[Extensive purulent processes after combined phlebectomy]. / Obshirnye nagnoitel'nye protsessy posle kombinirovannoi flebéktomii.

OBJECTIVE: To analyze the causes and develop methods for the treatment of extensive purulent processes after combined phlebectomy in patients with lower limb varicose veins. MATERIAL AND METHODS: The authors reported 3 cases of extensive phlegmon after phlebectomy for the period from 2014 to 2018. It is shown that comprehensive debridement of purulent-inflammatory lesion with application of additional methods including high-energy exposure by the air-plasma flow is essential for effective treatment of this complication. In addition, literature review showed only few observations of severe septic complications after traditional varicose vein surgery. RESULTS: Radical debridement of purulent wounds with wide excision of necrotic subcutaneous tissue and fascia, combination of standard surgical technique and plasma scalpel, as well as subsequent plasmodynamic staged wound repair in a therapeutic mode prevented severe purulent-inflammatory process, stopped systemic inflammatory syndrome and resulted fast wound healing. CONCLUSION: Active surgical approach combined with air-plasma technology was followed by high-quality correction of extensive suppurative process. Minimally invasive management of varicose disease with improvement of surgical techniques will minimize the likelihood of these complications.

[Ultrasound assessment of vocal cords function after thyroid surgery]. / Pervyi opyt otsenki funktsii golosovykh sviazok ul'trazvukovym metodom issledovaniia u bol'nykh posle operatsii na shchitovidnoi zheleze.

OBJECTIVE: To analyze vocal cords function after thyroid surgery by using of ultrasound examination. MATERIAL AND METHODS: Assessment of voice quality according to GRBAS scale, ultrasound examination of vocal cords and indirect laryngoscopy were performed in 57 patients after thyroid surgery. RESULTS: Postoperative indirect laryngoscopy and ultrasound revealed normal mobility of vocal cords in all patients. However, 98.3% of patients subjectively noted deterioration of voice quality due to hoarseness and fatiguein early and long-term period, respectively. Complete restoration of vocal function occurred after 6 months postoperatively. Impaired voice quality is probably due to edema of vocal cords after intubation that is manifested by unclear contours during ultrasound. Ultrasound is useful to diagnose shortening and displacement of paretic vocal cords. CONCLUSION: Ultrasound of vocal cords could be alternative to indirect laryngoscopy for postoperative assessment of vocal cords function in patients after thyroid surgery.

[Plasma management in complex treatment of late inflammatory complications after injection contour plasty with polyacrylamide gel]. / Plazmennaia obrabotka pri lechenii pozdnikh vospalitel'no-gnoinykh oslozhnenii in''ektsionnoi konturnoi plastiki poliakrilamidnym gelem.

AIM: To improve the results of treatment of late inflammatory complications after injection contour plasty with polyacrylamide gel. MATERIAL AND METHODS: The authors analyze treatment of 21 patients with late septic complications of body contour plasty with polyacrylamide gel (PAGE) for the period 2010-2015. Mean age of women was 47.4 years. Time after primary intervention was 10-22 years. The depth of soft tissue lesion corresponded to II-III grade by D. Ahrenholz classification (1991), length - from 67 to 180 cm2. Mammary glands were the most common area of augmentation (18 cases). Besides antibiotic therapy and surgery complex treatment included exposure with plasma flows in various modes. RESULTS: Plasma technology significantly accelerated regenerative processes and provided stable microbial decontamination in 100% patients. High-energy vaporization was associated with maximum possible removal of PAGE from the tissues that was confirmed by histological examination.

[Plasma flow in complex treatment of large pyonecrotic lesions of soft tissues].

Results of complex treatment of 46 patients with large necrotic and purulent lesions of soft tissues with plasma technology are analyzed. In "short-distance coagulation" regimen high-energy argon and air-plasma flows were successfully used at final stage of surgical treatment of suppurative focus. Number of consecutive necrectomies and intraoperative hemorrhage has been significantly reduced. Plasma flow in "therapy" regimen accelerated regeneration and epithelization of the wound. Advantage of plasma technologies was also confirmed by the data of microbiological, cytological and histological studies. The developed method and algorithm of treatment with a focus on specific clinical situation reduced lethality and hospital stay 1.5-fold.

[Argon plasma flowing the complex treatment of different forms of erysipelas].

The results of complex treatment of 113 patients with different forms of erysipelas were analyzed. In 73 (64.6%) of them argon plasma using "Argon scalpel SP-CPT" in therapeutic regimen was applied as daily local exposure. In 40 (35,4%) patients with complicated form of erysipelas regimen "coagulation" was applied for additional sanitation of wound surface after surgical treatment of purulent focus. The results of treatment in the study group were better than in the control group. Argon plasma may be regarded as effective method of prophylaxis of necrotic and purulent complications particularly in patients with high risk of these complications.

[Complex treatment of varicosity of the lower extremities]. / Kompleksnoe lechenie varikoznogo rasshireniia ven nizhnikh konechnostei.

Over 10 years 1296 patients with an uncomplicated form of varicose disease were treated with compressive sclerotherapy before surgery. Sclerotherapy was performed as the first stage of complex treatment in combination with various surgeries. Over the last 5 years Doppler ultrasound study and coloured angioscanning were carried out in each patient before treatment. There were a total 1457 surgeries. The majority of the patients (916) were examined 4 months to 6 years postoperatively. The results of the treatment were good in 91.6% patients, the rate of recurrence after surgery did exceed not 4.03%. This complex therapy enhances the cosmetic effect and shortens the time treatment without loss for radicality.

[Methods of treatment of acute thrombophlebitis of greater saphenous vein]. / Sposob lecheniia ostrogo tromboflebita bol'shoi podkozhnoi veny bedra.

One-stage combination of thrombectomy on the thigh with compressive sclerotherapy is proposed. This method was used in 66 patients with acute thrombophlebitis of greater saphenous vein (GSV) trunk. It permitted to improve treatment quality, to reduce the scope of subsequent radical operation and to improve its cosmetic result. There were no intraoperative complications. All the patients were discharged in satisfactory state, repeated radical operation for varicose veins of the leg was recommended.