Year 2015 Vol. 23 No 5

SCIENRIFIC PUBLICATIONS
EXPERIMENTAL SURGERY

N.I. ZHERNAKOVA1, A.A. DOLZHIKOV1, S.V. SHKODKIN1,2, K.A. BOCHAROVA1, A.J. KOLPAKOV1, V.N. DMITRIEM1

ASSESSMENT OF CYTOTOXICITY OF CARBON-CONTAINING NANOSIZED COATINGS

FSAEE HPE "Belgorod State National Research University"1,
SBEH "Belgorod Regional Clinical Hospital of Saint Joasaph"2
The Russian Federation

Objectives. To study bioinertness of new nanosized carbon-containing in compounds in experiment.
Methods. The pulsed vacuum arc method was used to deposite the coating of nitinol wire. Nitinol wire stents were implanted in the parenchymal organs (kidney and liver) and in the choledoch of sexually mature Wistar rats. The animals were taken out of the experiment on the 14th and 30th day after implantation. The thickness of developing reactive tissue areas was measured; the cytoarchitectonics around the implants was evaluated.
Results. In the cases of implantation in the parenchymal organs the quantitative and qualitative characteristics depended on the implantation site have been defined. Inflammatory changes around implants in the liver proved to be 1,5-2 fold more intensive than in the kidneys the same period of observation. Qualitative analysis of cytoarchitectonics around the implants in different groups has not revealed statistically significant differences depending on the implant material. The quantitative assessment of inflammatory infiltration in the group with nanostructured coating based on amorphous carbon matrix with including of silver nanoscale clusters was less intense regardless of the implantation site. Implantation of new carbon nanoscale materials into the rat choledoch lumen has not followed by necrobiotic changes and perforation of its wall; no mortality was observed in the study groups. The reaction of the extrahepatic biliary tract to the introduction of implant such homologous when it implanted in parenchymal organs.
Conclusion. The materials being developed for implantation showed no cytotoxicity. The best indicators of bioinertness were registered in the group of implants with nanostructural coating based on amorphous carbon matrix with inclusions of nanoscale clusters of silver. This result can be explained by the inertia of the carbon to the tissues and by antiproliferative properties of silver.

