[Quality of life of patients at late terms after surgical treatment of complicated forms of diabetic foot syndrome].

Quality of life were explored in an open prospective controlled study in 116 patients with complicated diabetic foot syndrome (experimental group) and 30 diabetics without this syndrome (control group) by questioning of quality of life (questionnaires SF-36, Functional Scale of Lower Extremity) in long terms (6-18 months) after surgical treatment. Advantages of foot "saving" resections in surgical treatment of complicated diabetic boot syndrome were detected: patients without amputations had the physical wellbeing score and the Functional Scale of Lower Extremity number, comparable with the group of diabetics without diabetic foot syndrome. The integral mental wellbeing scores were low in all observed groups of patients.

[Results of duodenal non-formed lateral fistulas treatment].

Results of treatment of 66 patients with non-formed lateral fistulas of the duodenum by the methods of active external and double (external and internal) drainage of the fistula zone, and more rarely--by passive drainage or obturation were analyzed. Lethality of the patients was 35.4%. The lethality of the patients was shown to directly depend on the spreading of purulent complications of fistulas of the duodenum up to 87.5% with a combination of diffuse peritonitis and retroperitoneal phlegmon. The immediate causes of death of the patients with lateral fistulas of the duodenum were severe abdominal sepsis due to spacious purulent lesions of the abdominal cavity and retroperitoneal fat, more rarely--profuse erosive bleedings from the fistula zone.

[Decision on the operative approach and volume of interventions in patients with tubular intestine fistulas].

Results of operative treatment of 93 patients with tubular small and large intestine fistulas were analyzed depending on the operative access and volume of interventions. In the postoperative period incompetence of the intestinal anastomosis and recurrent intestine fistulas are found more often in the group of patients with not removed causes of maintenance of the fistula persistence. These complications are rarer in patients operated from the bordering access with liquidation of the cause of long existence of the fistula. The liquidation of the persistence causes and operative access some distance away from the external opening of the fistula resulted in the absence of incompetence of the intestinal anastomosis and recurrent fistulas.

[Staged treatment of patients with external small bowel fistulas].

Results of staged treatment of small bowel fistulas in 115 patients were analyzed. Staged treatment of 21.7% of patients resulted in healing the fistulas without operations. Modern methods of nutritional maintenance were shown to allow surgical restorative treatment to be performed in the optimal period in 82.2% of patients. The number of postoperative complications and lethality rate were reduced to 5.6%, general lethality to 7.8%.

[Indications and contraindications to extraperitoneal closing external intestinal fistulas].

Prognostic factors of recurrent external intestinal fistulas after extraperitoneal closing them were studied in 74 patients operated on in the Sverdlovsk region clinical hospital N1 in 1990-2004. There were no lethal outcomes. Good results were noted in 40 out of 74 (54.05%) patients. Postoperative complications developed in 34 (45.95%) patients, including 21 (28.38%) recurrent intestinal fistulas. Using the methods of mathematical analysis it was found that the recurrent intestinal fistulas resulted from persisting inflammatory alterations in the tissues of the peritoneal and intestinal walls and also from appearing due to operation mechanical injuries of patency of the intestine canal in the places of suturing the fistulas or the initial ones - in the abducent parts of the intestine. The indications and contraindications are proposed concerning the using, rational technical means of extraperitoneal closing the external intestinal fistulas.

[Dynamics of thickness and width of the scar after suturing the wound of the stomach wall with different methods of external protection of the penetrating suture in an experiment]. / Dinamika tolshchiny i shiriny rubtsa posle ushivaniia ran stenki zheludka s razlichnymi sposobami naruzhnoi zashchity skvoznogo shva v éksperimente.

The results of morphometric study of the effect of one-row penetrating suture external protection with musculoserous sutures, flap of the great omentum on vascular peduncle, surgical glue "Sulfacrilat" and collagenic explant "Sanguicol" in necrotic gastric wounds of 79 rabbits were represented. Single orientation of dynamics of the scar width and thickness under protection with the great omentum flap, surgical glue and collagenic explant and peculiarities of their dynamics in peritonization with musculoserous sutures were demonstrated. In submucosal coat the scar width was shown to exceed those in muscular one during initial period of the intervention and heterochronous convergention of the scar width in the gastric wall layers dependent on the method of external protection was discovered as well.

[Changes in the size of the stomach and its sections in human early postnatal ontogeny]. / Izmenenie razmerov zheludka i ego otdelov v rannem postnatal'nom ontogeneze cheloveka.

The present study represents findings of the examination of change dynamics in dimensions of human stomach and its regions since birth up to the age of 6 months, carried out in cadavers of 40 children using methods of parametric and nonparametric statistics (newborns, below 2 months of age, 2-4 and 4-6 months) according to the results of relative and absolute dimensions of measurements. Differences in parameter growth for anatomical regions of stomach were found. Heterochronous pattern of the stomach (cardial and pyloric) regions increase were found together with the presence of 2 (2 and 4-6 months) periods of intensive growth and the period of the delayed growth (2-4 months).

[A method for the differential staining of muscle and connective tissues from organs and their complexes]. / Metodika differentsial'noi okraski myshechnoi i soedinitel'noi tkanei organov i ikh kompleksov.

The method of differential staining of muscles and connective tissue in the genitourinary organs (urinary bladder, ureters, renal pelvis) and gastrointestinal tract is suggested. The method consists of the intermittent use of known tissue van Gieson dyes (picric acid and fuchsin). When applied at pH = 7.2-8.0 (phosphate or citrate buffer) they stain the connective tissue in red and muscles in gold-yellow colour. A saturated solution of picric acid was mixed at equal proportions with water-free glycerol. Fuchsin was taken as 0.3% buffered solution or as 1% solution applied on the organ intermittently with picric acid. The organs, before staining, are fixed in 0.3 alcoholic solution of carbonic acid.

[Method of protecting of sutures in the stomach and intestines]. / Sposob zashchity shvov na zheludke i kishechnike.

The authors have developed and described the method for intraoperative prophylaxis of complications caused by incompetence of the sutures on the stomach and bowels. It consists in closure of the sutures along the line of contiguity by two-layers of compact-porous collagenous explants, which possess antibacterial properties, the period of resorption in abdominal cavity being 15-20 days. The characteristics of the explants are presented and their advantages compared to commonly used methods covering by pellicle or glue film peritonization by sero-muscular sutures. Application of collagenous explants from "Sanguicol" preparation in surgical treatment of 155 patients with external intestinal fistulas, compared to peritonization by sero-muscular sutures (66 patients), has demonstrated a high effectiveness of proposed explants in prevention of postoperative intraabdominal complications.