[Content of middle mass molecules in blood serum of patients with burns after hemosorption treatment]. / Soderzhanie molekul srednei massy v syvorotke krovi bol'nykh s ozhogami pri lechenii gemosorbtsiei.

Content of so-called "middle mass molecules" in blood serum of patients with acute burn toxemia was studied by means of gel filtration on Sephadex G-25. Acute burn toxemia was accompanied by accumulation of the molecules in blood serum of the patients with burns; amount of these molecules correlated with a severity of burn trauma. The "middle mass molecules" were effectively eliminated after haemosorption on a charcoal sorbent SKN.2M. The rate of the "middle mass molecules" elimination in haemosorption correlated with improvement of the patients clinical state, with a decrease in symptoms of intoxication; manifestations of acute psychosis were also decreased.

[Free transplantation of skin flaps with axial blood supply in IV degree burns]. / Svobodnaia peresadka kozhnykh loskutov s osevym krovosnabzheniem pri ozhogakh IV stepeni.

The article analyses the results of free transplantation of skin grafts with axial blood supply in 45 patients with IV degree burns and their sequelae. Bearing in mind the peculiarities of damage to the tissues and vessels in a thermal trauma, it is advisable to anastomose the vein grafts with the large subcutaneous veins. Skin grafts with a long vascular pedicle are preferable. The difficulties which are encountered in the choice of the surgical tactics and in planning the operative intervention in patients with multiple areas with IV degree damage or their combination with extensive III degree burns insistently dictate the need for stricter indications for microsurgical transplantations, and rational and substantiated combination of plasty by free grafts and skin flaps with an axial blood supply type.

[Dermatoplasty in treating trophic ulcers of the lower extremities]. / Kozhnaia plastika pri lechenii troficheskikh iazv nizhnikh konechnostei.

The main principle of the surgical treatment of trophic ulcers of the lower extremities consists in a radical excision of all the pathologically changed tissues around the ulcer and under it and, in case of disorders of the venous reflux, in various surgical restorative and corrective interventions followed with plastic closure of the wound defect. 422 patients were operated upon (462 operations). The choice of the radical method of treatment resulted in a stable healing of ulcers in 84% of cases.

[Acute digestive tract ulcers in patients suffering from burns]. / Ostrye iazvy pishchevaritel'nogo trakta u postradavshikh ot ozhogov.

Among the burned who died in the clinic of thermal injuries for the last 17 years acute ulcer of the gastrointestinal tract of various localization and number were found in 48 cases. Only in 13 of them the clinical diagnosis had been established. Bleeding from acute ulcers of the digestive tract and their perforation had been found, as a rule, at the 2nd and mainly at the 3rd week from the moment of the burn injury. A high lethality among the Curling's ulcer eases following both conservative and surgical treatment is noted.

[Certain problems of pathogenesis and clinical course of chronic venous insufficiency in the lower limbs after deep burns]. / Nekotorye voprosy patogeneza i kliniki khronicheskoi venoznoi nedostatochnosti nizhnikh konechnostei posle glubokikh ozhogov.

Based on the examination of 66 patients with chronic venous insufficiency of the lower limbs following deep burns, the authors found that its occurrence mainly results from thromboses of profound veins of the lower extremities during the period of existence of burn wounds and mechnic obstruction of venous outflow, produced by extensive scars. In associated lesions of venous and lymph systems secondary postburn elephantiasis may develop.

[Prevention of cicatricial deformities following surgical repair of the skin in patients with burns]. / Profilaktika rubtsovykh deformatsii posle operativnogo vosstanovleniia kozhnogo pokrova u postradavshikh ot ozhogov.

Under study was the dynamics of clinical and morphological changes of 348 portions of the repaired skin in 266 patients in different periods after plasty. Recommendations are proposed to prevent secondary cicatricial deformities.

[Plastic repair of wound defects using skin-muscle flaps]. / Plastika kozhno-myshechnymi loskutami ranevykh defektov.

The work describes the application of 4 kinds of skin-muscle flaps in 22 patients with wound defects of various localizations. In 13 patients the flap was cut out in immediate proximity to the wound, in 9 patients free skin-muscle transplants with micro-vascular anastomoses were used. Quite satisfactory results obtained demonstrate good prospects for the new method of plasty of wound defects.

[Principles of the modern treatment of frostbite]. / O nekotorykh printsipakh sovremennogo lecheniia otmorozhenii.

Actual questions of the treatment of frostbites are considered on the basis of an experience of the treatment of 397 patients. The experience shows that superficial frostbites are healing well when treated by any method of local treatment. High degrees of frostbites are to be operated upon not earlier than the third week after injury, when the injury degree is established and acute inflammation has subsided. It has been established that the use of free and non-free skin plasty for closure of finger stumps and extremity segments improves functional outcomes and shortens the time of the treatment.

[Pathogenesis and treatment of late lysis of autodermotransplants in burns]. / O patogeneze i lechenii pozdnego lizisa autodermotransplantatov u obozhzhennykh.

Forms of late lysis of autodermotransplants were studied in 35 burned patients. The authors distinguish a "simple" lysis (20 patients) resulting from autoimmune processes and lysis in acute inflammation (5 patients) due to pathogenic microflora.

[Plastic surgery using islet triangular flaps in 4th degree frostbite of the fingers]. / Plastika ostrovkovymi treugol'nymi loskutami pri otmorozheniiakh IV stepeni pal'tsev.

