[Postoperative suppurative complications and immune status in the surgical treatment of rectal neoplasms]. / Posleoperatsionnye gnoinye oslozhneniia i immunnyi status organizma pri operativnom lechenii raka tolstoi kishki.

The authors studied the course of the disease in the postoperative period in 308 patients with carcinoma of the rectum. The literature data and personal experience made it possible to reveal the high frequency of purulent complications among this category of patients. In view of this, the values of humoral and cellular metabolism were studied in some patients with uncomplicated forms of rectal carcinoma. Special attention was given for the first time to the peculiarities of local defence reactions of the peritoneum.

[Regulation of wound process by the method of vacuum therapy in middle-aged and aged patients]. / Reguliatsiia ranevogo protsessa u bol'nykh pozhilogo i starcheskogo vozrasta metodom vakuum-terapii.

Comparative analysis of the wound process in patients of various age groups allowed the conclusion that in elderly and old-age patients the wounds heal longer because of prolongation of the inflammatory phase, poorer local defence reactions, and sluggish reparative processes. This allows scientific substantiation of the postponed removal of the sutures in elderly and old patients. The method of vacuum therapy applied in patients over 60 produces a positive effect in the form of rapid abatement of the inflammatory reaction in the wound. This creates real preconditions for mobilization of the reparative property of the tissues which is diminishes at old age, active proliferation of the connective tissue elements, which results in the formation of a strong and mature scar in a shorter time. Vacuum therapy brings the terms of wound healing in elderly and old patients close to the terms of wound healing by first intention in the young and middle-aged.

[Wound healing after vacuum drainage]. / Zazhivlenie ran v usloviiakh vakuumnogo drenirovaniia.

Vacuum therapy was applied in the management of 63 patients with postoperative ventral hernias, 101 patients with a similar pathological conditions were treated by the traditional method for wound healing. From analysis of the results of treatment and with due consideration for the results of additional methods of examination it was established that vacuum prevents accumulation of exudate and blood clots in the wound cavity and removes the risk medium for the development of pyo-inflammatory complications. Moreover, by promoting the coming together of the wound edges and liquidation of the wound cavity, vacuum therapy affects the metabolic reorganizations in the tissues and leads to stabilization of the regeneration mechanisms. The use of vacuum therapy in the postoperative period creates the possibility of regulating the reparative reactions through an active effect on the healing of the wound in the phase of inflammation, protecting in this manner the biology of the wound process and preventing infectious complications.

[Treatment of generalized suppurative peritonitis]. / Lechenie obshchego gnoinogo peritonita.

In the period from 1980 to 1986 fifty-nine patients were treated for generalized purulent peritonitis of 72-hour duration. The traditional methods of therapy were applied--removal of the source of peritonitis and drainage of the abdominal cavity. The mortality was 62.7%. Since 1987, peritoneal lavage with enteral administration of oxygenized 5% glucose solution is used in the treatment of patients with generalized peritonitis in the stage of poly-organic insufficiency. Peritoneal-enteral lavage was applied in the management of 41 patients, 10 of them died. The mortality was 36.5%. The efficacy of the method was judged on basis of bacteriological study, electroenterography, and functional tests for the absorptive capacity of the small intestine. The results of stage peritoneal lavage and the findings of bacteriological study lead to the conclusion that it is extremely dangerous to postpone repeated cleansing of the abdominal cavity in such patients because progressive deterioration of the condition with a fatal outcome occurs in this case. Cleansing of the abdominal cavity must be accomplished during the first lavage or 24 hours later during relaparotomy and no hope should be entertained that inadequate cleansing will be compensated for during subsequent relaparotomies.

[Peritoneo-enteric lavage in generalized purulent peritonitis during multiple organ insufficiency]. / Peritoneal'no-énteral'nyi lavazh pri obshchem gnoinom peritonite v stadii poliorgannoi nedostatochnosti.

The article analyses two matched groups of patients with generalized purulent peritonitis of 72-hour duration in the stage of polyorganic insufficiency. There were 100 patients. Application of organ-resuscitation measures in the abdominosplanchnic zone is the key moment of the surgical treatment of patients with generalized purulent peritonitis. In view of this, peritoneoenteric lavage with oxygenated energy mass of 5-10% glucose solution is indicated together with intensive infusion-transfusion, antibacterial therapy, and extracorporeal detoxification for such patients. Combination of peritoneal lavage with enteric through a distal retrograde immobilizing dehydrostatic iliostomy produces the best results.

