[THE ADVANCED METHOD OF VESSEL SEPARATION AND HEMOSTASIS].

The authors suggested the advanced method of vessel separation and hemostasis, which was applied in 13 patients. This method was compared with the traditional method used for 8 patients. Proposed approach allowed separation of vascular fascicle twice faster than in usual way. There were noted a less decrease of hemoglobin level and shortening of hospital stay. The results of treatment were improved due to the application of the method of vessel mobilization and temporal hemostasis in surgery of stab-cut wound of the neck.

[Treatment of patients with purulent wounds by using the original method of hydrodynamical drainage].

In this article the work of the Omsk State Medical Academy's department of general surgery is presented. The aim of study was to treat patients with purulent and necrotic wounds of soft tissue by using novel hydrodynamical drainaige. In this research 92 patients were taken part, who were inpatient treatment in the department of purulent surgery City Clinical Hospital No 1 named Kabanov A. N. 2010-2013 with purulent and necrotic wounds of soft tissue. Clinical, laboratory, cytological, bacteriological monitoring were conducted over the of wound process during the treatment. Assessment of the reliability of differences between the mean value of clinical indicators was with the calculation of the criterion t--Student, the method chi2 and Criterion Mann-Whitney U. The proposed method of treatment of purulent wound promotes fast the removal of necrotic tissue and pus in the first phase of the wound process that led to more rapid relief of symptoms of intoxication (fever, leukocytosis and common symptoms) at the patients of the basic group. Due to faster removal of necrotic tissue, reduction of common symptoms of intoxication at the patients of the basic group the transition from degenerative and inflammatory type of cystograms to regenerative occurred one or two days before than in the comparison group.

[Treatment of patients with purulent wound infection under conditions of extreme north].

An examination and treatment of 345 patients with purulent wounds of soft tissues of different localization has established that ozone-ultrasound treatment of purulent wounds using sodium hypochlorite for irrigation-wash drainage and wetting the gauze pads, tampons, turundas applied on the wound surface allow placing the early secondary sutures, skin plasty and exclusion of frequent painful bandages, saving the bandage materials and 2 times shorter period of treatment. The use of sodium hypochlorite and ozone-ultrasound treatment of the wound facilitates quicker ripening the granulation tissue and earlier epithelization.

[Clinical assessment of various treatments for tracheal stenosis].

The paper deals with the management of cicatricial stenoses of the trachea, which is a topical problem of modern thoracic surgery. Surgical techniques and endoscopic operations aimed at expanding and maintaining the lumen of the airways have been employed. Original types of surgical operations and new endoscopic tools are proposed.

[The application of an impulse plasma jet for trauma of the liver]. / Primenenie impul'snoi plazmennoi strui pri travme pecheni.

The authors made an analysis of the application of a plasma jet with the help of an apparatus of original construction used for treatment of wounds of the liver in 36 patients. This apparatus has a number of advantages as compared with others. The plasma jet gives a reliable homostasis and minimum heat injuries to the liver tissues.

[Express method of determining blood in the abdominal cavity in closed abdominal injuries]. / Ekspress-metod opredeleniia krovi v briushnoi polosti pri zakrytoi travme zhivota.

The article describes an express-method of determining intraabdominal bleeding with the help of a benzidine test based on the ability of the hemine group of hemoglobin to catalyze the reaction of benzidine oxidation with hydrogen peroxide.

[Use of low-frequency ultrasound with special gas agents in acute generalized peritonitis]. / Primenenie nizkochastotnogo ul'trazvuka s tselevymi gazoobraznymi agentami pri ostrom rasprostranennom peritonite.

Optimal parameters of peritoneal cavity treatment by low-frequency ultrasound with alternative use of carbon dioxide and oxygen were selected in experimental animals. Sanitation of peritoneal cavity in fecal peritonitis led to a significant desintoxication effect. The results of treatment of acute generalized peritonitis by this method in 28 patients were good. On day 2 or 3 after surgery all the patients underwent extracorporeal detoxication with hemosorbent AUSRITC-1 with good result. In severe toxemia and water-electrolyte disturbances plasmapheresis was applied. 4 patients of 28 died, lethality was 14.2%.

[Catheterization of the subclavian vein in patients with combined trauma in emergency situations]. / Kateterizatsiia podkliuchichnoi veny u bol'nykh s sochetannoi travmoi v ékstrennykh situatsiiakh.

The authors describe a simplified method of catheterization of the subclavian vein available in all medical institutions and in any situation.

