Vol 10, No 1 (2021): Материалы XIV Международного хирургического форума «ИННОВАЦИОННЫЕ ТЕХНОЛОГИИ В ХИРУРГИИ»

Surgical infection occupies one of the leading places in the structure of surgical morbidity, and occurs with open soft tissue injuries in 60% of victims.  

The aim of the study is to study the effectiveness of the combined use of oxygen and sorption effects in the treatment of soft tissue wounds.  

Materials and methods. The study of the effect of the new treatment method on the course of the wound process of "clean" (block I) and purulent wounds (block II) was performed on 240 Wistar rats. Each block included 4 groups of animals: in the 1st control group, no treatment was performed, in the 2nd control group, the wounds were treated with an oxygen jet, in the 3rd control group, the sorbent was applied, and in the main group, the developed method was used. 

Results. In the treatment of purulent wounds, the use of the developed method accelerated the duration of the wound process by an average of 1.2-1.6 times, and reduced the wound area by 85.0% of the initial values by the 7th day. 

Conclusion. The study showed the safety and high efficiency of the combined use of oxygen and sorption effects in the treatment of wounds, which was confirmed by a reduction in the time of purification, granulation and epithelization of defects, and consequently, the time of the wound process. 

Keywords: wounds, soft tissues, treatment. 

Clinical and instrumental substantiation of angioplasty with stenting of coronary arteries in ACS is an urgent and debatable problem. The aim is to compare the early results of myocardial revascularization in ACS by angioplasty with stenting. Coronary angiography determined the localization, type of stenosis, the severity of atherosclerotic narrowing, as well as the anatomical features and vascular geometry of the coronary bed. After the study, PCI was performed according to the indications. For risk stratification, the GRACE scale was used with the identification of low-risk groups.

It was found that the systolic function of the left ventricle affects the level of risk of an unfavorable outcome of ACS. In the groups of patients of medium and high risk according to the GRACE scale, after the stenting of the coronary arteries, the systolic function of the left ventricle significantly improved. In the group of patients with ACS with ST segment elevation, angioplasty with stenting of the coronary arteries did not reduce the incidence of myocardial infarction, but significantly reduced the risk of an unfavorable outcome of ACS. In patients with ACS with ST segment elevation, prehospital thrombolysis significantly improved the parameters of myocardial systolic function, therefore, reduced the risk of an unfavorable outcome of ACS.

Abstract: Relevance: Osteomyelitis is one of the intractable inflammatory diseases of the musculoskeletal system . Difficulties in the early diagnosis and treatment of osteomyelitis lead to a large number of complications and to the disability of the working-age population aged 35 to 50 years.
            

Purpose: increasing the efficiency of relief of chronic osteomyelitis using ultrasonic cavitation and a complex consisting of rubidium chloride, amikacin and hydroxyapatite .

Methods: The experiment s prov edeny on 175 male rats Wistar weighing 280-300 g . All the animals were divided into 5 groups : 3 -x experienced e and 2 -x controlling e . In the 1st control group, no treatment was performed . In other g RUPP ah performed two-stage surgical remediation using micromotor and mud pulse systems with subsequent ultrasonic cavitation. In the 1st experimental group, powdered rubidium chloride was additionally introduced into the defect area. In the 2nd test group after surgeons h eskoy readjustment was introduced into the wound antibiotic amikacin a maximum concentration of 15 mg / kg / day. In the 3rd experimental group, the combined use of both techniques was used.

Results: The combined application of ultrasonic cavitation, rubidium chloride, and mikatsina and hydroxyapatite bone regeneration was observed much earlier , than at their isolated application .

Conclusion: The proposed method for the treatment of chronic osteomyelitis using a complex consisting of rubidium chloride, amikacin and hydroxyapatite has shown high efficiency .

