[The value of surgical experience gained during the Great Patriotic War for the modern military surgery].

The surgical experience gained during the Great Patriotic War (1941-1945) is a basis of the modern Russian military surgery, which allows providing any options for surgical care to the wounded. The article describes the main achievements of the military surgeons in our country during the Great Patriotic War, which helped the Soviet (Russian) military field surgery to achieve a leading position in the world of military medicine. The role of the united martial medical doctrine, three editions of "Guidelines for the military surgery", the qualified surgical assistance as a mean that helped to deliver surgical care to the wounded, the introduction of specialized medical care, technology development of medical triage, as well as the origins of the tactics of a multi-stage surgical treatment of combat trauma and special treatment of minimally wounded during the war. The problems in establishing registers of combat injuries. and training military surgeons are analysed.

[PIECETIME BURNS. SOURCES OF DANGER].

We analysed 54 foreign publications concerning sources of danger of thermal injuries inflicted in pieacetime. The negative effect of alcohol consumption is emphasised. Special attention is given to the necessity of safety measures when makingfire by people engaging in leisure activities and to the cases of chemical burns resulting from aggressive attacks of third persons. Certain authors report marked cicatrical deformities developing after skin restoration. A variety of sources of danger necessitates the development and introduction of effective of socio-legislative normatives designed to reduce the occurrence of thermal injuries.

[The set of wearable medical equipment for medical and nursing teams].

The kit is designed in accordance with the list of the first medical aid procedures and syndromic standards of emergency medical care providing. The kit contains modern local hemostatic agents, vent tubes, cricothyrotomy, needles to eliminate pneumothorax, portable oxygen machine, sets for intravenous and intraosseous infusion therapy, collapsible plastic tires, anti-shock pelvic girdle, and other medical products and pharmaceuticals. As containers used backpack and trolley bag on wheels camouflage colours. For the convenience and safety of the personnel of the vest is designed discharge to be converted in the body armour.

[Surgical service at the Central Military Hospital of People's Commissariat of Defence shortly before the Great Patriotic War].

Authors present the article historical data on the foundation and development of surgical service at the 1st Therapeutic Red Cross Hospital (Central Military Hospital of People's Commissariat. of Defense) since its organization. The structure of the hospital surgical service and organization of surgical activity during the pre-war years is presented. Provided information about outstanding surgeons who was working in the hospital.

[Scoring of severity of patients' condition with acute surgical diseases and injuries of the abdominal cavity].

Ten of the most frequent symptoms that do not require special methods of their determination except general clinical examinations established by any health care professional on pre-hospital stage were determined on the basis of analysis of more than one thousand records of patients with acute surgical abdominal diseases and clinical symptom load. The authors performed an assessment of each symptom depending on severity of patient's condition ranging from 1 point (satisfactory condition) till 5 points (critical condition). Information has been obtained: in case of satisfactory condition--up to 10 points, moderate--up to 20 points, heavy--up to 30 points, extremely heavy condition--up to 45 points and terminal condition--more than 45 points. Thus, conditional descriptive method of assessment of patient's condition during the clinical examination is combined with objective-scoring. The given method combines numeric expression with methods accepted in literature--"MFS-CA", "APACHE II" and allows to perform an objective assessment of the treatment process at different stages, to practice health care standards, to perform an analysis of outcomes. The article provides tables, which substantiate proposed method.

[The use of plasma surgery in military medicine].

Scientists have been carrying out plasma energy research with the aim to apply to surgical practice. Domestic plasma devices "SUPR-M", "Fakel-01", "Gemoplaz-VP" and "Plazon" passed tests and were approved not only in clinical practice but also in condition of armed conflicts. Biological influence of air-plasma flows on tissues was examined. Nitrogen oxide (NO) is continuously produced in humans and animals involving enzymatic NO-synthase (NOS), acting as a universal regulator of diverse biological and physiological processes. Comparative analysis of the treatment of gunshot wounds and infectious complications clearly demonstrated the efficacy of using plasma flows at the final stage of surgical treatment. Use in military surgery, oncology, urology and gynecology, thoracic and abdominal surgery should be considered as a promising direction of this technology.

[Peculiarities of diagnostics of hyperplastic processes in endometrium during long postmenopause].

Comparative characteristics of hyperplastic processes are presented based on the results of ultrasound and postoperative histological studies. The informative value of ultrasound diagnostics of hyperplastic processes in endometrium during long postmenopause was estimated at 60%. Up to 40% of such diagnoses were not confirmed by histological studies of the material obtained by differential curettage of cervical canal and uterine walls. No evidence of the influence of human factor (diagnostic error) was obtained.

[Hyperplastic processes in endometrium of women during prolonged menopause].

A total of 651 patients were available for observation during prolonged menopause. It was shown that fibrous-glandular polyps of endometrium occur much more frequently in such women than glandular and glandular-cystic hyperplasia (54.37 and 2.91% respectively). Prolonged menopause changes the relationship between the causes of hyperplastic processes with decreasing influence of hyperestrogenism in combination with disturbances of lipid and carbohydrate metabolism (from 60-70 to 6.7%) and increasing atrophy (from 30-40 to 93.3%). Ultrasound examination of small pelvis organs is obligatory in these patients even if it is fraught with hyperdiagnostics of endometrium pathology.

