A Model of Acute Peritonitis.

The biological models used in the study of generalized peritonitis can be subdivided into 5 groups (introduction of foreign bodies, cultures of microorganisms, suspensions of feces, chemicals, and mechanical damage to the gastrointestinal tract) or into 4 groups (introduction of foreign bodies, chemicals, bacterial contamination of the abdominal cavity, and combined methods). After analysis of published reports, the most justified classification of methods of peritonitis modelling is based on the type of peritonitis-inducing agent and the administration route and on the nature of peritonitis developing in the abdominal cavity. The choice of the model maximally close reproducing clinical conditions of peritonitis should be based on the specific objectives of the study, focusing on the etiology, pathogenesis, and severity of the disease course, planned measures aimed at eliminating the process, and other factors.

Simulation of Mechanical and Thermal Wounds of Soft Tissues.

Millions of accidental and surgical injuries of soft tissues are registered annually around the world [5]. Untimely and insufficiently effective treatment of wounds in 50-70% leads to the development of purulent-septic infection and the development of septic conditions and fatal outcomes [1-4], which necessitates thorough study of inflammatory and regenerative processes occurring in the injured soft tissues. Various models of mechanical and thermal damage to soft tissues are proposed for studying the inflammatory and reparative processes, for assessing the therapeutic effects and developing new approaches to wound treatment. However, the developed models do not fully meet the requirements of researchers and are not always simple and uniformly reproducible, close to the course of the pathology in humans, and highly reliable. When choosing the model of mechanical and thermal wounds, the experience of other researchers should be taken into consideration due to the need of actualization and improvement of existing models.

ASSESSMENT OF EFFICACY OF THE METHOD OF PROGRAMMED IRRIGATION ASPIRATION SANATION IN COMPLEX TREATMENT OF PATIENTS WITH CHRONIC POSTTRAUMATIC OSTEOMYELITIS OF THE LONG BONES.

The analysis of treatment results of 128 patients aged from 21 to 62 years old with chronic posttraumatic osteomyelitis of the long bones was made at the period from 2006 to 2013. The main group included 67 patients and the method of programmed irrigation aspiration sanation was applied for them. The comparison group consisted of 61 patients and drainage was performed for these patients using the conventional ways. The authors noted good immediate results in the main group in 56 (83,58%) out of 67 patients and in the comparison group - in 43 (70,49%) out of 61 patients. The long-term results were analyzed in 116 (90,6%) out of 128 patients in terms from two to five years after treatment. The rate of recurrences such as formation of purulent fistula were twice less in patients of the main group, than in the comparison group. According to the results of questionnaire SF-36, there was noticed, that patients of the main group got better mean indices of quality of life on all 8 scales compared with the other group.

[Significance of indicator microorganisms in the assessment of a microbial risk in the occurrence of epidemic hazard in drinking water use].

Summary. The paper provides comparative characteristics of water quality in the assessment of a risk for intestinal infections in drinking water use. It has shown that of the greatest predictive value is direct detection of potentially pathogenic microorganisms, as well as the integral indicator determined by glucose fermentation, such as glucose-positive coliform bacteria. Estimation of the per cent of nonstandard samples of water before its entering the distribution network and in the latter, including glucose-positive Escherichia coli GPEC, is recommended. The samples containing GPEC in a quantity of more than 2 CFU/100 ml should be singly taken into account.

[Influence of the temperature regimen of sanitation of the abdominal cavity on the course of the syndrome of post-sanitation intoxication in patients with acute diffuse peritonitis].

The aim of the investigation was to work out and study effectiveness of the method of sanitation of the abdominal cavity in patients with acute diffuse peritonitis based on a combination of using the properties of hypo- and hyper-thermal solutions. The complex of experimental investigations has proved the safe clinical use of the proposed method to be possible, discovered main pathogenetic mechanisms of a positive influence of heterothermy when performing sanitation of the abdominal cavity against the background of acute peritonitis. The results of clinical approbation of the method in 86 patients have shown sufficiently high efficiency of using sanitation of the abdominal cavity in heterothermal regimen in a complex of measures for treatment of patients with acute peritonitis that allowed getting reliably lower degree of post-sanitation intoxication, less number of complications and lethal outcomes.

[Minimally-invasive surgical treatment of perforated gastroduodenal ulcers].

The results of treatment of 249 patients aged 15 to 78 years with perforated gastroduodenal ulcers were analyzed. The study group consisted of 128 patients in whom video-laparoscopic procedure was used for suturing of ulcer, control group -- of 107 patients treated conventionally. Conversion of laparoscopic procedure to open surgery was in 14 cases. It is demonstrated that the intensity of pain syndrome, hospital stay and the number of postoperative complications in the study group were less that in the control group. Indications and contraindications for video-laparoscopic method in these patients were formulated.

[The method of parietal-cavitary sanitation of intestines in complex treatment of acute diffuse peritonitis]. / Metod pristenochno-polostnoi sanatsii kishechnika v kompleksnom lechenii ostrogo rasprostranennogo peritonita.

Experimental investigations carried out in 154 white rats and 24 mongrel dogs have proved pathogenetical effectiveness and safety of using the method of parietal-cavitary sanitation of the intestine in treatment of acute experimental peritonitis. This method used in complex treatment in 28 patients with acute diffuse peritonitis allowed a 1.5-2 times quicker arrest of the syndrome of endogenous intoxication and liquidation of intestinal paresis. Infectious complications were 43% less frequent and the lethality indices were reduced by 9.5% as compared with the results obtained in the control group.