Richard Folkman was born in 1830 in Leipzig in family of the privatdozent of the local university. Richard Folkman studied medicine at Gallet and Gissen's universities, in 1854 graduated from medical faculty of the Berlin university. In 1854 Folkman defended the dissertation then he works as the assistant, the privatdozent, extraordinary professor in surgical clinic of professor Blazius at Halle University. He participates in the German military campaigns 1865-1866 and 1870-1871 of. During the French-German war works as the chief physician in the 4th army body, is later in the Maas and Southern army. In 1866 receives the invitation to management of surgery of Halle University of department. From 1867 to 1885 Folkman ordinary professor of surgery and the director of university surgical clinic in Halle. From 70th years he begins to publish a series of monographs devoted to internal diseases, surgery and gynecology "A collection of clinical reports", since 1880 becomes the coeditor of the surgical edition "Zentralblatt fur Chirurgie". One of the main merits of Richard Folkman is broad promoting of a method of antiseptics. Folkman made extremely important contribution to increase in efficiency of treatment of the patients by use of an occlusive bandage in the conditions of wartime developed by it wire T-shaped immobilized tires, ways of treatment of bone changes by an extension method. It described several forms of bone tuberculosis. In 1872 Richard Folkman with colleagues created the German society of surgeons which chairman he was since 1885. In 1885 Folkman was awarded a noble rank. The name of Folkman is born by the contracture described by it, a number of surgeries, devices and tools. In 1889 Richard Folkman died.

Relevance. The introduction of new methods of liver resection has contributed to a significant expansion of the indications for liver resections, but acute liver failure remains a difficult problem among postoperative complications. 

Aim of the study. Reducing the risk of acute liver failure during liver resection, by intraoperative administration of cyanocobalamin in an experiment. 

Materials and methods. The experiments were performed on 96 male Wistar rats. All animals underwent typical liver resection (TRP); in the 2nd control group-additional intrahepatic injections of 1 ml of 0.9% NaCl were performed; in the 1st experimental group – intrahepatic injections of 1 ml of cyanocobalamin; in the 2nd experimental group-1 ml of cyanocobalamin was administered intraperitoneally. On days 1, 5, 7, and 14, blood was collected for biochemical testing. Statistical processing was performed using the program Statistica 6.0. 

Results. On the 14th day of the study, normalization of the indicators of cytolysis, cholestasis and hepatic cell insufficiency syndromes was observed in the 1st experimental group in almost all animals, in the control groups and the 2nd experimental group, the results were significantly lower. 

Conclusion. The proposed method provides normalization of the metabolic processes of the liver in the early postoperative period, prevents the development of acute liver failure. 

Cyanocobalamin is a "classic" hepatoprotector that has hematopoietic, hemostatic and analgesic effects. Most of the mechanisms of its action are realized through participation in the processes of nucleic acid synthesis, homocysteine metabolism, and DNA replication. Methylcobalamin – one of the active coenzyme forms, has a stimulating effect on rapidly proliferating cells, including the liver. The use of cyanocobalamin preparations leads to the elimination of hypoxia, is accompanied by an increase in hepatocyte resistance, acceleration of regenerative processes in the liver parenchyma and improvement of its detoxification function. Thus, today the use of cyanocobalamin as a drug that promotes the recovery of the liver after surgery is relevant. 

Abstract: the paper presents the experience of treating patients with lesions Delfoi.
Diagnosis and treatment of the syndrome Delfoi remains one of the most important problems of emergency surgery. Today is the actual task of creating a unified and effective tactics of treatment of lesions Delfoi.
Goal. Improve the results of diagnosis and treatment of Dielafua lesion by identifying the nuances of its clinical course and analyzing the use of different types of endoscopic hemostasis in patients with this syndrome.
Methods and materials. The analysis of 21 case histories of patients with Dielafua lesion who were treated in the Department of Surgery of the Tverye State Clinical Hospital in Perm was performed. The features of the clinical course and laboratory data, the results of fibroesophagogastroduodenoscopy( FEGDS), endoscopic and surgical methods of treatment and their final results were studied.
Results. 66.6% of patients with Dielafua lesion were men, 61.9% of patients were in the age category of 40-59 years. Upon admission, all patients underwent fibroesophagogastroduodenoscopy in combination with subsequent endoscopic hemostasis using alcohol irrigation, clipping, and argonoplasmic coagulation. Relapse of bleeding occurred in 4 patients who were treated with alcohol irrigation and clipping. When combined irrigation alcohol with argon plasma coagulation recurrence was not observed. All patients with recurrent bleeding were operated on.
Conclusion. Among patients with lesions Delfoi dominated by men 40-59 years with severe blood loss. The most effective method of endoscopic hemostasis with the defeat of Dieulafoy showed a combination of irrigation alcohol with argon plasma coagulation.

The article presents experimental data about the treatment of purulent wound process by electrostimulation in rats with simulated purulent wounds, and reveals the effects of electrostimulating impacts on body tissues, in particular in the wound.