[Scientific, pedagogical, and surgical work of professor V.F.Voyno-Yasenetsky during the Great Patriotic War].

The article is devoted to activities in the period 1941-1945. Krasnoyarsk and Tambov, a professor of surgery Valentine Feliksovich Voyno-Yasenetsky (Archbishop Luka)--doctor of medical sciences, laureate of the State (Stalin) Prize of the USSR, who made a significant contribution to the success of modern surgical science. A brilliant scholar and successor of the ideas of the outstanding scientist and surgeon Nikolai Pirogov, as in the Great Patriotic War surgeon and consultant evacuation hospitals, along with leading surgeons in the Soviet Union had a significant impact on the results of treatment of wounded soldiers and officers, thereby affecting the development of military field surgery. In our country it is rightfully considered the founder of contaminated surgery.

[Valuation of effectiveness of optimized algorithm of diagnostics and treatment of acute pancreatitis].

The work is founded on the results of examination and treatment of 1242 patients with acute pancreatits in 1991-2007. There was compared results of diagnostics and treatment of 520 patients in 1991-1999 (group of comparison) before insertion of protocols of diagnostics and treatment of acute pancreatitis and after their insertion and optimization - 722 patients in 2000-2007 (main group). Compared groups are equitable in all categories. It's determined that that after insertion of standardized algorithm of diagnostics and treatment of acute pancreatitis in the work of surgical units of the 442nd Regional military clinical hospital of Leningrade military region, it was achieved a decrease of general lethality in conditions of this disease from 8.8% in group of comparison to 3.4% in main group (p<0.05). In conditions of sthenic acute pancreatitis after-operational lethality decreased from 39.6% to 23.1%, and general lethality - from 33.3% to 15% (p<0.001).

[The local use of Aubazipor for treating suppurative wounds]. / Mestnoe primenenie "Aubazipora" dlia lecheniia gnoinykh ran.

An experience with using Aubazipor for treatment of patients with purulent wounds of soft tissues is presented. A preparation in the form of a porous plate was used for the stimulation of reparative processes on the purulent wound. The effectiveness of Aubazipor is due to the mechanical cleansing of the wound surface from pyo-necrotic masses, to a decreased amount of microbe bodies in the purulent wound. Aubazipor brought about the maturation of the granular tissue, more rapid concentric scarring, shorter terms of healing and improved outcomes of treatment of purulent wounds.

[Characteristics of chemotherapy of infectious diseases associated with gunshot wounds and trauma]. / Osobennosti khimioterapii infektsionnykh zabolevanii v sochetanii s ognestrel'nymi raneniiami i travmami.

The experience in treating infectious diseases in wounded and traumatized persons from the contingent of the Soviet Troops in ++Afghanistan is described. The syndrome of the joint effect of the injury and infection is characterized. Features of the chemotherapy of the injured patients with viral hepatitis, malaria, typhoid fever and enteric and ++extra-enteric amebiasis under the ecological and professional stress and with an account of the etiology of the wound infection are presented. The favourable effect of the developed methods for chemotherapy of the joint affections was shown.

[The classification of penetrating gunshot wounds of the abdomen]. / O klassifikatsii ognestrel'nykh pronikaiushchikh ranenii zhivota.

The present-day classification of gunshot penetrating abdominal wounds has a several number of limitations, namely: sometimes it is difficult to classify correctly the gravity of wounds, thus patients with different gravity status frequently form the same group of wounded. The authors propose to concretize the existing classification. A new variant will provide for a straight definition between the groups, the wounded who belong to the same group could be comparable in their gravity status. Generally, this new classification give a more complete and precise notion concerning the character of modern gunshot penetrating abdominal injuries.

[The surgical aspects of the lessons of the war in Afghanistan]. / Khirurgicheskie aspekty urokov voiny v Afganistane.

