scholarly journals WAYS FOR IMPROVING THE RESULTS OF TREATMENT OF VICTIMS WITH DEEP ELECTRICAL BURNS

2021 ◽  
Vol 14 (3) ◽  
Author(s):  
A Fayazov ◽  
D Tulyaganov ◽  
U Kamilov ◽  
A Mirzakulov ◽  
A Khalilov
Keyword(s):  
Temperature Difference ◽  
Inpatient Treatment ◽  
Statistical Processing ◽  
Blood Oxygenation ◽  
Burn Shock ◽  
Mild Degree ◽  
Results Of Treatment ◽  
Surgical Tactics ◽  
Electrical Burns ◽  
Statistical Indicators

Aim. improving the results of treatment of victims with electrical injury, through early diagnosis of the depth and extent of the lesion and the introduction of methods of active surgical tactics.Material and methods. We examined 674 patients with electrical injuries admitted to the RSCEMP in the period from 2001 to 2017. the patients used the methods of bilateral comparative dermal thermometry and X-ray densitometry. To assess the severity of burn shock, the indicators of central and peripheral hemodynamics, blood oxygenation, Frank’s index, thermometry and neutrophil-lymphocyte index were assessed. The calculation of statistical indicators was carried out using the Microsoft Excel 2010 software package, including built-in statistical processing functions. The significance of differences between the groups in the quantitative values of the parameters was determined by the Student’s test. Statistical indicators were considered reliable, with p <0.05. Results. It was found that the temperature difference in the armpit and the first interdigital space of the foot by 0.5-1.5 ° C corresponds to a mild degree of burn shock, and in severe and extremely severe burn shock, the temperature difference in these zones was 1.6 -4 ° С and above 4 ° С. It is noted that active surgical tactics by early fasciotomy on the first day of injury and early necrectomy contributes to a significant decrease in the frequency of amputation and disarticulation of the extremities from 55.8 to 9.8%, makes it possible to perform early autodermoplasty, improves the survival rate of autografts and shortens the period of inpatient treatment. Active surgical tactics contributed to an improvement in the engraftability of autografts (95.2% versus 87.4%), a 2.6-fold decrease in the frequency of repeated autodermoplasty at sites of non-engraftment, a significant decrease in the frequency of mutilation operations (amputation and disarticulation of the extremities) and a reduction in the duration of inpatient treatment with 41.1 ± 12.3 to 37.7 ± 10.4 days. Conclusions. Early fasciotomy on the first day of injury and early necrectomy contribute to a significant decrease in the frequency of amputation and disarticulation of the extremities from 55.8 to 9.8%, make it possible to perform autodermoplasty in the shortest possible time and reduce the time of inpatient treatment. The process of osteonecrosis is completed within 2 weeks after the injury, and by this time it is possible to start osteonecrectomy, including one-stage radical osteonecrectomy over the entire surface of osteonecrosis.

scholarly journals Septic complications in patients with neck wounds

2020 ◽  
Vol 84 (3) ◽  
pp. 64-66
Author(s):  
M.Yu. Sizyi
Keyword(s):  
Head And Neck ◽  
Social Conditions ◽  
Steady Increase ◽  
Neck Trauma ◽  
Septic Complications ◽  
Traumatic Injuries ◽  
Results Of Treatment ◽  
Car Accidents ◽  
The Social ◽  
Surgical Tactics

Nowadays, we have been a steady increase in injuries as the social conditions of life and have changed. Statistically found that 54.0 % of people of car accidents have injuries to the head and neck. According to the literature, mortality in patients with neck injury which is complicating by pyoinflammatory persists up to 30.0-76.0 %. The management of neck trauma can be challenging and sometimes overwhelming, as this anatomical region contains many vital structures. These structures may pose a diagnostic and therapeutic dilemma. Our research based on the results of diagnosis and treatment of 124 patients with a purulent mediastinitis, complicating traumatic injuries of the neck organs. Among these men – 92 (74.2 %), women – 32 (25.8 %). The results of treatment depend on timely diagnosis, hospitalization in a specialized compartment and conducting active surgical tactics

scholarly journals SURGICAL TREATMENT OF CHRONIC VENOUS DEFICIENCY OF LOWER EXTREMITIES

2020 ◽  
pp. 68-73
Author(s):  
I. B. Babynkina ◽  
A. A. Novikova ◽  
G. P. Babynkina
Keyword(s):  
Surgical Treatment ◽  
Lower Extremities ◽  
Outpatient Basis ◽  
Perforating Veins ◽  
Results Of Treatment ◽  
Cosmetic Effect ◽  
Modern Economic ◽  
Surgical Tactics ◽  
Tissue Trauma ◽  
Standard Operations