[Use of ozone therapy and hydro-pressure technologies in complex intensive therapy of surgical sepsis]. / Primenenie ozonoterapii i gidropressivnykh tekhnologii v komplekse intensivnoi terapii khirurgicheskogo sepsisa.

Results of treatment of 214 patients with severe sepsis and septic shock were analyzed. 125 patients treated with various methods of ozonotherapy and hydropressive sanation of infectious foci formed the study group. Control group consisted of 89 patients treated according to generally accepted principles. Comparative analysis of treatment efficacy was carried out with numerous laboratory and instrumental study methods. It is shown that ozonotherapy and hydropressive technologies reduced a lethality from 39.2% in the control group to 25.6% in the study group.

[Diagnosis and treatment of liver abscesses]. / Diagnostika i lechenie abstsessov pecheni.

The authors experience in diagnosing and treating 67 patients with abscesses are summarized. The value of different methods of topic diagnosis is analyzed. New approaches to surgical treatment are presented, which involves the use of both open methods (dissection, sanitation and drainage of abscesses) and minimum invasive methods (abscess puncture under ultrasound and video laparoscopy guidance). The new method of assisted minimum invasive surgical treatment of large hepatic abscesses is described. To realize the principle of different approach to choosing treatment method and using new technologies permits improvement of treatment outcomes in these patients.

Modeling of acute experimental peritonitis.

A new method of modeling of acute diffuse peritonitis was designed and tested. The method reproduces clinical picture of severe purulent process in the abdominal cavity with clear phasic dynamics and uniform (in their nature and extent of dissemination) pathological reactions, which improves reliability of experimental data.

[New trends in the treatment of liver abscesses]. / Novye napravleniia v lechenii pri abstsessakh pecheni.

The authors share their experiences with treatment of 85 patients with abscesses of the liver aged from 17 to 83 years. The size of abscesses was from 2.5 to 23 cm in diameter. For the topical diagnostics the following methods were used: ultrasound scanning, computed tomography, scintigraphy, diagnostic puncture biopsy of the liver, laparoscopy etc. Decision between the methods of operative treatment depended on the concrete clinical situation. Both open and minimally invasive methods were used. Hydropressive technologies and ozone therapy were used for better sanitation of the abscess cavity. A new method of the assisted minimally invasive intervention was developed especially for treatment of patients with large abscesses of the liver. The new technologies allowed to reduce the amount of postoperative complications and to make the time of staying at the hospital substantially shorter.

[Treatment of peritonitis using ozone and hydropressive technology]. / Lechenie peritonita s primeneniem ozona i gidropressivnykh tekhnologii.

In the experiment on 144 mongrel dogs and 546 white rats the methods of ozone therapy and hydropressive treatment of the abdominal cavity have been worked out. These methods were used in the treatment of 94 patients aged from 13 to 89 years with severe forms of acute peritonitis. The control group consisted of 174 patients with peritonitis. A high antimicrobial effect was detected in the treatment of the abdominal cavity with microdisperse stream of the ozonated solution under pressure. After 1-2 procedures of the intestinal ozone dialysis the number of microbial bodies in the lumen of the small bowel in 65% of patients has decreased 2-3 times, the terms of elimination of the paresis has decreased 3-4 times, and more rapid dynamics of elimination of the endogenous intoxication syndrome was detected. The application of the developed programme of curative measures promote lowering of the lethality from 62.07% in the control group to 37.23%--in the test one.

[Wound treatment using the flow of an ozonized solution under high pressure]. / Lechenie ran s ispol'zovaniem potoka ozonirovannogo rastvora pod vysokim davleniem.

New method for treatment of infected and festered, among them wounds with lingering healing was developed. The method was based on local application of fine-dispersion ozonized solution stream high pressure. This stream of ozonized fluid is generated under pressure of 350 ATM with the help of "Device for hydro-pressive treatment of wounds", ozonization of the solution is performed by the "OZh-2" apparatus developed by the authors. Application of the method of hydropressive ozonization provides fast cleansing of wound surface from pyonecrotic masses, promotes elimination of infection and thus substantially reduces the period of treatment of the patients.

[Use of thymogen in the treatment of various forms of acute abdominal disorders in an experiment]. / Primenenie timogena v lechenii nekotorykh vidov ostroi abdominal'noi patologii v éksperimente.

The authors have carried out experimental studies of thymogen action on the course of acute pancreatitis and acute peritonitis in white albino rat males. The preparation was introduced into the abdominal cavity early after the modeling and every 24 hours for 5 days. The results of the trial demonstrate that the degree of autoenzyme aggression (the data of blood serum alpha-amylolytic activity control) and the content of lipid peroxidation products (assessment of malonic dialdehyde quantity in tissue homogenate) were low in the experimental group as compared to the untreated animals. In the experimental group less pronounced depression of antiradical activity (superoxide dismutase and catalase activity control) was found, leukocytosis and leukocyte intoxication index were diminished. Thus, the efficiency of thymogen in acute inflammatory and destructive abdominal diseases has been proved.

[Complex program of detoxication measures in terminal peritonitis using ozone and hydropressive technologies]. / Kompleksnaia programma detoksikatsionnykh meropriiatii pri terminal'nom peritonite s ispol'zovaniem ozona i gidropressivnykh tekhnologii.

Different methods of ozone therapy and hydropressive technologies were used in the treatment of acute diffuse peritonitis, including hydropressive sanitation of the abdominal cavity, intestinal ozone therapy, etc. These methods brought about many good effects, improving the outcomes for this patient population in general.