[A model for assessing and correcting the risk of developing pressure ulcers in the system of long-term care for geriatric patients with limited mobility.]

The article is devoted to the results of the third stage of the scientific and practical project on the introduction of advanced social practices based on innovative gerontotechnologies into the system of long-term care for geriatric patients. It has been established that senile xerosis or skin «frailty¼ occurs in 75% of the population over 65 years old, when increased dryness of the skin leads to peeling, the formation of microcracks, the appearance of senile itching, sleep disturbances, the development of pressure ulcers and, as a result, a decrease in motor activity. During the project, a tactic was developed for the care of «frail¼ skin in patients with senile xerosis and the risk of pressure ulcers. The article presents information about the current problems of diagnosis, correction and prevention of pressure ulcers in patients with limited mobility of elderly and senile age. The results of a comparative analysis of the severity of pressure ulcers and their impact on the quality of life in the system of long-term care for geriatric patients with limited mobility before and after the use of Cicalfate+ Eau Thermale Avène («Pierre Fabre¼, France) emollient were presented. A model was built and practical recommendations were given on the use of the most informative and adequate scales for predicting and assessing the risk of developing pressure ulcers in patients of older age groups.

[Bacteriophages in complex treatment of septic diseases of the hand]. / Ispol'zovanie lekarstvennykh preparatov bakteriofagov v kompleksnom lechenii gnoinykh zabolevanii kisti.

OBJECTIVE: To evaluate the effectiveness of bacteriophages in complex surgical treatment of septic diseases of the hand. MATERIAL AND METHODS: We analyzed treatment outcomes in 111 patients with septic diseases of the hand (septic arthritis, tendovaginitis, phlegmon). Surgical treatment was finished by primary sutures and drainage. They were divided into two groups. Bacteriophages were used in the main group. Other components of treatment were identical. «Pyobacteriophage complex¼ was injected into drainage tubes during dressings. Effectiveness of treatment was evaluated considering elimination of septic process, bacterial flora and healing of surgical wound. In addition, we performed in vitro testing of microorganisms for sensitivity to Pyobacteriophage. RESULTS: Staphylococcus and Streptococcus genus prevailed in hand infections. Pasteurella multocida has been isolated after pet bites. Growth of microflora in drainage tubes was observed in 16.7% and 21.1% of cases, respectively (p=0.02). Wound healing via primary intention was found in 83.6% and 71.4%, respectively (p=0.03). When testing in vitro, we observed lysis of cultures of Staphylococcus aureus in 83.6% of cases, Streptococcus pyogenes - in 33.3% of cases. CONCLUSION: «Pyobacteriophage complex¼ was effective for septic diseases of the hand. However, its partial lytic activity against the most common pathogens makes it advisable to combine phages and antibiotic therapy. Systematic renewal of phages is important due to widespread resistance of bacteria.

[Current problems of polypharmacy in geriatric patients when taking drugs with a risk of photosensitivity.]

The article presents an overview of the current problems of polypharmacy in geriatric patients when taking drugs with a risk of photosensitivity. The article contains information about emerging adverse drug reactions, as well as methods for diagnosing, correcting and preventing phototoxic and photoallergic reactions in patients of older age groups. The main aspects of dermatological support in the system of long-term care for geriatric patients when taking drugs with a risk of photosensitivity are outlined. Clinical signs of senile xerosis and skin manifestations of adverse drug reactions were studied when taking drugs with the risk of photosensitization before and after the use of a photoprotector in elderly patients.

[Acute haematogenous osteomyelitis of the pelvis with multifocal pyogenic abscesses in an adult]. / Ostryi gematogennyi osteomielit taza u vzroslogo s mnozhestvennymi gnoinymi metastazami.

Acute hematogenous osteomyelitis (AHO) in adults is a rare disease complicating timely diagnosis. Even greater difficulties are observed in case of pelvic bone lesion. The authors report AHO of the pelvis an adult. Osteomyelitis was complicated by generalized infection and multiple pyogenic abscesses in subcutaneous adipose tissue of the upper and lower extremities. Detection of primary infectious focus was complicated by extreme severity of the patient's condition and low informative value of X-ray and ultrasound at the early stage of disease. Staphylococcus aureus was obtained from blood culture and infectious foci. Surgical debridement along with complex intensive care ensured a positive outcome.

[Endovascular surgery for critical ischemia of lower extremities with suppurative-necrotic lesion of the feet]. / Rentgenoéndovaskuliarnaia khirurgiia pri kriticheskoi ishemii nizhnikh konechnostei s gnoino-nekroticheskim porazheniem stop.

AIM: To improve treatment of patients with grade IV chronic ischemia of lower extremities via endovascular angioplasty combined with surgical methods for suppurative-necrotic lesions of the feet. MATERIAL AND METHODS: 51 patients with grade IV chronic ischemia of lower extremities underwent endovascular interventions (balloon angioplasty, stenting). A total of 23 stents were deployed in 16 patients including 12 stents in superficial and common femoral arteries, 5 in popliteal artery, 6 in iliac artery. There were no stents in crural arteries. The most perspective artery for wound healing was preferred in case of revascularization below popliteal segment. Necrectomy was performed along with angioplasty in patients with suppurative-necrotic lesion of the feet followed by delayed reconstructive operations if it was necessary. RESULTS: Endovascular surgery for grade IV chronic ischemia of lower extremities was associated with good immediate results in most cases due to revascularization and organ-sparing interventions for suppurative lesions of the feet. Current endovascular methods allow to perform successful re-operations to restore blood flow in previously repaired arteries and implanted stents with restenosis or thrombosis.