EXPERIENCE TREATMENT OF CHILDREN WITH POST-BURN SCAR CONTRACTURE OF THE NECK

Cicatricial deformations of the neck occur in 4-30.5 % of children suffered from burn trauma, and are the most severe consequences. Early reconstructive surgery in this pathology provides free growth and development of the skull and upper body and promote psychological and social recovery of the child. The treatment of such patients presents great difficulties, and in each case requires an individual approach. The article presents the experience of treatment of two children with severe scar contracture of the neck, complicated by the lack of reserves in undamaged tissues of the neck and the surrounding areas. We used a combination of several methods of skin grafting, including axial flow and the prefabrication of flaps, divided in time into stages. In one case in a child with total neck contracture, we performed pre-surgical (3.5 weeks before the main stage surgical intervention) preparation of the two flaps - scapular and epaulet flaps. In the other case, 4-year old girl with subtotal flexion contracture, a month before the main surgery we prepared scapular flap and increased its area expander dermotension, with endoscopic implantation of endoexpander. In this paper, we describe in detail the technology of operative treatment of these two patients. In both cases, there were no postoperative complications. The use of modern medical technologies based on conventional techniques in surgical correction of severe flexion scar contractures of the neck of the presented patients decided both functional and aesthetic problems

Experience in the Treatment of Hemangioma in Children

The article reflects modern views on epidemiology, clinical manifestations, classification, principles of diagnostics and treatment of hemangiomas. The purpose of our study was the analysis of the results of different methods of treatment inof children with hemangioma over a ten-year period (from 2007 to 2017) at Irkutsk Regional Children Hospital. We have found a significant reduction in cases of invasive treatment in patients with this pathology. In 2017, inhemangioma was excised in 179 children, and in 2017, this method was used only in 28 patients. Since 2009 cryolysis of vascular neoplasms has not been performedcryolysis. Conservative treatment of hemangiomas include hormone therapy with prednisone as well as systemic and local treatment with beta-adrenergic blocking agents. At the same time, we showed that conservative treatment of hemangiomas is effective before surgery. That is confirmed by the clinical observation of the child with an extensive perineal hemangioma, who underwent the combined treatment using surgical cryodestruction and hormone therapy. This example shows that a good aesthetic result has been obtained only when using hormone therapy, while partial excision of hemangiomas resulted in a violation of the anatomy of the external genitalia, and cryodestruction resulted in an extensive hypertrophic scar on both buttocks. It is concluded that the reasons for the change in treatment tactics in children with hemangiomas are determined by the possibility of using non-invasive methods with obtaining the optimal result of treatment in both oncological and aesthetic terms

C. difficile-инфекция у новорожденных: решенные и нерешенные вопросы

The article presents an analytical review of the works of domestic and foreign authors on the problem of studying the peculiarities of the formation of the intestinal microbiota and risk factors for the development of microdysbiosis in newborns with the activation of opportunistic bacteria, including C. difficile. Special attention is paid to the effect of antibiotics on the state of the intestinal microbiota and the activation of toxigenic strains of C. difficile. Divergent views on the role of toxigenic strains of C. difficile in the development of infectious pathology of newborns are presented.В статье представлен аналитический обзор работ отечественных и зарубежных авторов по проблеме изучения особенностей формирования микробиоты кишечника и факторов риска развития микродисбиоза у новорожденных с активацией условно патогенных бактерий (УПБ), в том числе Clostridioides difficile. Особое внимание уделено влиянию антибиотиков на состояние микробиоты кишечника и активацию токсигенных штаммов C. difficile. Приведены разнонаправленные взгляды на роль токсигенных штаммов C. difficile в развитии инфекционной патологии новорожденных

Probiotics in pediatrics: Pros and cons in the context of evidence-based medicine

The paper gives an update on the problem of studying the gut microbiota and a classification of the representatives of the intestinal microflora and describes its positive and negative functions. The authors depict indications for the use of drugs, such as probiotics, to treat different childhood diseases from the clinical standpoint of evidence-based medicine in the age aspect. Particular attention is given to the side effects of probiotics and to contraindications to their use in children