[Histological manifestations of the sparing effect of cooling in heat dissection of the cerebral cortex and liver]. / Gistologicheskie proiavleniia shchadiashchego éffekta kholodovoi zashchity pri teplovom rassechenii kory bol'shogo mozga i pecheni.

A new method of heat dissection of tissues combined with application of cooling was studied experimentally in white rats. Histologic changes of tissues of the cerebrum cortex and the liver wounds were investigated. It was found out that automatic selection of temperature regimen in combination of heat and cold ensured stable effect which was well balanced from the point of view of its depth and prevented overheating of tissues surrounding a wound channel. In comparison with cut wounds the above mentioned method allowed to gain better safety of cells.

[Hemodynamic changes in patients with arteriosclerosis obliterans of the lower extremities after restoration of the circulation]. / Izmenenie gemodinamiki u bo'lnykh obliteriruiushchim arterio- sklerozom nizhnikh konechnostei posle vosstanovleniia magistra'l- nogo krovotoka.

It was established that reconstructive operations allow to adequately reestablish regional hemodynamics, the linear and capacitance velocity of the blood flow along the explant in the group of prosthesis being close to the values of patients in the group of shunting. The data obtained allow to make a conclusion on high efficiency of shunting by the method of transprosthesis aortotomy in patients with obliterating arteriosclerosis of lower extremities.

[Pulse jet administration of liquid in the treatment of suppurative wounds]. / Primenenie pu'lsiruiushchei strui zhidkosti v lechenii gnoinykh ran.

The work presents data on dynamics of microbial dissemination of purulent wounds in the process of surgical treatment with an additional action of the beating jet of liquid and repeated treatment by the beating jet of antibiotics. An analysis of results of healing the wounds has shown efficiency of the method when finishing the surgical treatment of purulent wounds by putting sutures as well as by plastic closure of the wounds.

[Acid-base equilibrium, tissue oxygenation and hemodynamics in arteriosclerosis obliterans after sympathectomy]. / Kislotno-osnovnoi balans, oksigenatsiia tkanei i gemodinamika pri obliteriruiushchem arterioskleroze posle simpatéktomii.

The authors have shown that operation of lumbar sympathectomy increases the skin oxygenation level, increases the volume blood flow in the main arteries and gives rise to positive shifts in metabolic processes in the extremity tissues. The operation is most effective at the 2nd stage of the disease but is getting less effective at the third stage. At the 4th stage of the disease the operation is indicated but with limited necroses of distal parts of the extremity, intact blood flow not less than 40% of the normal, the leg skin oxygenation level higher than 30 mm Hg, shift of blood pH to subcompensated acidosis.

[A shunting method in the aortoiliac segment]. / Sposob shuntirovaniia v aorto-podvzdoshnom segmente.

Results of various kinds of reconstructive interventions in 237 patients with atherosclerotic occlusions of the abdominal aorta and iliac arteries are described. Shunting operations and prostheses in the aortoiliac segment in 76% of the patients give prolonged and considerable improvement of blood circulation in lower extremities. The most favorable results were obtained in patients who had been subjected to reconstructive operations on the aortoiliac segment with transprosthesis aortotomy not requiring an exclusion of the aorta and iliac arteries from blood circulation. There were no severe complications and lethal outcomes in this group of patients. The amount of thromboses decreased markedly, intestinal pareses were less frequent, the volume of blood transfusions became less and operations shorter.

[Oxygen tension in tissues of the extremities during lumbar sympathectomy]. / Napriazhenie kisloroda v tkaniakh konechnostei vo vremia poiasnichnoi simpatektomii.

Measurements of oxygen tension in the lower extremity skin in patients with obliterating atherosclerosis has revealed the basal decrease of tissue oxygenation. Lumbar sympathectomy caused a temporary aggravation of regional hypoxia resulting from reflex responses to mechanical irritation of autonomic ganglions during operation. A preliminary injection of pentamine, blockade of lumbar ganglia with novocaine, sparing technique of ganglionectomy considerably reduced or even prevented hypoxic reaction of tissues. The efficiency of the operation is dependent on the degree of basal arterial ischemia, stage of the disease and technique of performing sympathectomy.

[Late results of reconstructive operations on the abdominal aorta and iliac arteries]. / Otdalennye rezul'taty rekonstruktivnykh operatsii na briushnoi aorte i podvzdoshnykh arteriiakh.

The authors conducted 170 various reconstructive operations on the abdominal aorta and iliac arteries in patients with atherosclerotic lesions in this segment. The late results of surgical treatment were studied in 135 patients in follow-up periods of one to 15 years. In 92 (68.1%) patients the lower extremity was preserved for a lengthy period of time and functioned satisfactorily. The results of bifurcation shunts were better than those of unilateral shunting and endarterectomy. The authors' experience allows the conclusion that the use of Soviet-made vascular prostheses in reconstructive operations on the abdominal aorta and iliac vessels and iliac vessels is fully justified.

[Intestinal ischemia after aortoiliac reconstructions]. / Kishechnaia ishemiia posle aorto-podvzdoshnykh rekonstruktsii.

The analysis of lethal outcomes and complications following the reconstruction of the abdominal aorta and iliac arteries has shown that in the small and large intestines of 6 patients (12,6%) among 225 operated upon there were deep morphological alterations of the ulcero-necrotic type. The main cause of intestinal ischemia and severe enteropareses following the reconstructive operations on the aorto-iliac segment was found to be a continuous hypotonia and reduced capacitance blood flow in the system of celio-mesenterial arteries. Prophylactic measures against hypotensive reactions during the operations and in the postoperative period in combination with peridural blockade, decompression of the intestine, administration of sorbitol and other drugs are of great significance in the prevention of intestinal ischemia, severe postoperative gastro-enteropareses following reconstructive operations on the abdominal aorta and iliac arteries.

[False aneurysms after prosthesis of the abdominal aorta and major arteries]. / Lozhnye anevrizmy posle protezirovaniia briushnoi aorty i magistral'nykh arterii.

In 170 restorative operations performed by the authors false aneurisms made their appearance in 8 patients (4.7%) within 1 month--8 years after plasty. In 7 patients false aneurisms were formed in the area of anastomosis of the prosthesis with the femoral artery; in one patient there was an aneurism of the autovenous graft. Five patients with false aneurisms after rposthezing the abdominal aorta and main arteries were subjected to repeated reconstructive operations. The effect was good in four of them.

[Suppurative complications after prosthesis of the abdominal aorta and main arteries]. / Gnoinye oslozhneniia posle protezirovaniia briushnoi aorty i magistral'nykh arterii

The classification of a local wound infection, developed after reconstructive operations on the abdominal aorta and its distal branches, is given. Among 245 reconstructive-restorative procedures there were 14 cases of deep local wound infection associated with an exposure of vascular grafts. A system of measures for prevention of infectious complications has been elaborated. It comprised strict observation of the asepsis rules, an improvement of the technic of surgical intervention, lessening of the duration of surgery and blood loss. Special attention is given to the technic of closure and management of vascular wounds, prophylactic application of antibiotics of a wide spectrum of action. In development of the wound infection it seems rational to accomplish an active drainage of the wound with local and general administration of massive doses of specific antibiotics, proteolytic enzymes, antiseptics and then to close a vascular graft by viable tissues. Should these measures fail, then a bypass shunting and removal of the infected prosthesis is indicated.