[Vacuum-assisted laparostomy in complex treatment of patient with peritonitis and internal biliary fistula].

Negative pressure wound therapy (NPWT) is one of the newest methods used in the treatment of wounds. It allows speeding up and optimizing the healing process and reducing the cost of treatment. Negative pressure stimulates proliferation of granulation tissue, provides a continuous evacuation of fluid and effectively cleans wound surface. The authors introduce the reader to the results of treatment of patient with peritonitis and internal duodenal fistula using a vacuum-assisted laparostomy.

[Haemodynamic and clinical efficacy of electric muscular stimulation of the venous outflow in prevention of postoperative venous thromboembolic complications].

The present clinical and experimental study was carried out in order to evaluate efficacy of electrical stimulation of the crural muscles with the purpose of preventing postoperative venous thromboembolic complications. At the first stage by means of ultrasonographic angioscanning in apparently healthy volunteers (n=21) we evaluated the linear velocity of blood flow on the popliteal vein on the background of using myostimulation and compression bandage with various levels of pressure applied either separately or in a combination with each other. It was revealed that electrical stimulation of the crural muscles led to a 2.8-4.5-fold increase in the peck velocity of blood flow, while the compression decreased the parameters of the venous outflow both at rest and during muscular contraction. By means of theoretical calculations it was determined that an optimal compression profile for a combination with electrical stimulation is a pressure under the bandage equalling 20-40 mm Hg, providing substantial acceleration of the venous outflow with the laminary blood flow preserved. At the second stage we assessed efficacy of comprehensive prevention of venous thromboembolism with the use of electromyostimulation, the respective compression bandage and direct anticoagulants in surgical-profile patients from a high-risk group (n=90) by means of ultrasound screening of the venous system during the whole postoperative period. When myostimulation was used in the regimen of 3-5 procedures a day, the frequency of venous thrombosis amounted to 40% (n=10) and did not significantly differ from that in patients not subjected to myostimulation (25%, n=40). When myostimulation was used in the regimen of 5-10 procedures per day, the frequency of venous thrombosis turned out to be considerably lower (2.5%, n=40). A conclusion was made on efficacy of using this method in the examined group of patients.

[The application of topical negative pressure in the complex treatment of acute suppurative diseases of soft tissues].

Negative pressure wound treatment (NPWT) is one of the newest methods used in the treatment of wounds. It allows speeding up and optimizing the healing process and reducing the cost of treatment. Negative pressure stimulates proliferation of granulation tissue, provides a continuous evacuation of fluid and effectively cleans wound surface. The authors present to the reader the results of treatment of acute suppurative diseases of soft tissues with the method of topical negative pressure.

[The use of thrombocytic growth factors and collagen-containing substances in treatment of the chronic wounds of various etiology].

The technical aspects of wound biocoverage production from the platelets' enriched plasma is represented. The substance shows high regenerative potential by causing the activation of thrombocytic growth factors. The authors' experience of the treatment of 38 patients with chronic trophic ulcers of various etiology is analyzed.

[Serum albumin in systemic inflammatory reaction syndrome].

A group of patients with pyoinflammatory surgical disease, which showed a strong correlation between the serum concentration of albumin and the number of signs of a systemic inflammatory reaction (SIR), was examined. It was found that the more number of such signs the patient had, the less blood concentration of albumin was: the linear correlation coefficient averaged -0.78 (p < 0.01) in the group. In the natural development of the disease, the larger number of signs of SIR (negative changes) is followed by decreased albumin concentrations and their reduction (positive changes) leads to an increase and even complete restoration of albumin concentrations. With a fatal outcome, there is a much greater drop in the serum concentration of albumin, which is inconsistent with the magnitude of criteria of SIR. The possible reasons for a reduction in blood albumin concentration and for ineffective correction of hypoalbuminemia in sepsis are discussed.

[Antibiotic prophylaxis, antibiotic therapy and microbiological situation in surgical unit]. / Antibiotikoprofilaktika, antibiotikoterapiia i mikrobiologicheskaia situatsiia v khirurgicheskom statsionare.

The clinical and economic efficacies of antibiotic prophylaxis in the surgical unit of the Hospital were confirmed by the results of the analysis of 1313 case records of the patients operated during a year for acute appendicitis and acute cholecystitis. At the same time it was shown advisable to use antibiotic therapy in the patients with various pathological processes. The dynamics of the microbial dissemination in the surgical unit and some other units of the Hospital, as well as the dynamics of antibiotic resistance of the microflora, its interrelation with the volume of the antibacterials used and their rotation are described.