[The new approach to ventral hernia repair: anatomic and functional basis].

A new pathogenetically and functionally grounded way of large and giant ventral hernia repair is suggested. The anterior wall of rectus sheath is formed with own aponeurosis and the posterior wall is formed by the endoprothesis. It reduces the risk of the complications, typical for the subcutaneous mesh position and provides for elasticity of muscle-aponeurotic abdominal wall structures. Satisfactory early and follow-up results are achieved in all 34 patients treated using the method. No hernia recurrences were registered.

[Clinicopathologic basis of ozonomagnetophoresis in treatment of festering wounds].

Results of treatment of 60 patients with festering wounds were comparatively studeid. According to the mode of local treatment the patients were divided into 2 groups: wound irrigation with ozone was carried out in the first group; in the second group local ozone therapy was carried out in combination with low-frequency magnetic fields--ozonomagnetophoresis. Bactericidal effect and antibiotic susceptibility of microflora is more marked using ozonomagnetophoresis. Tendency to purulo-necrotic tissue rejection from wound surface, regress of inflammation exudative stage with natural forming of granulation tissue in relatively short terms, its accelerated maturing and reparation are histologicaly marked.

[Intraperitoneal perfusion of perftoran in the treatment of patients with diffuse purulent peritonitis]. / Vnutribriushinnaia perfuziia perftorana v lechenii bol'nykh rasprostranennym gnoinym peritonitom.

For higher efficacy of general purulent peritonitis treatment, intraperitoneal perfusion of Perftoran emulsion was proposed. The drug was administered as a single dose of 100-150 ml before wound suturing. In 48 hours an increase of phagocytizing cells fraction in peritoneal exudate and their higher functional activity was revealed: the phagocytic activity and phagocytic index was 2 times higher than in the control group, complete phagocytosis index--1.5 times higher. Significant reduction of microbial contamination in abdominal cavity was also revealed: in 48 hours there were less aerobic bacteria than in the control group, there were no anaerobic bacteria, or anaerobes were detected in a minimum quantity. Local use of Perftoran allowed to decrease the rate of repeated peritoneal sanitation by 44.4% and to decrease mortality by 5.2%.

[Programmed relaparotomy in peritonitis]. / Programirovannaia relaparotomiia pri peritonite.

Statistical analysis of the clinical picture, history data, intraoperative findings and outcomes of treatment in 214 patients with generalized purulent peritonitis provided an algorithm for defining of indications for programmed relaparotomy. The algorithm allowed errors to decrease from 25.2 to 2.4% in the choice of surgical policy for peritonitis and to decrease mortality from 21.0 to 16.7%.

[Treatment of linea alba hernia and diastasis of rectus abdominis]. / Lechenie gryzh beloí linii zhivota i diastaza priamykh myshts zhivota.

The asynchronous development of structural and metabolic disorders of aponeurosis, leading to the development of defects in sheath of the rectus abdominis is the major factor of hernia of linea alba formation. Development of diastasis of m. rectus abdominis is caused by primary structural and metabolic changes of myocytes caused by the extreme overload. The important factor of the operation is restoration of anatomic and physiologic parameters of the abdominal wall by bringing mm. rectus abdominis together, shortening and enforsing of aponeurosis makes it possible to distribute regularly the load on the aponeurotic sheath of musculi recti.

[Results of surgical treatment of diastasis of the rectus abdominis muscles]. / Rezultaty khirurgicheskogo lecheniia diastaza priamykh myshts zhivota.

The work gives a comparative analysis of the treatment of 249 patients with diastasis of the rectus abdominis muscles according to the degree of restoration of the working capacity, the existence of gastrointestinal discomfort, recurrence of the disease, and the dynamics of changes of the morphological and functional values of these muscles. The clinical and functional-morphological results were best after plastics of the anterior abdominal wall by the method suggested by the authors. With the use of this method the results were good in 40 (71.4%) and satisfactory in 16 (28.6%) of patients. Recurrences were not encountered.