[Peculiarities of surgical treatment of patients with complicated forms of the diabetic foot syndrome].

There were analyzed the results of surgical treatment of 246 patients, suffering diabetes mellitus, with destructive forms of the diabetic foot syndrome. It was established, that application of an active surgical tactic using cutaneo-adipose flap of their own and cellular culture of fibroblasts on the background of selective prolonged intraarterial complex therapy permits to perform economic amputation of foot, reduces risk of performance of high amputation of the lower extremity and reoperations.

[The prolonged intraarterial medicinal therapy of the destructive forms of diabetic foot syndrome].

The results of surgical treatment of 76 patients. suffering diabetes mellitus with purulent--necrotic affection of the foot. were analyzed. In 48 of them the selective prolonged intraarterial medicinal therapy was conducted. The efficacy of durable application of intraarterial desaggregant and antibacterial therapy was substantiated, permitting to perform predominantly "small" operation on the foot and to save its supportive function in 96% of observations.

[Ways of improvement in surgical treatment of purulent-necrotic complications in the diabetic foot syndrome]. / Puti sovershenstvovaniia taktiki khirurgicheskogo lecheniia gnoino-nekroticheskikh oslozhnenii sindroma diabeticheskoi stopy.

Results of surgical treatment of 168 patients with diabetes mellitus (DM) in the diabetic foot syndrome (DFS) were analyzed. Expediency of operative intervention was substantiated by pathogenic form of affection, its depth and diffusion, composition of microorganisms in purulent-necrotic focus. Performance of more extensive surgical treatment or distal amputation of foot with consequent closure of vast wound defect using full-layer subcutaneous-cutaneous flap with protracted selective intra-arterial anti-aggregate and antibacterial therapy was indicated in order to preserve the lower extremity supporting function and for prophylaxis of diffusion of purulent-necrotic affection. Application of improved tactics and surgical treatment in patients with DFS have allowed to reduce frequency of the lower extremity high amputation performance from 24 to 8.6%.

[Diagnosis of acute intestinal obstruction]. / Diagnostika ostroi neprokhodimosti kishechnika.

The results of treatment of 182 patients with an acute ileus were analyzed. While roentgenography conduction the characteristical signs of the disease were noted in 68.7% of patients and in 31.3% they were absent or mildly pronounced. In the last situation a contrast substance passage was studied, permitting to make a diagnosis in 67.6% of patients.

[Significance of the separate symptoms in acute appendicitis]. / Znachimost' otdel'nykh simptomov ostrogo appenditsita.

On the basis of the experience with treatment of 19,346 patients with acute appendicitis, the authors have established that pain in the right inguinal region, rigidity of muscles of the anterior abdominal wall, and a Volkovich-Kocher symptom were the most informative symptoms. The Shchetkin-Blumberg symptom caused by the development of an inflammatory process in the peritoneum is not an appendicular symptom; the Rovzing, Voskresensky, Obraztsov symptoms, not being the specific symptoms of acute appendicitis, are of essential informative value only in combination with the other symptoms of the disease.

[The results of the surgical treatment of femoral hernias by suture-free alloplasty]. / Rezul'taty operativnogo lecheniia bedrennykh gryzh metodom besshovnoi alloplastiki.

A new method of plasty of hernial hilus for femoral hernias is proposed which consists in sutureless fixation of allotransplants made of silicone having the form of a mushroom-shaped element. The transplant gives good and reliable closure of the hernial hilus without changing the interrelation of tissues. The duration of the operative procedure becomes considerably shorter, any injuries of large vessels were excluded as well as the development of ligature fistulas, suppuration of the wounds and recurrent hernias. An analysis of nearest and long-term results of treatment of 68 patients operated upon shows high efficiency of the method proposed.

[Clinico-roentgenological symptoms of acute adhesive intestinal obstruction]. / Kliniko-rentgenologicheskie priznaki ostroi spaechnoi neprokho- dimosti kishechnika.

The clinico-roentgenological signs of acute commissural ileus were analysed in 226 patients. Of them, 192 were operated on. In 6.4% of the patients in plain roentgenography, the signs of acute ileus were absent, in 27.7%--they were not prominent. Study of the barium suspension passage through the small intestine, as the authors consider, is indicated in unmarked clinical features of the disease, and as well in its short duration (less than 6 h) with the aim of establishing a degree of ileus (complete, or partial).