Keywords: biomedical materials, implant, pulsed vacuum arc method, stent, antiproliferative properties of silver, inflammation, cytotoxicity
p. 491-499 of the original issue
References
  1. Fedelini P, Verze P, Meccariello C, Arcaniolo D, Taglialatela D, Mirone VG. Intraoperative and postoperative complications of laparoscopic pyeloplasty: a single surgical team experience with 236 cases. J Endourol. 2013 Oct;27(10):1224-9. doi: 10.1089/end.2013.030.
  2. Maruschke M, Kram W, Nebe JB, Vollmar B, Zimpfer A, Hakenberg OW. Development of a rat model for investigation of experimental splinted uretero-ureterostomy, ureteral stenting and stenosis. In Vivo. 2013 Mar-Apr;27(2):245-49.
  3. Chepurov AK, Zenkov SS, Mamaev IE, Pronkin EA. Dlitel'noe drenirovanie mochetochnikovymi stentami: sovremennoe sostoianie voprosa i perspektivy [Prolonged drainage of ureteral stent: the present state of and prospects]. Andrologiia i Genital Khirurgiia. 2009;(2):32-40.
  4. Volova TG. Sintez biorezorbiruemykh polimerov. Struktura i svoistva [Synthesis of bioresorbable polymers. The structure and properties]. Izvestiia Vysshikh Uch Zavedenii. Fizika. 2013;(56)12-3:27-32.
  5. Nau P, Liu J, Ellison EC, Hazey JW, Henn M, Muscarella P, Narula VK, Melvin WS.Novel reconstruction of the extrahepatic biliary tree with a biosynthetic absorbable graft. HPB (Oxford). 2011 Aug;13(8):573-78. doi: 10.1111/j.1477-2574.2011.00337.x.
  6. Canena JM, Liberato MJ, Rio-Tinto RA, Pinto-Marques PM, Romão CM, Coutinho AV, Neves BA, Santos-Silva MF.A comparison of the temporary placement of 3 different self-expanding stents for the treatment of refractory benign esophageal strictures: a prospective multicentre study. BMC Gastroenterol. 2012 Jun (12);12:70.
  7. Fu WJ, Xu YD, Wang ZX, Li G, Shi JG, Cui FZ, Zhang Y, Zhang X. New ureteral scaffold constructed with composite poly(L-lactic acid)-collagen and urothelial cells by new centrifugal seeding system. J Biomed Mater Res A. 2012 Jul;100(7):1725-33. doi: 10.1002/jbm.a.34134.
  8. Griffiths EA, Gregory CJ, Pursnani KG, Ward JB, Stockwell RC. The use of biodegradable (SX-ELLA) oesophageal stents to treat dysphagia due to benign and malignant oesophageal disease. Surg Endosc. 2012 Aug;26(8):2367-75. doi: 10.1007/s00464-012-2192-9.
  9. Moskovitz B, Halachmi S, Nativ O.A new self-expanding, large-caliber ureteral stent: results of a multicenter experience. J Endourol. 2012 Nov;26(11):1523-7. doi: 10.1089/end.2012.0279.
  10. Hämäläinen M, Nieminen R, Uurto I, Salenius JP, Kellomäki M, Mikkonen J, Kotsar A, Isotalo T, Teuvo Tammela LJ, Talja M, Moilanen E. Dexamethasone-eluting vascular stents. Basic Clin Pharmacol Toxicol. 2013 May;112(5):296-301. doi: 10.1111/bcpt.12056.
  11. Rodrigues C, Oliveira A, Santos L, Pires E, Deus J. Biodegradable stent for the treatment of a colonic stricture in Crohn's disease. World J Gastrointest Endosc. 2013 May 16;5(5):265-69. doi: 10.4253/wjge.v5.i5.265.
  12. Brotherhood H, Lange D, Chew BH. Advances in ureteral stents. Transl Androl Urol 2014;3(3):314-319. doi: 10.3978/j.issn.2223-4683.2014.06.06.
  13. Yin Y, Zhang Y, Zhao X. Safety and efficacy of biodegradable drug-eluting vs. bare metal stents: a meta-analysis from randomized trials. PLoS One. 2014 Jun 19;9(6):e99648. doi: 10.1371/journal.pone.0099648. eCollection 2014.
Address for correspondence:
308015, Rossiiskaia Federatsiia, g. Belgorod, ul. Pobedy, d. 85, kor. 10, kom. 3-12 dekanat lechebnogo dela i pediatrii Meditsinskogo instituta FGAOU VPO "Belgorodskii gosudarstvennyi natsional'nyi issledovatel'skii universitet", tel. +7 (4722) 30-12-85,
e-mail: zhernakova@bsu.edu.ru,
Zhernakova Nina Ivanovna
Information about the authors:
Zhernakova N.I., MD, professor, a dean of the medical affairs and pediatrics Medical Institute FSAEI HPE "Belgorod State University."
Dolzhikov A.A., MD, professor, a head of the department of histology of the Medical Institute FSAEI HPE "Belgorod State University."
Shkodkin S.V., PhD., an assistant professor of surgery hospital of the Medical Institute FSAEI HPE "Belgorod State University", department of urology, resident of OSBEH "Belgorod Regional Clinical Hospital of Saint Joasaph".
Bocharova K.A., PhD, an associate professor of faculty therapy Medical Institute FSAEI HPE "Belgorod State University."
Kolpakov A.Y., PhD, Professor, a head of a research laboratory of the problems of development and introduction of ion-plasma technology FSAEI HPE "Belgorod State Nationsal research University."
Dmitriev V.N., PhD, an associate professor of the chair of faculty surgery of Medical Institute FSAEI HPE "Belgorod State University."