In 36 patients with IV degree frostbites the guillotine amputation of 91 fingers was performed at the level of the ungual, middle and distal thirds of main phalanges. The wound of the stump butt was substituted by an islet triangular flap. It gave a functionally adaptable stump without shortening the bone phalange.

[Dynamics of indicators of dermocytograms and reparative capacity of the body in burns]. / Dinamika pokazatelei dermotsitogramm i reparativnye sposobnosti organizma u obozhzhennykh.

The investigation of dermocytograms by a modified method of the "skin window" in 101 patients with different square surfaces of deep burns has shown that the dynamics of mononuclear content is dependent on the injury degree. Lower parameters of mononuclear content in dermocytograms during the course of treatment correspond to the disturbance of reparative capacities of the organism in groups of patients with the complicated course of the disease. The "skin window" test can be used for the treatment since it shows the degree of the burn trauma dynamics and character of its course, facilitates the prognosis of complications.

[Autologous blood transfusion in surgical treatment of deep burns and their sequelae]. / Autotransfuzii krovi pri operativnom lechenii glubokikh ozhogov i ikh posledstvii.

The experience of the treatment of 74 burned cases by means of autotransfusion is presented. The application of autotransfusion made it possible to rule out donor blood transfusions in surgical treatment of a considerable group of the burned. There are grounds to believe that different variants of this method will be widely practised in specialized medical installations dealing with the treatment of the burned and with reconstructive surgery.

[Immunological prognosis of the early lysis of dermatoautografts in burn patients]. / Immunologicheskoe prognozirovanie rannego lizisa autodermotransplantatov u obozhzhennykh.

The state of immunity was studied in 28 burned patients with deep lesions on skin before and after autodermoplasty. In 23 patients with a complete take of transplants the immune indices were within normality. In 5 patients with a complete on partial lysis of the transplanted skin there was an increased amount of "active" T-lymphocytes, "stable" T-lymphocytes and lymphocytes forming rosettes with autoerythrocytes. After immunodepressive therapy the immune indices became normal and the following autodermoplastic procedures gave a successful grafting.

[Classification of the methods of skin autoplasty]. / O klassifikatsii metodov kozhnoi autoplastiki.

The authors propose a classification of methods of skin plasty. It is based on two main features: the anatomical structure of the autoplasty material and the state of its blood circulation.

[Plastic surgery using cutaneo-fascial flaps in the treatment of burns]. / Plastika kozhno-fastsial'nymi loskutami pri lechenii ozhogov.

Results of 67 plasties with fasciocutaneous flaps in 59 patients operated upon for burns and their sequellae are described. The correlation of length and width of the flaps was from 1.5:1 and 3:1. Good results were obtained in 90% of the patients. Causes of unfavorable outcomes are analyzed. The method is recommended for the introduction into practice of treatment of burns and their sequellae.

[Surgical treatment of 4th degree frostbite of the extremities]. / Operativnoe lechenie otmorzhenii konechnostei IV stepeni.

The aim of the operative treatment of IV degree frostbite is not only to save the bone stump, but also to achieve its functional fitness after primary surgery or in future due to creation of favourable conditions for the following reconstructive operations. Dermo-plastic operations, both well-known and modified ones were used. The experience of the authors includes 347 patients.

[The first experience with crural plastic surgery using island composite skin flaps]. / Pervyi opyt plastiki ostrovkovymi slozhnymi kozhnymi loskutami goleni.

An analysis of literature data, topographo-anatomical studies of 23 lower extremities and an experience with using 18 island fasciocutaneous flaps of the lower leg are presented. The article describes the possibilities of using a new donor area for plasty of limited defects of the lower leg and foot after various traumas and their sequelae.

[Treatment of burn shock with crystalloid solutions]. / Lechenie ozhogovogo shoka kristalloidnymi rastvorami.

The authors describe their experience of the treatment of burn shock in 124 patients with the square surface of the thermal injury about 20-49% of the body surface with the help of crystalloid solutions. The investigation of a number of parameters of hemodynamics, hemoconcentration, metabolism showed that patients with the Frank index 20-60 could be helped out of burn shock not only without blood and its albuminous preparations but also without infusions of dextran drugs. Transfusions of blood and its albuminous preparations are shown to be necessary in the nearest postshock period in patients with the Frank index 30-60. It is emphasized that the volume of intravenous infusions should be reduced in cases of associated lesions of the skin and the respiratory tracts.

[Frostbite as a problem for dermatoplastic surgery]. / Otmorozheniia kak problema kozhno-plasticheskoi khirurgii.

An analysis of the 35-years experiences with treatment of 621 patients with the IV-degree frostbite of hands and feet is presented. The surgical strategy of treatment of frostbite has undergone considerable evolution for these years. In addition to classical surgical treatment, the surgeons began to widely use methods of dermo-plastic surgery which allowed not only to save the maximum possible length of the extremity segment stump, but also to reduce the frequency of purulent complications and reamputations and thus to shorten the duration of hospital treatment.

[Various aspects of organization of microsurgical autologous transplantation of composite skin flaps]. / Nekotorye aspekty organizatsii mikrokhirurgicheskikh autotrans- plantatsii slozhnykh kozhnykh loskutov.

An experience with 137 microsurgical transplantations enabled the authors to consider questions of rational organization of these complex, and severe operations. Different variants of work of the second team of surgeons are analyzed aimed at shortening the duration of the operation and getting less load by its participants.