[VACUUM-THERAPY OF DIFFUSE PERITONITIS].

The experience of treatment of 37 patients, suffering diffuse peritonitis, in 18 of them in complex with vacuum-therapy, is adduced. In a comparison group a sanation relaparotomy was applied only. International classifications SOFA, APACHE II, Manheim's Index of the Peritonitis Severity were used for estimation of the patients' state severity. The vacuum-therapy application have promoted significant reduction of the abdominal cavity microbial soiling, permitted to escape the compartment syndrome occurrence, and to reduce the sanation relaparotomy performance rate.

[The symptoms and surgical tactics for complicated forms of the abdominal cavity tuberculosis].

The results of treatment of 12 patients, suffering complicated forms of abdominal tuberculosis and external intestinal fistulas, were presented. Late diagnosis of abdominal tuberculosis in the patients, suffering the complications phase of the disease, is caused by unclear symptoms presence in early stages of the disease. Clinical and laboratory indices in peritonitis of a phthisis origin are nonspeciphic. In 91% of patients, admitted to the hospital for complicated forms of abdominal tuberculosis and external intestinal fistulas, the operative treatment was indicated. Surgical intervention (more frequently right-sided hemicolectomy, enterostomy, the abscesses opening, the caseously-changed lymph nodes excision, formation of anastomosis) was performed in 11 patients for peritonitis and external intestinal fistulas. The method of a secure invagination anastomoses formation was elaborated, permitting to perform primary restoration operations. An early diagnosis, early effective therapy and radical surgical intervention conduction for complicated abdominal tuberculosis promote the patients to survive.

[Treatment of purulent wounds using vacuum-therapy].

The results of treatment of complex wounds in 115 patients, in 56 of whom vacuum-therapy was conducted, were analyzed. The duration of a bandage holding constitutes 1 - 3 days at average. The peculiarities of clinical course, the dynamics of the wounds microbic spillage, cellular content in the wounding prints, phagocytic activity and phagocytic number, the phagocytosis completeness index were estimated and calculated. Application of vacuum-therapy have promoted the earlier cleansing and epithelization of the wounds as well as the tissues reparation occurrence and the laboratory indices normalization.

[The splenic abscess: alternative surgery].

The experience of treatment of patients for splenic abscess, using the abscess cavity puncture and drainage under ultrasonographic guidance, was summarized. The authors consider the method applied as a perspective one, noting, yet, its risks and a need for further studying.

[Non-clostridial epi-fascia phlegmon]. / Neklostridial'naia épifastsial'naia flegmona.

Complex method of surgical treatment of epifascial phlegmon is elaborated. The flaps tailoring and dividing in accordance to anatomic site and its blood supply permits to do radical cleansing and sanitation of focus with mixture of hydrogen peroxide and spirituous solution of iodine preserving the viable skin maximally. In contrast to conventional "stripe" incisions, application of the proposed method permits to preserve the wound from significant lympho--and plasma losses, causing the wound exhaustion, secures the possibility of visual control of the necrotic process course. The wound coverage with cutaneo-subcutaneous flap of the full value assists reducing of the pain intensity. The flap fixation prevents its shortening, that's why good cosmetic effect is noted after the wound healing concludes. Complex program of the necrotic fascitis treatment proposed had permitted to reduce the hospitalization duration of patients twice and to lower the mortality rate more than in 3 times.