GENERAL & SPECIAL SURGERY

I.V. SAMSONOVA, V.A. KLOPOVA, I.S. SHEVCHENKO

COLLAGEN IV AND VI EXPRESSION IN PANCREAS AT CHRONIC PANCREATITIS

EE "Vitebsk State Medical University"
The Republic of Belarus

Objectives. To study collagen IV and VI expression in pancreas at chronic pancreatitis (CP).
Methods. Using morphological, immunohistochemical, morphometric and statistical methods the pancreatic tissue specimens of 28 patients with CP, stained with lyophilised monoclonal antibodies Collagen Type IV and Collagen Type VI (Novocastra) have been investigated. Control group included 7 pancreatic head specimens without any pathology of pancreas takon from people died due to by accidents.
Results. Collagen IV-positive reaction was determined as different intensity brown staining of basement membrane in the wall of vessels, ducts and in acini of all pancreatic specimens. At CP the expression level was 750,2±2,86, that corresponded to 1093297,22±3340,36 mkm2 total expression area. In control group the expression was significantly higher – 924,11±8,5, but total expression area was significantly lower – 751045,11±10096,45 mkm2.
In pancreas without pathologic changes expression of collagen VI was mainly determined in the connective tissue cells and was almost absent in the acinar cells. At CP collagen VI positive expression was mainly determined in the basal part of acinar cell and duct epithelium cytoplasm as well as in the connective tissue cells. In control group expression was 615,15 ±19,34 mkm2, at CP – 85524,08± 3433,07 mkm2. The expression total area at CP was 241506 ìêì2, that was 2,8 fold more high comparing with control group.
Conclusion. The chronic pancreatitis is characterized by changes of the Collagen Type IV and Collagen Type VI expression degree, character of distribution and expression area in the pancreas. It is supposed the revealed changes of Collagen Type IV and Collagen Type VI expression to result from collagen synthesis disturbances at chronic inflammation, that can explained by activation of mesenchimal cells, their proliferation and changes of epitheliocytes activity.

