[Improvement of curative measures for peritonites of obstetric and gynecological etiology]. / Sovershenstvovanie lechebnykh meropriiatii pri peritonitakh akusherskoi i ginekologicheskoi étiologii.

The authors describe results of treatment of 117 patients with obstetric and gynecological peritonites. The first group consisted of 43 patients treated by conventional methods. The second group included 74 patients treated by unguent sanitation of the abdominal cavity and prolonged intraarterial catheter (PIAC) against the background of unguent sanitation. The unguent sanitation of the abdominal cavity with water-soluble antibacterial ointments has decreased the number of intra-abdominal and extra-abdominal complications. However in especially severe cases and at high virulence of the abdominal cavity microflora the application of the unguent sanitation alone was not sufficiently effective. So, in 19 patients PIAC was used by the developed scheme. The complex treatment with the unguent sanitation of the abdominal cavity and PIAC allowed to perform the adequate sanitation of the abdominal cavity with lower microbe dissemination of the abdominal cavity up to the critical level on the third day after operation and resulted in less number of intra-abdominal complications from 39.0 to 19.6%, extra-abdominal complications from 15.0 to 7.5% and lethality from 23.2 to 10.8%.

[New approaches to the treatment of postoperative peritonitis]. / Novye podkhody k lecheniiu posleoperatsionnykh peritonitov.

A retrospective comparative analysis of results of surgical treatment of 245 patients with postoperative peritonitis was made. In 114 patients (control group) furacin was used for sanitation of the abdominal cavity, and in 131 patients (main group) sanitation of the abdominal cavity was performed with water-soluble antibacterial ointments. It was established that the proposed ointment sanitation of the abdominal cavity in combination with active surgical methods based on using programmed relaparotomy resulted in 24.1% lower lethality as compared with the traditional method of sanitation. The authors assert that under conditions of marked polyorganic insufficiency the method of programmed relaparotomy with the ointment sanitation of the abdominal cavity is not very effective while using this method before the development of systemic complications is the decisive factor of the favorable prognosis.

[Cytology of peritoneal exudate as the criterion for phases of inflammation in diffuse purulent peritonitis]. / Tsitologicheskaia kartina ékssudata briushnoi polosti kak kriterii faz vospaleniia briushiny pri rasprostranennom gnoinom peritonite.

A cytological study was made of the exudation from the abdominal cavity in 131 patient with diffuse peritonitis to determine the time-related course of the inflammatory process in the peritoneum against the background of the therapy conducted. The exudation from the abdominal cavity was assayed at hospital admission, at surgery, and in the postoperative period, the planned ointment assanations having been performed. Used in the cytological study was the M. P. Pokrovsky and M. S. Makarov method in modification of D. M. Steinberg (1948) who suggested ways for the amounts of the microflora and those cell types occurring in the exudate to be determined in smears-impressions with the relevant cytogrammes made up. The most significant characteristics of the maiden, second, and third phases of inflammation of the peritoneum were revealed. On the basis of the above characteristics (cytologic signs) we have developed criteria for phases of inflammation of the peritoneum that permit the assessment of efficiency of the therapy treatments administered to be carried out.

[Role of prolonged intraarterial catheter therapy in general peritonitis]. / Rol' i mesto dlitel'noi vnutriarterial'noi keteternoi terapii pri rasprostranennom gnoinom peritonite.

The analyses of treatment results in 82 patients with general purulent peritonitis are presented. In these patients long-term intraarterial catheter therapy (IACT) was included in the complex of postoperative treatment after elimination of infection source. Postoperative peritonitis was in 66 patients, 52 patients of them underwent reoperations for persisting general peritonitis. Use of IACT promoted arrest of abdominal inflammatory process and polyorganic insufficiency due to high concentration of antibiotics in the affection focus, improvement of regional circulation, reduced number of postoperative complications and a sharp fall of lethality of 8.5%.

[Dynamics of changes in brain metabolism in experimental peritonitis]. / Dinamika izmenenii obmena veshchestv v golovnom mozge pri éksperimentalnom peritonite.

The condition of metabolic processes in the brain during the development of experimental peritonitis was studied in experiments on 100 unisexual pubertal rats weighting from 250 to 300 g. Blood samples were studied for the content of total protein, albumin, urea, total lipids, cholesterol, B-lipoproteins, and glucose with calculation of the arteriovenous difference (AVD) of each of these substrates. Marked phase changes in the character of metabolism of total protein, albumin, total lipids, B-lipoproteins, and glucose occur in the brain of rats with experimental peritonitis. It was found that energy and plastic substances were "washed out" of the brain of rats in the terminal stages of experimental peritonitis. In view of this it is pointed out that the complex of therapeutic measures applied in peritonitis must be critically revised and supplemented with agents which improve brain metabolism.