Summary. The aim. Improving the results of treatment of patients with decompensated forms of chronic venous insufficiency in post-thrombophlebitic and varicose diseases based on the use of differentiated pathogenetically substantiated surgical tactics. Materials and methods. The basis of the work is the study of the results of surgical treatment of 102 patients not previously operated on with postthrombophlebitic disease of the lower extremities in the decompensated stage of CVI. All patients underwent combined surgical treatment, including the elimination of perforating insufficiency and various modifications of the operation on the superficial veins to eliminate vertical reflux. Results and discussion. The combined operation for clipping perforating veins allows the operation to interrupt blood circulation through insolvent perforating veins, including on an outpatient basis, minimizing tissue trauma during puncture rather than sectional access to a vein. The cosmetic effect of the operation is significantly increased, which is especially important in the treatment of women. Since the operation can be performed on an outpatient basis, the number of days of incapacity for work is significantly reduced compared to standard operations on perforating veins, which is a particularly important circumstance in modern economic conditions. Conclusion. Using the proposed method allows to achieve optimal conditions for the restoration of trophism of affected tissues, leading to a decrease in the number of complications and a reduction in hospitalization.

scholarly journals MODERN TRENDS IN THE TREATMENT OF ACUTE ADHESION IN INTESTINAL OBSTRUCTION

2020 ◽  
pp. 58-61
Author(s):  
V. V. Lesnoy ◽  
A. S. Lesnay
Keyword(s):  
Intestinal Obstruction ◽  
Inpatient Treatment ◽  
Conservative Therapy ◽  
Postoperative Treatment ◽  
Surgical Interventions ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Restoration Time ◽  
Days Open ◽  
Adhesive Obstruction

Summary. Aim. To perform the modern tactics of acute adhesive obstruction (AAO) treatment. Materials and methods. The basis of the work is the analysis of the results of treatment of 38 patients hospitalized in an urgent order to the surgical department with the clinic AAO. Results. 20 (52.6 %) patients with the background of conservative therapy, the phenomenon of intestinal obstruction was regressed. Repeated hospitalization during the year with the hospital was required by AAO 2 (5.3 %) patients. Laparoscopic adhesion was performed 4 (10.5 %) patients whose average intestinal restoration time was (1.8±1.2) days, and the duration of postoperative inpatient treatment was (5.1±1.3) days. Open surgical interventions were performed 14 (36.8 %) patients, in whom the period of restoration of the intestine function was (3.8±1.5) days, and the duration of postoperative treatment was (10.1±1.2) days. Conclusion. Conservative therapy is effective in 52.6 % of patients. Laparoscopic adhesion is indicated in the absence of peritoneal symptoms, if ≤ 2 laparotomies were noted in the history, with a peritoneal index of adhesion ≤ 9 points.

scholarly journals Тhe use of corticosteroids in patients with severe burn injuries

2020 ◽  
Keyword(s):  
Burn Injury ◽  
Burn Shock ◽  
Burn Patients ◽  
Severe Burn ◽  
Septic Complications ◽  
Results Of Treatment ◽  
Adults And Children ◽  
Severe Burn Injuries ◽  
Burn Disease ◽  
Severe Burn Injury

Modern treatment of burns has led to a significant reduction in mortality in patients with burns whose injuries were fatal several years ago. However, along with improved survival, new problems arose in the treatment of burn patients. Systemic inflammatory response, capillary leak, sepsis top the list of the most common problems in both adults and children with severe thermal injury. Currently, new strategies are being developed and studied in the treatment of this category of patients. One of the ways to improve the results of treatment of patients with severe burn injury is to prescribe corticosteroids, both in the stage of burn shock and in the development of septic complications. Do corticosteroids reduce mortality and improve recovery in burn patients? The discussion about this has been going on for many years, but the opinion about their effectiveness remains controversial. An analysis of the literature shows that corticosteroids can play a significant role in the treatment of patients with severe burn injury and can be successfully used at any stage of a burn disease. The effect of reducing capillary leakage, increasing myocardial contractility, antiemetic, membrane-stabilizing effect of corticosteroids will be useful in the stage of burn shock. The anti-inflammatory, immunomodulatory effect of corticosteroids will play a role in any stage of a burn disease. With the aim of preventing and treating sepsis, corticosteroids may be useful in the stage of toxemia, septicotoxemia. It is also necessary to remember about adrenal insufficiency, which develops in burn patients. The article analyzes the literature, substantiates the use of corticosteroids in patients with severe burn injury in different periods of a burn disease.

scholarly journals Comprehensive approach to choosing surgical tactics for locally advanced forms of colorectal cancer in patients of older age groups