[The bacteriological and immunological assessment of peritoneal-enteral lavage in the treatment of general suppurative peritonitis at the stage of multiple organ failure]. / Bakteriologicheskaia i immunologicheskaia otsenka peritoneal'no-énteral'nogo lavazha v lechenii obshchego gnoinogo peritonita v stadii poliorgannoi nedostatochnosti.

The article shows that peritoneal-enteral lavage reduced the yield of microorganisms from the suppurative focus, the reduced yield after a single lavage might be considered as a favourable prognostic sign. Results of a quantitative bacteriological analysis are thought to be an objective criterion for performing or completing the stage of the peritoneal lavage. The peritoneal-enteral lavage promotes the activation of local defensive reactions in the abdominal cavity.

[Pathogenetic mechanisms of the effect of vacuum therapy on the course of the wound process]. / Patogeneticheskie mekhanizmy vliianiia vakuum-terapii na techenie ranevogo protsessa.

On the basis of the analysed results of treatment of 248 patients with abscesses, phlegmons, and purulent wounds who received vacuum therapy and 215 patients with the same diseases treated by the traditional incision-drainage-method, as well as on the grounds of additional examination findings, the authors show the mechanisms of the effect of vacuum therapy on the course of the wound process. They substantiate pathogenetically the marked therapeutic effect of this method in patients with acute purulent diseases of the soft tissues and purulent wounds.

[Thrombembolectomy in the treatment of patients with acute disorders of mesenteric circulation]. / Trombémboléktomiia v lechenii bol'nykh s ostrym narusheniem krovotoka v sosudakh bryzheiki.

In acute impairement of the mesenterial circulation, the authors in 31 patient performed thrombembolectomy from the superior mesenteric artery, which in 22 was supplemented with resection of a necrotized area of the intestine. Five patients recovered. In these patients within the first 24 hours, the control relaparotomy was performed and the early postischemic disorders were cupped off with the use of tubal decompression, active aspiration of the intestinal contents, lavage of the intestine with the balanced electrolyte solution, hemosorption and intraintestinal administration of the oxygenated 10% glucose solution.

[Bacteriologic and cytologic evaluation of vacuum therapy of suppurative wounds]. / Bakteriologicheskaia i tsitologicheskaia otsenka vakuum-terapii gnoinykh ran.

Results of the treatment of 438 patients have shown vacuum therapy of purulent wounds to make them clear from pus and microbes in short terms which contributes to the activation of reparative processes and ultimately makes the terms of the treatment shorter. The regeneration-degeneration index proposed allowed to mathematize the cytogram and results in a simpler and more objective orientation in the phases of the wound process.

[Vacuum therapy of acute suppurative diseases of soft tissues and suppurative wounds]. / Vakuum-terapiia v lechenii ostrykh gnoinykh zabolevanii miagkikh tkanei i gnoinykh ran.

The article analyzes results of treatment of 338 patients with abscesses, phlegmons and purulent wounds. A comparative investigation of treatment of 173 patients by traditional incisive-draining methods and 165 patients treated by using vacuum therapy by the method proposed by the authors was made. The advantages of vacuum therapy were shown in the acceleration of reparative processes and in shortening the time of treatment.

[Vacuum therapy in the treatment of suppurative lactation mastitis]. / Vakuum-terapiia v lechenii gnoinykh laktatsionnykh mastitov.

An analysis of results of treatment of 299 patients with acute purulent lactation mastitis has shown the use of vacuum therapy by the authors' method to result in a considerably shorter time of healing the wounds, in quicker detoxication of the organism. It controls pyo-septic complications, normalizes immune processes. The method is simple and may be used at any surgical department.

[Pathogenesis and the diagnosis of postoperative thromboses of the mesenteric vessels]. / Patogenez i diagnostika posleoperatsionnykh trombozov bryzheechnykh sosudov.

The examination of 36 patients with postoperative disorders of the circulation in the mesenterial vessels has shown postoperative infarctions of the intestine to be most frequently observed in elderly patients after surgery on the abdominal organs. Inflammatory-purulent diseases of the abdominal organs against the background of cardiovascular diseases are of special importance.