Keywords: pancreas, chronic pancreatitis, collagen IV, collagen VI, immunohistochemical investigation, proliferation, epitheliocytes activity
p. 500-505 of the original issue
References
  1. Minushkin ON. Khronicheskii pankreatit: nekotorye aspekty patogeneza, diagnostiki i lecheniia [Chronic pancreatitis: some aspects of the pathogenesis, diagnosis and treatment]. Consilium-Medicum. 2002;(4)1:23-26.
  2. Gubergrits NB, Khristich TN. Klinicheskaia pankreatologiia [Clinical pancreatology]. Donetsk, Ukraina: Lebed; 2000. 416 p.
  3. Layer P, Yamamoto H, Kalthoff L, Clain JE, Bakken LJ, DiMagno EP The different courses of early- and late-onset idiopathic and alcoholic chronic pancreatitis. Gastroenterology. 1994 Nov;107(5):1481-87.
  4. Apte MV, Haber PS, Applegate TL, Norton ID, McCaughan GW, Korsten MA, Pirola RC, Wilson JS. Periacinar stellate shaped cells in rat pancreas: identification, isolation, and culture. Gut. 1998 Jul;43(1):128-33.
  5. Apte M, Pirola R, Wilson J. The fibrosis of chronic pancreatitis: new insights into the role of pancreatic stellate cells. Antioxid Redox Signal. 2011 Nov 15;15(10):2711-22. doi: 10.1089/ars.2011.4079.
  6. Kadono G, Ishihara T, Yamaguchi T, Kato K, Kondo F, Naito I, Sado Y, Saisho H. Immunohistochemical localization of type IV collagen alpha chains in the basement membrane of the pancreatic duct in human normal pancreas and pancreatic diseases. Pancreas. 2004 Jul;29(1):61-66.
  7. Pöschl E, Schlötzer-Schrehardt U, Brachvogel B, Saito K, Ninomiya Y, Mayer U. Collagen IV is essential for basement membrane stability but dispensable for initiation of its assembly during early development. Development. 2004 Apr;131(7):1619-28.
  8. Das SK, Varadhan S, Dhanya L, Mukherjee S, Mohana S, Balakrishnan V, Vasudevan DM. Diagnostic efficiency of amylase and type IV collagen in predicting chronic pancreatitis. Indian J Clin Biochem. 2009 Jan;24(1):60-4. doi: 10.1007/s12291-009-0010-5.
  9. Ohlund D, Lundin C, Ardnor B, Oman M, Naredi P, Sund M.Type IV collagen is a tumour stroma-derived biomarker for pancreas cancer. Br J Cancer. 2009 Jul 7;101(1):91-7. doi: 10.1038/sj.bjc.6605107.
  10. Groulx JF, Gagné D, Benoit YD, Martel D, Basora N, Beaulieu JF. Collagen VI is a basement membrane component that regulates epithelial cell-fibronectin interactions. Matrix Biol. 2011 Apr;30(3):195-206. doi: 10.1016/j.matbio.2011.03.002.
  11. öhlund D, Franklin O, Lundberg E, Lundin C, Sund M. Type IV collagen stimulates pancreatic cancer cell proliferation, migration, and inhibits apoptosis through an autocrine loop. BMC Cancer. 2013 Mar 26;13:154. doi: 10.1186/1471-2407-13-154.
  12. Nishi O, Nishi K, Fujiwara T, Shirasawa E, Ohmoto Y. Effects of the cytokines on the proliferation of and collagen synthesis by human cataract lens epithelial cells. Br J Ophthalmol. 1996 Jan;80(1):63-68.
  13. Rühl M., Sahin E, Johannsen M, Somasundaram R, Manski D, Riecken EO, Schuppan D. Soluble collagen VI drives serum-starved fibroblasts through S phase and prevents apoptosis via down-regulation of Bax. J Biol Chem. 1999 Nov 26;274(48):34361-68.
  14. Gagné D, Groulx JF, Benoit YD, Basora N, Herring E, Vachon PH, Beaulieu JF. Integrin-linked kinase regulates migration and proliferation of human intestinal cells under a fibronectin-dependent mechanism. J Cell Physiol. 2010 Feb;222(2):387-400. doi: 10.1002/jcp.21963.
  15. Sabatelli P, Bonaldo P, Lattanzi G, Braghetta P, Bergamin N, Capanni C, Mattioli E, Columbaro M, Ognibene A, Pepe G, Bertini E, Merlini L, Maraldi NM, Squarzoni S. Collagen VI deficiency affects the organization of fibronectin in the extracellular matrix of cultured fibroblasts. Matrix Biol. 2001 Nov;20(7):475-86.
  16. Schnoor M, Cullen P, Lorkowski J, Stolle K, Robenek H, Troyer D, Rauterberg J, Lorkowski S. Production of type VI collagen by human macrophages: a new dimension in macrophage functional heterogeneity. J Immunol. 2008 Apr 15;180(8):5707-19.
Address for correspondence:
210023, Respublika Belarus',
g. Vitebsk, pr. Frunze, d. 27, UO «Vitebskii
gosudarstvennyi meditsinskii universitet»,
kafedra patologicheskoi anatomii,
e-mail: victoriya_06@tut.by,
Klopova Viktoriia Aleksandrovna
Information about the authors:
Samsonova I.V. PhD, an associate professor, a head of the chair of pathological anatomy EE "Vitebsk State Medical University."
Klopova V.A. PhD, an associate professor of the chair of pathological anatomy EE "Vitebsk State Medical University."
Shevchenko I.S. A senior lecturer of the chair of pathological anatomy EE "Vitebsk State Medical University."

Î.N. SADRIEV 1, À.D. GAIBOV 1,2

COMPLEX DIAGNOSTICS AND CURRENT PRINCIPLES OF PHEOCHROMOCYTOMA TREATMENT

Republican Scientific Center of Cardiovascular Surgery1,
Avicenna Tajik State Medical University2,
Dushanbe
The Republic of Tajikistan

Objectives. To evaluate the results of complex diagnostics and surgical treatment of patients with pheochromocytoma.
Methods. Treatment results of 25 patients with pheochromocytoma (PCC) have been analyzed (15 (60%) females and 10 (40%) males). The average age of patients was 35,9±4,2 years. Average duration on the disease was 4,6±1,7 years. Diagnosis was confirmed by ultrasonography (US), computerized tomography (CT) and determination of metanephrines (MN) and vanillylmandelic acid (VMA) levels. Depending on the preoperative tactics all patients were divided into 2 groups. Α-blockers of short-acting (phentolamine) were used to the patients of the first group (n=8) only during the operation. Α-blockers (doxazosin) were administered to the patiens of the second group (n=17) in the preoperative period.
Results. In all cases a reliable increase of MN and VMA levels was registered. No difference was found in studying MN excretion level depending on the tumor size and disease duration. Sensitivity of US and CT in PCC diagnostics made up 92% and 100%, and specificity 52% and 91,3%, respectively. In the 1st group 2 (25%) patients died due to the development of «uncontrolled hemodynamics» syndrome. There was no lethal outcome in the 2nd group (ð<0,05). Complications were observed in 5 (21,7%) patients during the operation (n=2) and in the early postoperative period (n=3). There was 1 (4,3%) lethal outcome after adrenalectomy. In the long-term period (1-8 yrs) good results were obtained in 21 (91,3%) operated patients and satisfactory – in 1 (4,3%).
Conclusion. The use of minimally invasive techniques in the treatment of pheochromocytoma can help reduce the incidence of postoperative complications and duration of hospitalization. In all cases the preoperative preparation should be carried out with the use of α-blockers. The patients are required clinical medical examination and proper conduction of hormone replacement therapy to prevent and treat adrenal insufficiency.