2019 ◽  
Vol 178 (2) ◽  
pp. 38-45
Author(s):  
N. A. Maistrenko ◽  
V. S. Chirsky ◽  
A. A. Sazonov ◽  
A. A. Erokhina
Keyword(s):  
Colorectal Cancer ◽  
Advanced Colorectal Cancer ◽  
Locally Advanced ◽  
Age Groups ◽  
Results Of Treatment ◽  
Age Factor ◽  
Locally Advanced Colorectal Cancer ◽  
Surgical Tactics ◽  
Personalized Approach ◽  
Functional Operability

The objective is to improve the results of treatment of locally advanced colorectal cancer in patients of older age groups due to the personalized approach to choosing surgical tactics with a comprehensive assessment of the functional operability and molecular biological properties of the tumor.Material and methods. A comparative evaluation of the results of surgical treatment of locally advanced colorectal cancer in patients of different age groups was conducted on representative clinical material. We studied the molecular profile of tumors, taking into account the age factor, and the clinical significance of specific markers in predicting the results of treatment.Results. The most significant indicators of functional operability of patients that must be considered when choosing a surgical tactic were identified. . The features of the immunophenotype of tumors, taking into account the age factor, were determined; and the prognostic significance of specific immunohistochemical indicators was estimated.Conclusion. The use of a personalized approach to choosing surgical tactics allows to achieve encouraging results of treatment in geriatric patients with locally advanced colorectal cancer.

scholarly journals Damage to Cranial Extension of the Small Saphenous Vein and Vein of Giacomini in Lower Limb Varicose Vein Disease

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
Rostyslav Vasyliovych Sabadosh
Keyword(s):  
Saphenous Vein ◽  
Lower Limb ◽  
Great Saphenous Vein ◽  
Subsequent Development ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Results Of Treatment ◽  
Surgical Tactics ◽  
Primary Chronic Venous Disease ◽  
Antegrade Flow

Abstract. The vein of Giacomini is often identified with the cranial extension of the small saphenous vein despite the fact that according to the international interdisciplinary anatomical nomenclature they are distinguished from one another.The objective of the research was to improve the results of treatment of patients with lower limb primary chronic venous disease disease studying the variation in anatomy and pathology of the vein of Giacomini and the cranial extension of the small saphenous vein with subsequent development of differential surgical tactics.Materials and methods. 502 patients with primary chronic venous disease on 605 legs were examined and treated. Each patient underwent preoperative ultrasonographic triplex scanning of the lower limb venous system.Results. Varicose dilatation of the vein of Giacomini was observed in 3.8% of patients (95% CI 2.4-5.6 %), and the pathology of the cranial extension of the small saphenous vein was detected in 1.7% of patients (95% CI 0.8-3.0%). When the arch of the small saphenous vein was present the following variations in the pathology of the vein of Giacomini were observed: 1) the spread of reflux from the great saphenous vein to the vein of Giacomini; 2) reflux from the terminal valve of the small saphenous vein intensified the antegrade flow of blood within the vein of Giacomini resulting in reflux in the great saphenous vein distal to the point where the vein of Giacomini drained into the great saphenous vein. The causes of failure of the valves in the trunk of the cranial extension of the small saphenous vein included: 1) reflux from the ostium of the cranial extension of the small saphenous vein; 2) perforating vein reflux; 3) reflux from the terminal valve of the small saphenous vein.Conclusions.  The pathology of the vein of Giacomini and the cranial extension of the small saphenous vein is not homogeneous; therefore, surgical tactics in every patient has to be hemodynamically justified and differentiated depending on the pathways of pathological reflux spreading. 

scholarly journals THE TACTIC OF CEMENTLESS TOTAL ENDOPROSTHESIS REPLACEMENT OF HIP JOINT IN PATIENTS WITH INHERENT HIP DISLOCATION

2017 ◽  
Vol 23 (3) ◽  
pp. 127-131 ◽  
Author(s):  
K. S Yusupov ◽  
N. N Pavlenko ◽  
A. S Letov ◽  
A. V Sertakova ◽  
O. Yu Voskresenskiy ◽  
...  
Keyword(s):  
Hip Joint ◽  
Hip Dislocation ◽  
Congenital Dislocation ◽  
Systemic Complications ◽  
Double Support ◽  
Results Of Treatment ◽  
Type Iv ◽  
Total Endoprosthesis ◽  
Dislocation Type ◽  
Surgical Tactics

