[Repeated general anesthesia, as a component of intensive therapy of critical conditions in children with severe burns].

Adequate maintenance of anaesthesia during bandaging of burn injuries in children remains to be the problem of current importance. The authors analyzed 166 bandage changes under anesthetic support (children under ketamine with various types of premedication). It is revealed, that the ketamine anesthesia irrespective of a way of its introduction stimulates cardiovascular system and reduces parameters of external breath. With an intramuscular dose of 10 mg/kg of body weight, or intravenous dose of 3 mg/kg as employed in anaesthesia, the effect of ketamine continues for 12 minutes. It is found that intravenous dose of 3 mg/kg ketamine, has the same effect on homodynamic and breath as the dose of 5 mg/kg ketamine. The intravenous infusion of 5 mg/kg ketamine continued anesthesia for 17 minutes. Premedication of diazepam, extended for 4 minutes duration of anesthesia. It is concluded that ketamine-diazepam combinations can be very useful for induction of general anaesthesia.

[Influence of the plaferon on healing of burned wounds of III - IV degrees].

The purpose of the given work was studying influence of a preparation Plaferon on the process of healing burned wounds. Experiments was carried out on 30 rats Wistar (the mass of body 220-250 g), that was divided into 3 groups: 1st group (control) -burns without treatment, 2nd group - treatment only with Dermazin, 3rd group - treatment with Dermazin and Plaferon. As a result of the burn wound modeling, it is established that under the effect of the thermal interaction the rats of all experimental groups had severe burns of the skin of III degree. After 5-10 days of observation the degree of necrotic changes in the burn surface in animal experimental groups was different. They were least expressed in the rats, that obtained treatment by Plaferon and Dermazin; further in increasing order of magnitude was located the group of the rats, that obtained treatment only by Dermazin. The greatest necrotic changes were noted in control animals. With a morphological study of wound defects with the treatment of Plaferon and Dermazin for 30 days in most of rats was noted the epithelization of the wounds. The rats, that obtained the treatment of the burns only by preparation of Dermazin, on the surface of wounds had the remainders of scab in the form the fibrous- leukocyte layer, under which was located granulating cloth with the regulated motion of weakly-fuxinophilous collagenic fibers. Summing up studying of influence Plaferon on healing of severe thermal burn of the skin in rats, it should be noted, that application of Plaferon together with drawing of preparation Dermazin on burned surface right after burning traumas daily, unitary, within the next 30 days noticeably weakens development of severe necrotic processes and accelerates healing of the burn.

[Correction of oxidative stress in the experimental thermal burn of the skin].

The white breedless rats have been investigated in conditional reflex activity restoration dynamics, exercise tolerance and prominence of oxidative stress after local burn injury of skin and effectiveness of Plaferon use, administered in the first three days after burn injury modeling. One day before administration the background values and the following dynamics of indexes on the first, third and fifth days were recorded. Tolerance exercise has been much higher in the group of animals receiving the Plafreon during the whole period of observation, but the prominence of oxidative stress has been lower than in the group of animals receiving no treatment. The use of the Plaferon has resulted in the improvement of the functional condition of animals, correlated with the level of oxidative stress change indexes.

[Results of treatment of severe burns in the specialized intensive care unit].

The present work is based on the analyses of treatment of 512 patients (228 adults and 224 children) with severe, critical and subcritical thermal injuries in the period from 1998 till 2005. Significant increase of the prevalence of patients with severe and critical burns was revealed in the general structure of the burn traumatisms. There is suggestive decrease in lethality of such patients due to optimization of the intensive treatment methods. The key of successful outcome is the close collaboration of the burns intensive care specialists and surgeons. The treatment tactic of severely burned patients has to be based on the individual qualities of the particular patient. The use of the modern intensive care techniques allows not only to prolong the patients life-time, but also to increase the survival rate of patients with critical burns.

[Peculiarities of wound infections in severe burns].

Infections in patients with burns remain as a one of the main unsolved problems. The present work is based on the analysis of the data obtained from the 642 patients with burns (adults and children) during 2000-2005. The staphylococcus infection is still the leading. At the same time the percent of the gram-positive infection increased. The basic risks-factors that promote the development of the nosocomial infection in the case of burns were revealed. The antibacterial therapy in the severely burned patients has to be based on the individual peculiarities of an every patient. The more severe pathology the less possibility using the standard regimen. The short and ultra-short preventive antibiotic in the patients with severe burns are unacceptable. The "step-by-step", escalation-returnable tactics of antibiotics administration has justified itself.