Keywords: pheochromocytoma, diagnostics, operative treatment, postoperative complications, metanephrines, α-adrenoblockers, adrenalectomy
p. 506-514 of the original issue
References
  1. Bokeriia LA, Abdulgasanov RA. Feokhromotsitomy: sovremennye metody diagnostiki i khirurgicheskogo lecheniia [Pheochromocytoma: modern methods of diagnosis and surgical treatment]. Annaly Khirurgii. 2011;(2):5-10.
  2. Bel'tsevich DG, Kuznetsov NS, Lysenko MA, Tsalikova AT. Feokhromotsitoma [Pheochromocytoma]. Sonsilium Medicum. 2007;9(9):88-94
  3. Fernández-Cruz L, Puig-Domingo M, Halperin I, Sesmilo G. Pheochromocytoma. Scand J Surg. 2004;93(4):302-9.
  4. Ilias I, Pacak K.A clinical overview of pheochromocytomas/paragangliomas and carcinoid tumors. Nucl Med Biol. 2008 Aug;35 Suppl 1:S27-34. doi: 10.1016/j.nucmedbio.2008.04.007.
  5. Bel'tsevich DG, Kuznetsov NS. Prichiny retsidivov u bol'nykh s opukholiami khromaffinnoi tkani [Causes of relapses in patients with tumors chromaffin tissue]. Khirurgiia. Zhurn im NI Pirogova. 2002;(8):19-23.
  6. Thompson LD. Pheochromocytoma of the adrenal gland scaled score (PASS) to separate benign from malignant neoplasms: A clinicopathologic and Immunophenotypic study of 100 cases. Am J Surg Pathol. 2002 May;26(5):551-66.
  7. Troshina EA, Bel'tsevich DG, Iukina MIu. Laboratornaia diagnostika feokhromotsitomy [Laboratory diagnosis of pheochromocytoma]. Probl Endokr. 2010;56(4):39-43.
  8. Vetshev PS, Simonenko VB, Ippolitov LI. Opukholi khromaffinnoi tkani (klinika, diagnostika, khirurgicheskoe lechenie) [Chromaffin tissue tumors (clinical features, diagnosis, surgical treatment)] Khirurgiia. Zhurn im NI Pirogova. 2002;(8):11-18.
  9. Mel'nichenko GA, Udovichenko OV, Shvedova AE. Endokrinologiia: tipichnye oshibki prakticheskogo vracha [Endocrinology: typical mistakes of practitioner]. Moscow, RF: Prakt Meditsina; 2011. 176 p.
  10. Emel'ianov SI, Kurganov IA, Oganesian SS, Bogdanov DIu. Rol' trekhmernogo virtual'nogo modelirovaniia i intraoperatsionnoi navigatsii pri laparoskopicheskikh vmeshatel'stvakh na nadpochechnikakh [The role of three-dimensional virtual simulation and intraoperative navigation in laparoscopy on the adrenal glands]. Endosk Khir. 2009;(5):41-47.
  11. Tsukanov IuT, Tsukanov AIu. Bokovoi vnebriushinnyi mini-dostup dlia adrenalektomii [Lateral extraperitoneal mini access for adrenalectomy]. Khirurgiia. Zhurn im NI Pirogova. 2003;(9):7-10.
  12. Bondarenko VO, Lutsevich OE. Topograficheskaia diagnostika i khirurgicheskie vmeshatel'stva pri gigantskikh feokhromotsitomakh nadpochechnika [Topographic diagnosis and surgery for adrenal pheochromocytoma giant]. Khirurgiia. Zhurn im NI Pirogova. 2011;(30):13-18.
  13. Dedov II, Bel'tsevich DG, Kuznetsov NS, Mel'nichenko G A. Feokhromotsitoma [Pheochromocytoma]. Moscow, RF: Prakt Meditsina; 2005. 216 p.
Address for correspondence:
734003, Republic of Tadzhikistan,
g. Dushanbe, prospekt Rudaki, d. 139,
Tadzhikskiy gosudarstvennyiy
meditsinskiy universitet imeni Abuali ibni Sino,
kafedra khirurgicheskih bolezney ¹2.
tel.: 992 915 25 00 55;
e-mail: sadriev_o_n@mail.ru,
Sadriev Okildzhon Nemadzhonovich
Information about the authors:
Sadriev O.N. A leading researcher of the Republican Scientific Center of Cardiovascular Surgery.
Gaibov A.D. Corresponding member of the Academy of Medical Sciences of the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan, MD, professor of the surgical diseases chair ¹2 of Avicenna Tajik State Medical University, professor and tutor of the vascular surgery department of the Republican Scientific Center of Cardiovascular Surgery.

