[Tissue metallosis of the implant bed as a late complication of metal osteosynthesis]. / Metalloz tkanei lozha implantata kak pozdnee oslozhnenie metallicheskogo osteosinteza.

Biopsies of soft tissues of 28 patients taken from the region of metallic construction implantation which were in the host for osteosynthesis from 5 months to 4 years were examined histologically, histochemically and electron microscopically. Control biopsis were taken in 4 patients with false joints of long bones 5 months--1 year after the trauma. It is proven that the signs of the metal corrosion destruction are most frequently observed when complex multicomponential metallic implants prepared from heterogeneous metals are used. Corrosion results in the "metallic" tissue response long after the implantation. This is characterized by the formation of dense fibrillar connective tissue, its focal infiltration with fragments of metallic constructions and the products of their destruction in the form of various metal-protein complexes, syderosis, acute or chronic inflammation as a results of corrosion, metallosis and trauma. Metallosis of tissues in the implant bed is to be considered as a late complication of the metallic osteosynthesis.

[Corrosion of the matallic constructions and matallosis of the tissues in the treatment of bone fractures]. / O korrozii matallicheskikh konstruktsii i metalloze tkanei pri lechenii perelomov kostee

Under observation were 192 patients in whom metallic construction were with-drawn. Clinical and metallographic findings indicated that till present time surgical specialists employ unjeustifiable big variety of stainless steels and titan alloys. Corrosion was noted in 18%, tissue metallosis--in 25%, fracture of fixators--in 12%, inflammatory response--in 11%. Compaound metallic constructions produced from different metals and alloys were subjected to corrosion 3 times as fregquntly. To thoroughly study the metallosis of tissues these were investigated by meands of a special analysis and histochemistry.

[The pathogenetic and treatment characteristics of general suppurative infection in multiple gunshot wounds]. / Osobennosti patogeneza i lecheniia obshchei gnoinoi infektsii pri mnozhestvennykh ognestrel'nykh raneniiakh.

A profound analysis of 32 cases of general purulent infection that led to aggravation of multiple gunshot injuries proves the pathogenetical connection between the character of trauma, health status of patient and possibility for sepsis development. The main factors which determine the appearance and the course of wound sepsis are the following: the character of reaction of the organism to trauma, volume of invaded tissues, adequacy of health care, type and virulence of agents of the infection. The state of vital systems of human organism as well as the possibilities of medical care play an important role in the sepsis development in the acute period of wound illness. The major part of repeated interventions was conditioned by defects of the first surgical management. The opportune diagnosis on an early phase of sepsis, i.e. toxemia, is of great importance for the determining of tactics for the treatment and for complex intensive therapy in which hyperbaric oxygenation will assume a key role.

[The potentials for hyperbaric oxygenation in the combined treatment of the victims of explosive mine wounds to the extremities]. / Vozmozhnosti giperbaricheskoi oksigenatsii v kompleksnom lechenii postradavshikh s minno-vzryvnymi raneniiami konechnostei.

Hyperbaric oxygenation was used in the combined post-operative treatment of 63 victims with distal segments of lower extremities torn off or damaged by mine and burst effect. The patients consecutively received medicamentous therapy, which improved tissue microcirculation (rheopolyglucinum, haemodesum), surgical intervention, course of hyperbaric oxygenation, and after it anticoagulant preparations (heparinum) were used. The article shows that the combined application of hyperbaric oxygenation and medicinal preparation, that improve microcirculation in traumatized tissues, has a pathogenetic approvement.

[The surgical aspects of the lessons of the war in Afghanistan]. / Khirurgicheskie aspekty urokov voiny v Afganistane.

There were no two identical wars in human history. From the medical point of view, the civil war, which is still going on in Afghanistan, also has its own face. The structure of sanitary losses, the character, gravity, and peculiarities of gunshot pathology give the possibility to call it as a mine war, because of its massive and, above all, effective mine warfare. The war in Afghanistan conclusively proves the predominance of blast injuries over other sanitary losses in the structure of combat surgical pathology, that may be considered as a common feature for the wars of century XX. The mine blast trauma must be regarded as a combat heavy concomitant trauma or gunshot blast polytrauma. This statement is the basic one for the rest of medical lessons gained from the war in Afghanistan. Using the comparative analysis of the different functions of medical service of two armies, the article shows the priority of organizational aspects for care and treatment of the wounded in war.