[Disputable issues of a gun shot thoracoabdominal injury in tangential wounding].

Experience of a specialized aid practice in thoracoabdominal shearing woundings was summarized. The authors suggest, that tangential, or shearing, woundings occupy rather small place in actual classification of thoracoabdominal woundings. The authors propose classification of their own of such woundings and algorithm of diagnosis and treatment in wounded persons, what would permit to improve the quality of a specialized aid delivery to such patients.

[The influence of peloids from volcanic deposits in Azerbaijan on the dynamics of sugar content in blood and urine and the wound healing in patients at the early stages of diabetic gangrene of the lower extremities].

The treatment of diabetic patients with pyonecrotic lesions in the lower extremities requires prolonged reflexo-segmental balneophysiotherapy to normalize functions of the nerve centres. Curative volcanic mud solutions (15-24 g/l) enriched with organic and nonorganic biologically active compounds from volcanic deposits in Azerbaijan were used for the first time to treat such patients. Peloids were applied to the lumbar region (location of sympathetic nerve nodes) and the lower legs above and beneath the affected sites. The patients were subjected to 12-15 seances of peloidotherapy (at 40-41 degrees Celsius) each lasting 20-30 minutes. The treatment was preceded by wound sanation using the standard procedure and a course of antibiotic therapy based on individual antibiotocograms. A total of 86 daibetic patients with leg gangrene underwent rheovasographic thermovision examination that revealed enhanced blood supply to the affected extremities under the action of the applied peloids. Peloidotherapy resulted in the normalization of blood and urine glucose levels in 53 (63%) of the patients. Simultaneously, the doses of medicamentous therapy could be lowered. Wound and ulcer healing was completed in the majority of the patients (86%) by the end of balneophysiotherapy when fresh granulation tissue began to develop and signs of oedema to disappear. These patients no longer needed amputation.

[Intraoperative dilatation of the ilio-femoral segment combined with reconstructive operations on the femoral arteries in "multi-level" lesions in patients from the risk group]. / Intraoperatsionnaia dilatatsiia podvzdoshno-bedrennogo segmenta v sochetanii s rekonstruktivnymi vmeshatel'stvami na bedrennykh arteriiakh pri "mnogoétazhnykh" porazheniiakh gruppy riska.

The authors analyse experience in the treatment of 96 patients at an increased risk of intervention. Ischemia of the lower extremities with relatively maintained peripheral vascular bed was the main criterion of an indicated operation. The malleolar systolic pressure index of at least 0.35 +/- 0.15 was considered essential in this case. With consideration for the risk, the interventions were carried out mainly under peridural anesthesia. Intraoperative dilatation of the iliac arteries was conducted under radiotelecontrol in combination with profundoplasty, thrombendarterectomy from the femoral arteries, and femoropopliteal autovenoplasty. The efficacy of the operations was appraised by intraoperative angiography, electromanometry, and blood flow measurement. The results were studied in follow-up periods of up to 3 years. In the group of 96 patients 8 had poor results. Amputation of the extremity was performed in different periods.