[Analysis and working data of day hospital of district consultation-and-diagnostic out-patient hospital].

The article is devoted to organization and establishment, aims and capacity rates of day hospital of district consultion-and-diagnostic out-patient hospital. 7894 patients were treated in the day hospital during 2007-2011. Percent of patients treated in therapeutic department--65.3%, surgical department--16.7%, neurologic--18%. Length of hospital stay in average is 9.3 days. It is shorter than the length of hospital stay in specialized departments of the hospital. Average cost of stay in day hospital is 380 rubles. The price of stay in day hospital is significantly lower cheaper than in hospital. Except cost cut of treatment and rehabilitation, payments of temporary and permanent disability are diminished due to reduction of treatment terms in case of achievement of therapeutic effect. Also bed capacity of hospital gets free.

[Specialized surgical aid for combined burn trauma in armed conflicts in Northern Caucasus].

The article presents the experience of delivery of specialized health care to injured persons with combined ambustions during battle actions on the territory of Chechenian Republic (1994-1996, 1999-2002). It was effectuated the analyze of delivery of health care in 202 cases of combined ambustions, wherein the ambusions is predominates: 87 in 1994-1996 and 115 in 1999-2002. In the structure of sanitarium losses the burned took 4.1% and 6.4%, in accordance. During different periods of battle actions combined ambustions took from 11 to 24% of all burns. Active surgical tactics of treatment of injured with combined ambustions, based on using of small-invasive methods of diagnostics and treatment, permits to degrade general lethality from 13.5 to 7.3%, and lethality between injured with middle and hard degree of gravity on 19 and 14% (p < 0.05). It's showed that it is wise to use a group of specialized medical aid on single direction for delivery of health care to injured with combined ambustions.

[Ways of optimization of air-medical evacuation of wounded and ill patients during the armed conflict].

The article is devoted to the experience of airmedical evacuation struck during operations in territory of the Chechen Republic of 1999-2002. We consider, that optimal medical-evacuation system in local wars, local fight actions and battles consists only two stages, then victim after first physician aid is evacuated to specialized medical unit. Own experience of preflight preparation and support is generalized and analysed at carrying out of airmedical evacuation of 928 critically wounded patients and the struck on tactical, operative and strategic levels during a confrontation in territory of the Chechen Republic (1999-2002).

[The modern approaches to the choice of infusion agents used in the treatment of severe injuries and burns].

The article presents an analytical review of modern possibilities of the complex pathogenic treatment for severe traumas and injuries at the expense of systemic use of infusion drugs with antihypoxic and antioxidant effects. It is shown that hypoxia and oxidative stress is the typical; pathologic process that accompanies the development of traumatic disease during severe surgical pathology. One of the effective ways to correct the developing disorders is to use the regulatory or substrate antihypoxants as well as the drugs with antioxidant effect.

[Analyses of the competitive ability of military clinical-prophylactic institutions and the quality factor of medical care].

As a result of research it is proved, that the most significant factors of competitiveness are quality of rendered medical services. All can be estimated the necessary parties of quality on the basis of medical standards. The technique of an estimation of quality of out-patient medical aid consists in comparison of the standard of groups of parameters of quality (diagnostics, treatment, results), considering their factors of weightiness) with real data of concrete patients.

[Combined and multifactorial burn injuries in military conflicts: tactical approaches to diagnosis and treatment].

The article reflects the experience of the treatment of the servicemen with combined burn injuries got in the Chechen Republic (1994-1996, 1999-2001). 266 causes of medical treatment for combined injuries where the burn was decisive were analyzed: 141 of which were got in the Chechen Republic in 1994-1996, 10 - in Daghestan in August-September of 199 and 125 - in the Chechen Republic in 1999-2001. In the structure of sanitary losses with surgical profile the burnt amounted to 4,1%, and 6,4%. The development of the medical treatment system made it possible to reduce lethality from 13,5% to 7,5% (P < 0,05). The optimal option of the medical evacuation organization in local military conflicts and wars is a two-stage scheme of evacuation, the first stage is premedical care ann the second is qualified (specialized) medical care.

[Towards the problem of necessity to reduce the medical evacuation stages in conditions of local wars and armed conflicts]. / K voprosu o neobkhodimosti sokrashcheniia étapov meditsinskoi évakuatsii v usloviiakh lokal'nykh voin i vooruzhennykh konfliktov.

The article is devoted to the review of modern opinions concerning the experience of military operation medical support in conditions of local wars and military conflicts. On the base of analysis of medical assistance rendered to the wounded and casualties in Republic of Chechnya the advantages and defects of different approaches are discussed. The experience in rendering assistance to the casualties in the Armed Forces of NATO countries during the local wars for the last decades is discussed. It is shown that the optimal variant of organization of treatment-and-evacuation measures during the local armed conflicts and wars is the two-stage scheme of evacuation: the first medical aid--the qualified (specialized) medical aid.

[Experience of organization of the skilled and emergency specialized surgical care rendered during the armed conflicts in the North Caucasus]. / Opyt organizatsii kvalifitsirovannoi i neotlozhnoi spetsializirovannoi khirurgicheskoi pomoshchi v vooruzhennykh konfliktakh na Severnom Kavkaze.

At present the hepatosurgery in the Vishnevsky Central Military Clinical Hospital has become one of the most perspective and rapidly developing directions of the surgery. The authors present the review of hepatosurgery development in the hospital with the detailed analysis of treatment results at each stage of development, the description of technical support of the new methods for conducting the complex operations on liver. For the short time (since 1991) we have passed the way from atypical hepatic resections up to the liver autotransplantation. The importance of additional surgical manipulations and procedures facilitating the surgery, the postoperative period and improving the operation results are underlined.

[Experience in organizing the surgical work of a garrison hospital in an armed conflict]. / Opyt organizatsii khirurgicheskoi raboty garnizonnogo gospitalia v vooruzhennom konflikte.

The authors have summarized organizational experience of surgical work of garrison military hospital strengthened with specialized brigades during the period of armed conflict in Republic of Dagestan (August-September, 1999). From the start of active actions in order to render assistance specialized surgical teams from district military hospital equipped with special kits (at the rate of 7 operations/day during a week) were sent to garrison hospital. In this armed conflict there are features characterising both mine-and-explosive war in Afghanistan and sniper war in Chechen Republic resulting in increase in the number of seriously wounded (up to 46.7%) casualties during Botlikhskii operation constituted 1:4, Novolakskii (Kadarskii)--1:5. Bullet injuries were fatal in 49.4% of the cases, fragmentation (including MET)--50.6%. During 1.5 month of hospital work there were performed 303 surgical interventions. 22.7% of slightly wounded from local garrisons were treated in garrison hospitals. Treatment results--postoperative lethality in gunshot trauma at the given stage constituted 1.1%.