[Combined thoracoscopy in thoracoabdominal wounds using ultrasound, the CO2 laser and the plasma jet]. / Kombinirovannaia torakoskopiia pri torakoabdominal'nykh raneniiakh s ispol'zovaniem ul'trazvuka, CO2 lazers i strui plazmy.

Under analysis is an experience with treatment of 178 patients with thoracoabdominal wounds. The authors have developed a rational curative methods and original thoracoscopic techniques, which allowed to considerably reduce the amount of thoracotomies. Thoracoscopy was performed in 157 (88%) of 178 patients. Indications for thoracotomy were established in 7 patients, in 19 patients only drainage of the pleural cavity was made. Curative thoracoscopy was used in 131 patients, in 60 of them ultrasonic glue hermetization of the lung wound was made, 36 patients had laser photocoagulation of the lung wound, 21 patients had plasma coagulation of pleuro-pulmonary defects, in 14 patients--coagulated hemothorax was removed. Clinical effectiveness of thoracoscopic techniques was more than 90%. Thoracotomy was performed in 28 (15%) patients, in 11 patients it was supplemented with diaphragmotomy. Laparotomy was performed in 167 patients. Lethality was 6.8%.

[Surgical tactics in pleural empyema with regard to the use of a carbon dioxide laser and argon plasma]. / Khirurgicheskaia taktika pri émpieme plevry s uchetom ispol'zovaniia uglekislotnogo lazera i argonovoi plazmy.

The authors analyze the experience gained in treating 30 patients with acute and 23 with chronic pleural empyema. The management policy identified the following points. Laser thoracoscopic necrectomy and empyemic cavity sanitation are indicated in acute destructive pulmonitis. A combination of temporary bronchial occlusion and laser treatment of the empyemic cavity and bronchopleural fistula should be performed after debridement of a destructive pulmonitis area from necrotic tissues. Radical treatment of chronic pleural empyema should be better conducted in the early periods by employing a plasma scalpel at all the stages of surgical intervention for hemostasis, aerostasis and sterilization of the operation field.

[The thoracoscopic use of the CO2 laser in the combined treatment of pleural empyema]. / Torakoskopicheskoe primenenie CO2-lazera v kompleksnom lechenii émpiemy plevry.

A new method for treating acute pneumothorax with a bronchopleural fistula was experimentally developed and clinically tested. It is based on thoracoscopic use of CO2 laser radiation. The laser beam energy is employed for evaporation of necrotic tissues in the area of pulmonary destruction, "welding" of the bronchopulmonary fistulae, and general irradiation of the empyema cavity with a defocused beam. Nineteen patients with various disease duration were treated. In 16 patients the bronchial fistulae and the empyema cavity were eliminated and the lung re-expanded. The purulent inflammation in the pleural cavity was acute in these cases.

[The use of a plasma scalpel during thoracoscopy for the treatment of traumatic and spontaneous pneumothorax]. / Ispol'zovanie plazmennogo skal'pelia vo vremia torakoskopii dlia lecheniia travmaticheskogo i spontannogo pnevmotoraksa.

The authors suggest performing thoracoscopic coagulation of pleuropulmonary defects with a plasma stream (VSVU-160 apparatus) in patients with traumatic and spontaneous pneumothorax. A special nozzle and a manipulation trocar were designed for this purpose. Such combined thoracoscopy was used successfully in 31 patients with open and closed chest injury with rupture of the subpleural bullae. The manipulation makes it possible to reduce the number of emergency thoracotomies undertaken for hemo- and aerostatic indications.

[The use of a plasma unit in surgery of the lung and pleura]. / Ispol'zovanie plazmennoi ustanovki v khirurgii legkikh i plevry.

On the basis of 35 experiments on dogs and clinical experience in operations on the lungs and pleura in 11 patients with the use of a plasma stream and special miniature nozzles the authors revealed the following: reliable hemostasis and aerostasis in cutting pulmonary tissue and pleura; tissue wounds inflicted by a stream of plasma are sterile; the zone of coagulation necrosis is no larger than 1 mm; healing occurs predominantly according to the type of aseptic productive inflammation with growth of connective tissue into the thermal crust. The operation in all patients was successful, no complications developed. The design of the BCBY-160 plasma apparatus should be improved to make it more compact, to reduce its size.

[Repeated radical operations after surgical interventions in diseases of the lungs and pleura]. / Povtornye radikal'nye operatsii posle vmeshatel'stva po povodu zabolevanii legkikh i plevry.

The article elucidates the authors' experience with 144 repeated radical operations on lungs and pleura (89 out of them were resections of lungs). Recovery was achieved in 89,4% of patients subjected to a repeated resection of lung. Lethal outcomes were in 7% of cases.