CASE STUDIES

Name

Vasiliy S., 69 y.o

Diagnosis:

Hypopharynx cancer metastasis and neck lymph nodes on the right.

1 year ago - laryngectomy with resection of the hypopharynx. After surgery - course of radiation therapy.

On the 4th day after surgery:
- Massive post-surgery lymphorrhea
- MRSA-infected wound
-Necrosus of skin patches: defect of skin 8x10 cm - Denudation of carotid artery in the wound

Treatment:

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Name

Vasiliy S., 69 y.o

Diagnosis:

Hypopharynx cancer metastasis and neck lymph nodes on the right.

1 year ago - laryngectomy with resection of the hypopharynx. After surgery - course of radiation therapy.

On the 4th day after surgery:
- Massive post-surgery lymphorrhea
- MRSA-infected wound
-Necrosus of skin patches: defect of skin 8x10 cm - Denudation of carotid artery in the wound

Treatment:

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Patient:

Oleksii T., 41 y.o.

Disease history:​

Acute rotten pelviorectal abscess. Diabetes mellitus for 2 years.

Hospitalized after 7 days the disease has begun.
Leucocytes - 15,5 x 109/I. Sugar in blood - 8,0 mol/l

Local treatment:

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Patient:

Oleg L., 73 y.o.

Disease history:​

Diabetes mellitus - sickness duration 12 years.
Carbuncle of interscapular region - sickness duration 8 days.

Local treatment:

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Patient:

Mikhail Sh., 65 y.o.

Disease history:​

Diagnosis : Venous trophic ulcer VI stage according to International classifier of chronical vein diseases СЕАР. Disease duration 8 months. While microbiological test of the wound was infected with MRSA.

Local treatment:

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Patient:

Jacob A., 28 y.o

Injury:

Diagnosis : open right leg injury, debridement and external fixation done on same-day admission. Extensive laceration over the dorsum of the foot with foul odour, exudate and heavy slough over the surface of the wound.

The wound was initially cleansed with normal saline and covered with iodine solution. Unfortunately, wound healing process was slow

Local treatment:

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Patient:

Anonymous, 55 y.o.

Injury:

Avulsion injury of the right side of face. Injury resulted in the loss of tissue on the right side of face. There was complete loss of cheek wound communicated with the oral mucosa.

Wounds were required to granulate and or were required to heal by secondary intention with epithelialization.

Local treatment:

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Patient:

Anonymous, 27 y.o.

Injury:

Diagnosis: Excision of hypertrophic scars with wound cover with split thickness Skin graft (SSG). Ideally, the donor site is expected to heal by re-epithelialization. Donor site got infected.

By day four the wound had had active re-epithelialization. Had originally been scheduled to have surgery – a split thickness skin; however, after the use of Pathelen will not require any such surgery.

Wounds managed with Pathelen showed aggressive production of granulation tissue and also underwent good epithelialization. The use of Pathelen reduced the complexity of surgery required for wound management. Need for surgery was removed.

Local treatment:

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Patient:

Z.V., 68 Y.o.

Diagnosis:

Type 2 diabetes mellitus, diabetic foot syndrome neuroischemic form; wound infection of the left foot after amputation of fingers Case relevant history: Ischemic heart disease Hypertensive heart disease; Heart failure Atrial fibrillation is a permanent form

Microflora:

Blood tests:

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Name

N.O.O., male, 62 y.o.

Diagnosis:

Type 2 diabetes mellitus, diabetic foot syndrome neuroischemic form, abscess of the left tibia, abscess of the left leg.

Microflora:

Blood tests

White blood cells (WBCs): 13,5×109/l
Banded neutrophils – 28%.
The patient was accepted with complaints on pain and wounds on the anterior abdominal wall, the temperature 38.2C.Ps – 100/min. AP – 120/80 mm Hg.
The disease has began 6 days ago.
Date
Day of treatment
White blood cells
Banded neutrophils
2014-12-19
1 (before surgery)
13.5×109/L
29%
2014-12-19
1 (after surgery)
11.1×109/L
25%
2014-12-20
2 (start of the treatment by Pathelen)
11.5.x109/L
21%
2014-12-21
3
10.0×109/L
16%
2014-12-22
4
10.2×109/L
10%
2014-12-23
5
8.1.x109/L
8%
2014-12-26
7
7.2×109/L
6%
2014-12-28
9
6.0×109/L
4%
2014-12-30
11
6.1×109/L
4%

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Name

M.I., female, 20 y.o.

