression of the growth of connective tissue in the pericardium.Conclusions. Until now, none of the funds has all the necessary qualities to prevent adhesion in the pericardium. Therefore, the search for effective methods for the prevention of postoperative adhesions remains relevant for cardiac surgery.

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The authors declare that there are no conflicts of interest present.