["Preliminary" amputation for the irreversible ischemia of the lower extremities].

The author has summarized experiences of amputations of the shin and femur in 301 patients for 10 years of work, has developed a surgical strategy for certain kinds of high amputations that allowed improving the results of amputations of lower extremities in 178 patients in the following three years. One of important factors in decreasing the number of purulent postoperative complications and lethality was using the method of "preliminary" amputation and reamputation.

[Improved technique of amputation of the femur].

The author proposes an improved technique of amputation at the femur level. It consists in using the circular suture up to the intersection of the femur muscles for hemostasis and covering the bone stump, draining the stump through a special puncture in the posterior surface of the femur, and an intracutaneous absorbable suture.

[Lower limb amputations in patients with acute arterial insufficiency].

Over the ten-year period (1992-2002) 301 patients underwent lower limb amputation at the Department of Purulent Surgery. In 25 patients, the cause of major amputation was acute arterial insufficiency. The patients were distributed in two groups: the first group patients (n=19) underwent secondary amputation and the second group patients (n=6) were provided major amputation, without attempts at restoration of the main blood flow. On secondary amputation the results appeared worse than on primary amputation.

[Specific surgical strategy for gangrene of both lower extremities].

At admission of patients with gangrenes of both lower extremities the surgical strategy was not determined. The author has also failed to find corresponding recommendations in the available literature. On the basis of his clinical experiences with 12 patients who underwent big amputation of lower extremities for bilateral gangrene, the author proposes the surgical methods. The optimal variant is considered to be a by turns amputation with the interamputation period being determined by a relative stabilization of the life-support systems.

[Patient's quality of life and lifespan in the postamputation period]. / Kachestvo zhizni patsienta i ee prodolzhitel'nost' posle amputatsii.

Over the last decade, a total of 301 patients were subjected to high amputation of lower limbs at City Clinical Hospital N5 in Nizhniy Novgorod. The main cause of amputation was atherosclerotic and diabetic gangrene. The remote outcomes were examined in 116 patients at terms from 2 months to 10 years postoperatively. It turned out difficult to determine quality of life according to the world-accepted standards in this country. Therefore, we were mainly concerned with the most important, and highly significant for the patient problems, which allowed us to appropriately assess quality of life in the postamputation period, and to acknowledge it as unsatisfactory.

[Dilatation (congestive) cardiomyopathy: clinical aspects, diagnosis and treatment]. / Dilatatsionnaia (zastoinaia) kardiomiopatiia: klinika, diagnostika i lechenie.

Clinical and electrocardiographic manifestations of congestive cardiomyopathy are considered on the basis of observations of 25 patients with this pathology of the myocardium. No clinico-electrocardiographic signs specific for this disease were found. Most characteristic were cardiomegaly, congestive cardiac failure and various disturbances of rhythm and conductivity. Thromboembolic complications in the lung and kidney vessels are frequently found. Cardiac glycosides, saluretics and vasodilators were employed in the treatment of patients with congestive cardiomyopathy but the prognosis was usually poor.