[Several problems of pathogenesis and treatment of pulmonary gangrene]. / Nekotorye voprosy patogeneza i lecheniia gangreny legkikh.

The pathology and clinical picture of gangrene of the lungs were studied in detail in 213 patients in the specialized surgical department of the clinic of hospital surgery of the Kirov Military-Medical Academy from 1969 to 1987. The diffuse from of the disease (DLG) was encountered in 111 patients and the localized form (LLG) in 102 patients. The indications for various methods of treatment of lung gangrene are formulated. Lung resection was performed most frequently (in 67% of patients). Intensive preoperative therapy including hyperbaric oxygenation is necessary for most patients with gangrene of the lungs. Total mortality was 39.6% among patients with DLG and 16.6% among those with LLG. Mortality among patients with DLG after resection of the lungs was 34.1%. Study of the late-term results showed that 130 (61%) patients were alive, 64 (30%) had died from the main disease and its complications and 7 (3.5%) from other causes, the fate of 12 (5.7%) persons was not known.

[Prevention of wound infection after pulmonary resection of acute suppurative disease]. / Preduprezhdenie ranevoi infektsii posle rezektsii legkogo po povodu ostrogo gnoinogo zabolevaniia.

The appearance of suppuration of the operation wound is real after resection of lungs for a restricted and spread gangrene despite prophylactic use of antibiotics and washing of the wound with antiseptics. Early diagnosis of local suppuration of the wound, effective drainage of the focus and increase of non-specific resistance give a way out of the situation. Choice of diagnostic criteria of suppuration and a method of correction of healing the thoracotomic wound are presented.

[Expansion of the lung after partial resection for gangrene]. / Raspravlenie legkogo posle chastichnykh rezektsii po povodu gangreny.

On the basis of the experience with the treatment of 69 patients with lung gangrene the authors recommend to use a combination of active aspiration from the pleural cavity, occlusion of the segment bronchus and pneumoperitoneum for the efficient expansion of the lung after its resection in the early postoperative period.

[Elimination of a stable residual pleural cavity with an antibacterial fibrin filling]. / Likvidatsiia stoikoi ostatochnoi plevral'noi polosti antibakterial'noi fibrinnoi plomboi.

A simple, effective and safe method is proposed to liquidate a persistent residual pleural cavity by a biological filling prepared ex tempore from a solution of fibrinogen with antibacterial drugs. The method was used in 24 patients after pleura empyema. The method of filling is described as well as the conditions for a successful use of the new means of liquidation of the residual pleural cavity and prevention of recurrent pleura empyemas.

[Hyperbaric oxygenation in the treatment of patients with acute purulent-destructive lung and pleural diseases]. / Giperbaricheskaia oksigenatsiia v lechenii bol'nykh ostrymi gnoino-destruktivnymi porazheniiami legkikh i plevry.

In experiments in rabbits the authors have elaborated safe (in relation to a barotrauma of the lungs) regimens of the pressure changes taking place while performing HBO. In the treatment of 127 patients with acute suppurations of the lungs and pleura it was established that a short course of HBO (4-5 sessions) in the regimens used was safe and clinically effective. The method is recommended for the treatment of patients with spreaded injuries of the pulmonary tissue developing with a pronounced endogenous intoxication.

[Enzymologic and immunologic indices of the activity of inflammatory process in acute purulent-destructive lung and pleural diseases]. / Enzimologicheskie i immunologicheskie pokazateli aktivnosti vospalitel'nogo protsessa pri ostrykh gnoino-destruktivnykh zabolevaniiakh legkikh i plevry.

The dependence of the activity of lysosomal enzymes upon the degree of the pyo-destructive process and the character of the course of the postoperative period has been established on the basis of studying the activity of lysosomal enzymes of leukocytes of blood and pleural exudate, titre of natural and heterophyllic antibodies, components of the kallikrein-kinin system in pyo-destructive diseases of the lungs and pleura. Pathogenetically substantiated ways of prevention of postoperative infectious complications are proposed.

[Osmometry as a method of control of homeostasis in acute suppurative destructive diseases of the lung and pleura]. / Osmometriia kak metod kontrolia gomeostaza pri ostrykh gnoino-destruktivnykh zabolevaniiakh legkikh i plevry.

The osmolar status was studied in 63 patients with acute abscesses of lungs and empyema of pleura at different stages of the conservative and operative treatment. The hypoosmolarity syndrome was revealed at the acute stage of the disease against the background of a pronounced purulent intoxication. An increased excretion of nonidentified osmotically active metabolites with urine was registered at the height of pyodestructive process and postoperative disease.

[Local fibrinolytic therapy with terrilytin in coagulated hemothorax and pleural empyema]. / Mestnaia fibrinoliticheskaia terapiia terrilitinom pri svernuvshemsia gemotorakse i émpieme plevry.

On the basis of experimental and laboratory investigations high fibrinolytic effect of the home proteolytic enzyme terrilythin and the absence of general toxic reactions after intrapleural administration of the drug have been proved. The article describes results of clinical results of clinical tests of the effectiveness of terrilythin in coagulated hemothorax after traumas of the chest and operations on the lungs and in 55 patients with acute pro-fibrinous pleurisy. The successful preventive sanitation was performed in 43 of 50 patients with coagulated hemothorax and initial symptoms of the infectious process as well at the development of pleural empyema were averted.

[Use of pervomur for irrigation of purulent cavities]. / Primenenie pervomura dlia sanatsii gnoinykh polostei.

Experimentally it has been shown that diluted Pervomur (1:3) may be used for the intraoperation washing of the pleural cavity. The use of the diluted drug during the operations for acute purulent diseases of the lungs and pleura made it possible to prevent postoperative pleural empyemas and suppluration of soft tissue wounds in most patients.

[Surgical treatment of acute suppurative destructive lesions of the lungs and pleura in sepsis]. / Operativnoe lechenie ostrykh gnoino-destruktivnykh porazhenii legkikh i plevry pri sepsise.

Eleven patients with metastatic acute purulent-destructuve processes in the lungs and pleura in sepsis were operated on. Fifteen operations were performed: 3 lobectomy, 1 pneumonectomy, 8 drainages of the pleural cavity with its sanitation, 1 drainage of a pulmonary abscess with thoracocentesis and 1 thoracotomy. Sepsis was treated by complex methods. Nine patients were discharged in a good condition. Two patients died.