[Diagnostics of Achilles tendon ruptures].

This review is concerned with diagnostics, surgical and orthopedic treatment of fresh and long-standing Achilles tendon rupture. Despite seemingly easy diagnostics, different authors indicate that 15-29% of Achilles tendon rupture escape timely recognition which leads to inadequate treatment and its poor outcome. Hence, the importance of clinical tests permitting to improve diagnostics bearing in mind that such expensive methods as MRT are not readily available. We describe all (to our knowledge) clinical tests for the purpose as well as X-ray, ultrasonic, and MRT diagnostics (including differential) of Achilles tendon rupture.

[Surgical strategy for the treatment of complicated cholelithiasis in elderly and senile patients].

The author summarizes results of the treatment of 140 elderly and senile patients with complicated cholelithiasis divided into 2 groups using scales for the assessment of their clinical condition and prognosis of treatment outcome. Patients of groups 1 and 2 were given single- and multistep treatment respectively. It is concluded that differential approach to the treatment of complicated forms of cholelithiasis in elderly and senile patients permits not only to evaluate their condition but also to use the least invasive procedures for resolution of the biliary obstruction and thereby to reduce the risk of complications and fatal outcome.

[Infectious complications of combined injuries in large-scale catastrophes].

Main forms of infectious complications and their causes in large-scale catastrophes and baseline conditions were studied based on examination of 1463 casualties with combined injuries. The following parameters were analysed: mean injury severity (ISS and APACHE-II systems), shock severity, and blood volume deficit. The frequency of infectious complication of combined injuries was estimated with reference to severity of the major trauma and the number of affected body regions. Infectious complications were diagnosed in 46.6 and 30% of the casualties of natural cataclisms and car accidents respectively. They included wound suppuration (23.8%), osteomyelitis (17%), acute abscess (12.9%), sepsis (7.7%), and progressive peritonitis (6.7%). The incidence of complications directly correlated with the severity of injuries and shock, general conditions of the casualties, the character of the major injury, and the number of affected body regions.

[Usage of the neutral anolyte for trophic ulcer treatment in patients with postthrombophlebitic syndrome].

The results of the treatment of 38 patients with trophic ulcers of lower limbs developed against the postthrombophlebitic syndrome at the age of 43-73 years. The course of a disease exceeded 10 years. Trophic ulcers recrudesced in all patients, timeline of its appearance was 2.4 +/- 0.5 months. Daily trophic ulcers were irrigated by the neutral anolyte, it took from 5 to 7 sessions. The detersion of trophic ulcers came on the 3rd-4th day; granulation tissue appeared on the 5th day. The absence of bacterial population was noted in 89.5% of patients after 5.0 +/- 0.5 sessions. Trophic ulcers were epithelialized in 1 month, while in the group of comparison the whole epithelialization came only in 32% of patients.

[Rendering surgical care for the wounded presenting with injuries to limb vessels].

The proffered paper provides the information about rendering surgical care for the wounded presenting with vascular injuries inflicted and sustained during wars Russia was engaged in, to be followed by a detailed description of the haemorrhage-arresting methods and techniques used in N. I. Pirogov's time, during World War I, the Great Patriotic War, as well as in local military conflicts and combat operations. Also depicted herein is the role surgeons of Russia have played in the development of vascular surgery, and, finally, due coverage is given to the statistical data concerning the methods of rendering care for those having suffered firearm wounds and injuries involving vascular lesions.

[Organization of surgical measure in military hospitals].

The reform of military health service intends a clear organization of medical attendance, and, first of all, surgical one, particularly in military hospitals with different patient capacity. Seeing it leaders of surgery units in medical service got the task to elaborate the standards of realization of surgical attendance for military hospitals with different patient capacity during peaceful time, correctly execute all orders on preparation of military surgeons, enroot new high-quality and expensive types of maintenance into practice. Optimization and standardization of processes of surgical maintenance in Defense Establishment of Russian Federation, of tasks in the sphere of staff politics and of teaching process, modernization of technical equipment of medical service and enrooting new high-quality methods in practice allows augment the effectiveness of surgical attendance in military hospitals with different patient capacity.

[Medicinal and diagnostic laparoscopy in conditions of appendicitis].

The article presents the results of analyze of diagnostic laparoscopy on the example of 1028 patients with clinical characters of appendicitis, diagnosis of 682 patients (66.3%) is conformed. 667 patients (99.3%) had transformation of laparoscopy from diagnostic to medicinal. Postoperative prearranged sanitational laparoscopy was conducted with 28 patients (4.5%), including 1 time--21 patients, 2 times--6 patients, 3 times--patient. 24 patients had different complications (intraperitoneal hemorrhage, commissural and paralytic terminal ileuses, abscesses and infiltrates of abdominal cavity, infiltrates of anterior abdominal wall, subcutaneous eventration of small intestinal loop). There were no lethal outcomes. Average day in a hospital in conditions of acute appendicitis is 4.2 day, in conditions of chronic appendicitis--3.1 day.