[Alkaline phosphatase of granulocytes in open fractures of the long tubular bones]. / Shchelochnaia fosfataza granulotsitov pri otkrytykh perelomakh dlinnykh trubchatykh kostei

Investigations carried out in 60 patients with open fractures of long tubular bones in osteosynthesis with the Ilizarov apparatus indicated that alkaline phosphatase (AP) of granulocytes fully reflects the postoperative course. 10--24 hours following the trauma the level of AP in patients with grave injuries exceeds that in patients with slight ones. The differences are found to be reliable from the 1st to the 5th day after the injury.

[Bacterial flora and preventive antibiotic treatment in open fractures]. / Mikrobnaia flora i profilakticheskaia antibiotikoterapiia pri otkrytykh perelomakh

In 172 patients with open fractures of long tubular bones the wound bacterial flora was studied on their admission to the clinic and in occurrence of suppurative complications. There were no cases of "outdoor" microorganisms being the cause of suppuration. Pathogenic agents of suppurative infection differed from "outdoor" strains in their species content, signs of pathogenicity, sensitivity to antibiotics. As a rule, suppuration was preceded by soft tissues necrosis. Since wound suppuration was produced not by the initial or changed "outdoor" microorganisms but hospital strains, which penetrate in the wound due to inadequate observation of the rules of asepsis and antisepsis in surgical treatment or subsequent dressing, then prophylactic antibioticotherapy should cover mostly sensitivity of hospital bacterial strains. To this end, the study of bacteriological background for each surgical department seems to be absolutely necessary. In a small zone of the soft tissues injury under conditions of secure fixation of bone fragments with Ilizarov apparatus a limited use of antibiotics is believed to be permissible.