ABSTRACT
There were analyzed the results of surgical treatment of 246 patients, suffering diabetes mellitus, with destructive forms of the diabetic foot syndrome. It was established, that application of an active surgical tactic using cutaneo-adipose flap of their own and cellular culture of fibroblasts on the background of selective prolonged intraarterial complex therapy permits to perform economic amputation of foot, reduces risk of performance of high amputation of the lower extremity and reoperations.
Subject(s)
Diabetic Foot/surgery , Foot/surgery , Ischemia/surgery , Vascular Surgical Procedures , Adolescent , Adult , Aged , Diabetic Foot/etiology , Diabetic Foot/pathology , Female , Foot/blood supply , Foot/pathology , Gangrene/surgery , Humans , Ischemia/complications , Ischemia/pathology , Male , Middle Aged , SyndromeABSTRACT
The results of surgical treatment of 76 patients. suffering diabetes mellitus with purulent--necrotic affection of the foot. were analyzed. In 48 of them the selective prolonged intraarterial medicinal therapy was conducted. The efficacy of durable application of intraarterial desaggregant and antibacterial therapy was substantiated, permitting to perform predominantly "small" operation on the foot and to save its supportive function in 96% of observations.
Subject(s)
Diabetic Foot/drug therapy , Leg/blood supply , Pharmaceutical Preparations/administration & dosage , Diabetic Foot/surgery , Humans , Injections, Intra-Arterial , Leg/surgery , Middle Aged , Severity of Illness Index , Suppuration , Time Factors , Treatment OutcomeABSTRACT
Results of surgical treatment of 168 patients with diabetes mellitus (DM) in the diabetic foot syndrome (DFS) were analyzed. Expediency of operative intervention was substantiated by pathogenic form of affection, its depth and diffusion, composition of microorganisms in purulent-necrotic focus. Performance of more extensive surgical treatment or distal amputation of foot with consequent closure of vast wound defect using full-layer subcutaneous-cutaneous flap with protracted selective intra-arterial anti-aggregate and antibacterial therapy was indicated in order to preserve the lower extremity supporting function and for prophylaxis of diffusion of purulent-necrotic affection. Application of improved tactics and surgical treatment in patients with DFS have allowed to reduce frequency of the lower extremity high amputation performance from 24 to 8.6%.
Subject(s)
Diabetic Foot/surgery , Surgical Procedures, Operative/methods , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Retrospective StudiesSubject(s)
Carbon Dioxide , Condylomata Acuminata/surgery , Laser Therapy/methods , Rectal Diseases/surgery , Adult , Humans , Male , Severity of Illness IndexABSTRACT
The results of treatment of 182 patients with an acute ileus were analyzed. While roentgenography conduction the characteristical signs of the disease were noted in 68.7% of patients and in 31.3% they were absent or mildly pronounced. In the last situation a contrast substance passage was studied, permitting to make a diagnosis in 67.6% of patients.
Subject(s)
Intestinal Obstruction/diagnosis , Acute Disease , Aged , Female , Humans , Male , Middle AgedSubject(s)
Duodenal Ulcer/complications , Hemangioma/complications , Liver Neoplasms/complications , Peptic Ulcer Hemorrhage/complications , Aged , Duodenal Ulcer/diagnosis , Duodenal Ulcer/surgery , Duodenoscopy , Hemangioma/diagnosis , Humans , Liver Neoplasms/diagnosis , Male , Peptic Ulcer Hemorrhage/diagnosis , Peptic Ulcer Hemorrhage/surgeryABSTRACT
On the basis of the experience with treatment of 19,346 patients with acute appendicitis, the authors have established that pain in the right inguinal region, rigidity of muscles of the anterior abdominal wall, and a Volkovich-Kocher symptom were the most informative symptoms. The Shchetkin-Blumberg symptom caused by the development of an inflammatory process in the peritoneum is not an appendicular symptom; the Rovzing, Voskresensky, Obraztsov symptoms, not being the specific symptoms of acute appendicitis, are of essential informative value only in combination with the other symptoms of the disease.
Subject(s)
Appendicitis/diagnosis , Acute Disease , Diagnosis, Differential , HumansABSTRACT
A new method of plasty of hernial hilus for femoral hernias is proposed which consists in sutureless fixation of allotransplants made of silicone having the form of a mushroom-shaped element. The transplant gives good and reliable closure of the hernial hilus without changing the interrelation of tissues. The duration of the operative procedure becomes considerably shorter, any injuries of large vessels were excluded as well as the development of ligature fistulas, suppuration of the wounds and recurrent hernias. An analysis of nearest and long-term results of treatment of 68 patients operated upon shows high efficiency of the method proposed.