There were no two identical wars in human history. From the medical point of view, the civil war, which is still going on in Afghanistan, also has its own face. The structure of sanitary losses, the character, gravity, and peculiarities of gunshot pathology give the possibility to call it as a mine war, because of its massive and, above all, effective mine warfare. The war in Afghanistan conclusively proves the predominance of blast injuries over other sanitary losses in the structure of combat surgical pathology, that may be considered as a common feature for the wars of century XX. The mine blast trauma must be regarded as a combat heavy concomitant trauma or gunshot blast polytrauma. This statement is the basic one for the rest of medical lessons gained from the war in Afghanistan. Using the comparative analysis of the different functions of medical service of two armies, the article shows the priority of organizational aspects for care and treatment of the wounded in war.

[Antibiotics in the treatment of wounds in the victims of the earthquake in the Armenian SSR]. / Antibiotiki v lechenii ran u postradavshikh ot zemletriaseniia v Armianskoi SSR.

Purulent wounds in 88 victims of the Armenian earthquake with the syndrome of long-term squeezing were examined microbiologically and the experience with using antimicrobial drugs for their treatment was analyzed. In all the cases microbial associations were detected, coliform and nonfermenting gram-negative bacilli, enterococci, anaerobes and yeast-like fungi being isolated from 80, 20, 15 and 25 per cent of the patients respectively. 130 bacterial strains were studied in detail. 80 to 100 per cent of the bacterial isolates were resistant to the antibiotics routinely used in surgical practice, i.e. benzylpenicillin, tetracycline, levomycetin, kanamycin, cephalothin and cefazolin and highly sensitive to new antimicrobial drugs belonging to ureidopenicillins (mezlocillin), quinolones (ciprofloxacin) and cephalosporins of the 3rd generation (cefoperazone and ceftazidime). Retrospective estimation of the antibiotic therapy revealed its inadequacy in 55.7 per cent of the patients for the most part because of the isolates resistance. The 19 variants of the antibiotic use prescribed by the physicians mainly included penicillins, aminoglycosides and their combinations (in 67.2 per cent of the cases). The use of the highly efficient drugs of the groups of ureidopenicillins and quinolones was extremely rare which was likely due to lacking of information on the drugs.

[Characteristics of surgical tactics in rendering specialized services to the victims of the earthquake with long-term crush syndrome]. / Osobennosti khirurgicheskoi taktiki pri okazanii spetsializirovannoi pomoshchi postradavshim ot zemletriaseniia s sindromom dlitel'nogo sdavleniia.

Mass admission of patients with the crush syndrome to ++non-profile medical institutions allowed to detect three clinical forms of the crush syndrome. Adequate methods of surgical treatment are proposed for each of them.

[Effect of cystamine on the morphology of gunshot wound healing (a light and electron microscopic study)]. / Vliianie tsistamina na morfologiiu zazhivleniia ognestrel'noi rany (svetoopticheskoe i élektronno-mikroskopicheskoe issledovanie).

Electron microscopy and histochemical tests were used to study the effect of cystamine on gunshot wound healing in experiments on 24 rabbits. Cystamine was established to speed up maturation of the granulation tissue, epithelization of the wound surface and to make the period of gunshot wound healing 4-5 days shorter.

[Morphology of healing of an experimental gunshot wound following primary surgical treatment]. / Morfologiia zazhivleniia ognestrel'noi rany posle pervichnoi khirurgicheskoi obrabotki v éksperimente.

The time-course of healing of a perforating gunshot wound of soft tissues after primary surgical treatment was studied histologically, histochemically and electron microscopically in 24 rabbits. Throughout the observation period (1-28 days) disorders of the microcirculation, inflammatory reaction, degenerative and necrotic changes, disorders of the ultrastructure and metabolic processes in cells were observed in the wound tissues. Morphological changes developed in the zone of molecular concussion the presence of which delayed healing of the gunshot wound and reduced the efficiency of the primary surgical treatment. The experimental results extend current knowledge of the morpho-functional features of healing of gunshot wounds and indicate the proper choice of rational methods for surgical treatment.