U.U. ANDRUSHCHUK1, Y.P. OSTROVSKY1, V.V. ZHARKOV2, S.A. KURGANOVICH1, T.T. GEVORKYAN1, M.M. SHASHURO2, N.M. NAVITSKAYA1

ALGORITHM OF COMPLEX SURGICAL TREATMENT OF PATIENTS WITH TUMORS OF THE MAIN LOCATIONS AND CONCOMITANT CORONARY ARTERY DISEASE

Republican Scientific Practical Centre "Cardiology"1,
N.N. Aleksandrov National Cancer Centre of Belarus2
Minsk
The Republic of Belarus

Objectives. To evaluate the results of applying the algorithm of complex surgical treatment of patients with tumors of the main locations and concomitant coronary artery disease (CAD).
Methods. The developed algorithm of complex surgical treatment is based on the determination of the least patient risk of cardio- and radical oncosurgical intervention with the choice of simultaneous or staged approach of treatment and the possibility of their conversion. According to the developed algorithm 93 patients (group 1) and 49 patients (group 2) have been simultaneous and staged operated, respectively. The coronary arteries bypass grafting (CABG) and radical intervention on the tumors of the main locations (lung, esophagus, stomach, kidney, uterus, adnexa of uterus) have been conducted within the period from 2001 to 2014. The patients of the first group seem to have more common malignant of lung (p=0,005), and the patients of the second group – gastric (p=0,07), esophageal (p=0,04) and colorectal (p=0,03) cancer. There was no any difference in the degree of heart failure and angina in patients of both groups. In the first group the operations on the “working heart” were significantly more performed and, accordingly, in the second – under cardiopulmonary bypass (p=0,001).
Results. Overall hospital mortality of the first and second groups was 8,60% and 10,20%, respectively (p = 0,76), a major hospital complications – 23,66% and 32,65% (p=0,35), from which cardiac ones – 6,45% and 11,63% (p=0,34). The five-year survival rate was 39,30±5,51% and 45,32±11,71% (p=0,20), median – 33,47 and 60,10 months, respectively. The corrected free survival averaged 72,45 ± 7,86 and 64,08±11,14 months (p=0,51).
Conclusion. The developed algorithm of complex surgical treatment of patients with tumors of the main locations and concomitant CAD takes advantages of simultaneous and staged approaches and provides good immediate and long-term results.