Introduction. The total endoprosthesis replacement is a main method of treatment of congenital dislocation of hip. However, significant disorders of joint, resistant muscular contractures create technical complications under operation and force to apply various surgical tactics. Methods. The analysis was implemented concerning results of Crowe total endoprosthesis replacement in 69 patients with one-sided high hip dislocation type IV operated on the basis of traumatological orthopedic department of Saratovskii research institute of traumatology and orthopedics during 2010-2015. The treatment of patients was implemented using original genuine technique including total endoprosthesis replacement of hip joint combined with double V-subtrochanteric osteotomy. Results. The pathological types of implantation in operated hip joint are absent. On the whole, one can notice amelioration of bio-mechanical indices: cycle of step, period of double support, coefficient of rhythm. Among systemic complications of total endoprosthesis replacement one is to mark out phlebothrombosis established in 3 patients (7.1%) that was conditioned by sedentary state of patients. Among specific complications one stated dislocation related to inobservance of restrictive orthopedic regimen in 1 (2.4%) patient. None case of instability of prosthesis and difference in length of extremities in average periods of observation more than on 0.5 cm was established. This is a proof of effectiveness of developed technique of correcting V-subtrochanteric osteotomy. Therefore, the proposed technique of femoral bone osteotomy permitted to ameliorate the results of treatment and to diminish number of complications. The applied technique permits to obtain satisfactory clinical and technical results of surgical treatment of patients with high hip joint dislocation. The osteotomy permitted to eliminate difference in length of bones of patients and at that to ameliorate conditions for union of distal and proximal fragments of femur bone at the expense of larger surface of their contact.

scholarly journals THE RESULTS OF TREATMENT OF BONE CYSTS AND BONE TUMORS IN CHILDREN

2017 ◽  
Vol 25 (2) ◽  
pp. 264-269
Author(s):  
A.. E Solovyov ◽  
O. V. Laricheva
Keyword(s):  
Bone Tumors ◽  
Malignant Tumors ◽  
Treatment Programs ◽  
Benign Tumors ◽  
Bone Cysts ◽  
Free Survival ◽  
Results Of Treatment ◽  
Medical Institutions ◽  
Maximum Period ◽  
Surgical Tactics

This article presents the results of observation (maximum period 5 years) of 249 children with bone cysts and bone tumors, of these, 20,1% of children were diagnosed with aneurysmal cysts, 74,3% - of benign tumors and 5,6% - of malignant tumors. It was shown that a differentiated approach in the treatment of children with bone cysts and benign bone tumors, including conservative events and radical surgical tactics with the use of bioimpendance «Tutoplast R» and allografts, allows to obtain good and satisfactory results in 64,0% of the cases. However, the results of treatment of children with osteosarcoma at the present time remain unsatisfactory: the 5-year relapse-free survival was only 6 of 14 cases, recurrence of the disease in 5 cases, fatal in 8 cases. According to the authors, to im prove the results of treatment in this group of patients, it is necessary to improve cancer alertness of general practitioners and the use of combined modern treatment programs at specialized medical institutions in all these patients.

Surgical tactics and the results of treatment of patients with intravenous leiomyomatosis and intracardiac lesions

2018 ◽  
pp. 32-44
Author(s):  
I.S. Stilidi ◽  
E.R. Charchan ◽  
K.I. Zhordania ◽  
M.M. Davydov ◽  
I.O. Kulik ◽  
...  
Keyword(s):  
Intravenous Leiomyomatosis ◽  
Results Of Treatment ◽  
Surgical Tactics

scholarly journals Carbuncle - the actual problem of modern surgery (Literature review)

2019 ◽  
Vol 21 (4) ◽  
pp. 19-24
Author(s):  
K V Lipatov ◽  
Yu E Cherkasov ◽  
V I Khrupkin ◽  
M V Lysenko ◽  
E I Dekhissi
Keyword(s):  
Surgical Treatment ◽  
Literature Review ◽  
Plastic Surgery ◽  
Pathological Process ◽  
Tissue Viability ◽  
Actual Problem ◽  
Surgical Interventions ◽  
Timely Diagnosis ◽  
Results Of Treatment ◽  
Surgical Tactics

Analyzed the features of the surgical treatment of carbuncles. The severity of the purulent-necrotic process was assessed, the significance of the timely diagnosis of the inflammatory stage and the choice of the timing of surgical treatment is shown. The features of the options of surgical tactics - from gentle to radical surgical interventions, methods of intraoperative assessment of tissue viability in the inflammatory focus are described. The necessity of a differentiated approach to the treatment of carbuncles depending on the stage of the disease, the prevalence of the pathological process and its localization is substantiated. The significance of restorative skin-plastic surgery in the replacement of postnecrectomy defects of epithelial tissues in the treatment of extensive carbuncles is shown. Ways of improving the results of treatment of patients with carbuncles are outlined, including timely diagnosis, a differentiated approach to surgical treatment, rational antibacterial therapy, and adequate general treatment.

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