Diagnosis:

Acute posterior anorectal abscess

Case relevant history:

Neurocirculatory dystonia, mixed type. Epilepsy

Microflora:

Blood tests

White blood cells (WBCs): 10,0×109/l
Banded neutrophils – 8%.
The patient was admitted with complaints of pain in his left leg, redness and itching on the internal surface of the left tibia and femur.
Fever up to 39.5 °C, hemoglobin: Hb-80 g/l, and frequency of puls – 110/min showed that the patient had Systemic Inflammatory Response Syndrome (SIRS). Based on existence of purulent inflammation and SIRS, the Patient was diagnosed – Sepsis.
Date
Day of treatment
White blood cells
Banded neutrophils
2015-04-23
1 (before surgery)
10.0×109/L
8%
2015-04-23
1 (after surgery)
10.0×109/L
8%
2015-04-24
2
9.3.x109/L
9%
2015-04-25
3
9.0×109/L
9%
2015-04-26
4
9.2×109/L
7%
2015-04-27
5
8.5.x109/L
5%
2015-04-29
7
7.9×109/L
6%
2015-05-01
9
7.2×109/L
6%
2015-05-05
13
7.7×109/L
5%
2015-05-10
18
6.9×109/L
6%
2015-05-15
23
7.0×109/L
5%

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Name

L.V.I., male, 38 y.o.

Diagnosis:

Acute ischiorectal abscess. Sepsis

Case relevant history:

Microflora:

Blood tests

White blood cells (WBCs): 21,6×109/l
Banded neutrophils – 10%.
Fever up to 39.5 °C, and heart rate – 98 bpm showed that the patient had Systemic Inflammatory Response Syndrome (SIRS). Based on existence of purulent inflammation and SIRS, the Patient was diagnosed – Sepsis
Date
Day of treatment
White blood cells
Banded neutrophils
2014-11-13
1 (before surgery)
21.6×109/L
10%
2014-11-13
1 (after surgery)
12.0×109/L
17%
2014-11-14
2
11.8.x109/L
8%
2014-11-15
3
8.1×109/L
7%
2014-11-16
4
5.9×109/L
8%
2014-11-17
5
6.0.x109/L
8%
2014-11-20
8
8.1×109/L
10%
2014-11-21
9
6.0×109/L
2%
2014-11-24
12
4.5×109/L
4%

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Name

C.M., male, 44 y.o.

Diagnosis:

Acute anterior anorectal extrasphincteric abscess

Case relevant history:

Microflora:

Blood tests

White blood cells (WBCs): 6,4×109/l
Banded neutrophils – 9%.
Skin hyperemia without precise borders is visualized in 13 hours on conditional dial in the perianal region, in 4-5 cm from the anus – infiltrate 6×11 cm, the infiltrate is hot to the touch, painful, with soft area in its center.
Date
Day of treatment
White blood cells
Banded neutrophils
2014-12-03
1 (before surgery)
6.4×109/L
2014-12-06
5.6×109/L
9%
2014-12-08
6.3.x109/L
1%

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Name

M.T., male, 20 y.o.

Diagnosis:

Acute pilonidal abscess (sacrococcygeal region).

Microflora:

Blood tests

White blood cells (WBCs): 12,5×109/l
Banded neutrophils – 11%.
Complaints on the pain and swelling in the cleft on the top of buttocks.
Date
Day of treatment
White blood cells
Banded neutrophils
2014-11-20
2
9.0×109/L
6%
2014-11-21
3
6.3×109/L
2014-11-24
6
7.0.x109/L
10%

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Name

V., male, 48 y.o.

Diagnosis:

Diabetes mellitus type 2, diabetic foot syndrome neuropathic form, and trophic ulcers of both feet. Wagner 2 right foot. Wagner 3 left foot.

Microflora:

Blood tests

White blood cells (WBCs): 4,8×109/l
Banded neutrophils – 5%.
The patient was accepted into the hospital with complaints on the wound on the left foot, the patient have noted the wound 6 months ago.
Date
Day of treatment
White blood cells
Banded neutrophils
2014-12-10
1 (before surgery)
4.8×109/L
5%
2014-12-10
1 (after surgery)
4.8×109/L
5%
2014-12-11
2
5.5.x109/L
6%
2014-12-12
3
6.0×109/L
5%
2014-12-13
4
5.8×109/L
4%
2014-12-14
5
6.0.x109/L
4%
2014-12-15
6
4.5×109/L
3%
2014-12-16
7
5.0×109/L
2%
2014-12-17
8
6.0×109/L
2%
2014-12-18
9
5.5×109/L
2%
2014-12-19
10
5.0×109/L
1%
2014-12-20
11
5.0×109/L
1%

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