Keywords: cancer, algorithm, coronary artery disease, hospital mortality, surgery, survival, results
p. 515-524 of the original issue
References
  1. Janssen-Heijnen ML, Schipper RM, Razenberg PP, Crommelin MA, Coebergh JW. Prevalence of co-morbidity in lung cancer patients and its relationship with treatment: a population-based study. Lung Cancer. 1998 Aug;21(2):105-13.
  2. Foster ED, Davis KB, Carpenter JA, Abele S, Fray D. Risk of noncardiac operation in patients with defined coronary disease: The Coronary Artery Surgery Study (CASS) registry experience. Ann Thorac Surg. 1986 Jan;41(1):42-50.
  3. Danton MH, Anikin VA, McManus KG, McGuigan JA, Campalani G. Simultaneous cardiac surgery with pulmonary resection: presentation of series and review of literature. Eur J Cardiothorac Surg. 1998 Jun;13(6):667-72.
  4. Tourmousoglou CE, Apostolakis E, Dougenis D. Simultaneous occurrence of coronary artery disease and lung cancer: what is the best surgical treatment strategy? Interact Cardiovasc Thorac Surg. 2014 Oct;19(4):673-81. doi: 10.1093/icvts/ivu218.
  5. Patanè F, Verzini A, Zingarelli E, di Summa M. Simultaneous operation for cardiac disease and lung cancer. Interact Cardiovasc Thorac Surg. 2002 Dec;1(2):69-71.
  6. Voets AJ, Joesoef KS, van Teeffelen ME. Synchroneously occurring lung cancer (stages I-II) and coronary artery disease: concomitant versus staged surgical approach. Eur J Cardiothorac Surg. 1997 Nov;12(5):713-17.
  7. Davydov ÌI, Akchurin RS, Gerasimov SS, Brand IB, Dolgov IM. Khirurgicheskoe lechenie bol'nykh rakom legkogo s tiazhelymi soputstvuiushchimi serdechno-sosudistymi zabolevaniiami [Surgical treatment of lung cancer patients with severe concomitant cardiovascular disease]. Khirurgiia. Zhurn im NI Pirogova 2012;(7):18-26.
  8. Rao V, Todd TR, Weisel RD, Komeda M, Cohen G, Ikonomidis JS, Christakis GT. Results of combined pulmonary resection and cardiac operation. Ann Thorac Surg. 1996 Aug;62(2):342-46.
  9. Prokakis C, Koletsis E, Apostolakis E, Panagopoulos N, Charoulis N, Velissaris D, Filos K, Dougenis D. Combined heart surgery and lung tumor resection. Med Sci Monit. 2008 Mar;14(3):CS17-21.
  10. Cantarella F, Graziosi L, Cavazzoni E, Severini D, Da Col U, Ragni T, Donini A. Simultaneous surgery for obstructive coronary artery disease and ulcerated gastric cancer. J Surg Case Rep. 2011 Dec 1;2011(12):3. doi: 10.1093/jscr/2011.12.3.
  11. Vojácek J, Hlubocký J, Burkert J, Brázdil J, Durpekt R, Valek S, Spatenka J, Lischke R, Schützner J, Smejkal P, Horácek M, Pafko P, Pavel P. Simultaneous cardiac and thoracic operations. Zentralbl Chir. 2006 Jun;131(3):200-5. [Article in German].
  12. Yokoyama T, Derrick MJ, Lee AW. Cardiac operation with associated pulmonary resection. J Thorac Cardiovasc Surg. 1993 May;105(5):912-16.
  13. Canver CC, Bhayana JN, Lajos TZ, Raza ST, Lewin AN, Bergsland J, Mentzer RM Jr. Pulmonary resection combined with cardiac operations. Ann Thorac Surg. 1990 Nov;50(5):796-99.
  14. Andrushchuk UU, Ostrovskii IP, Zharkov VV, Kurganovich SA, Kurushko TV, Komarovskii AA, Novitskaia NM. Algoritm simul'tannogo khirurgicheskogo lecheniia patsientov s opukholiami osnovnykh lokalizatsii i soputstvuiushchei ishemicheskoi bolezn'iu serdtsa [Algorithm of simultaneous surgical treatment of patients with tumors of the main locations and concomitant coronary heart disease]. Kardiologiia v Belarusi. 2015;(40)3:6-18.
Address for correspondence:
220036, Respublika Belarus',
g. Minsk, ul. R. Liuksemburg, d. 110,
GU Respublikanskii nauchno-prakticheskii tsentr "Kardiologiia",
laboratoriia khirurgii serdtsa,
tel. rab. +375 17 2088605,
e-mail: heartslight@mail.ru,
Andrushchuk Vladimir Vladimirovich
Information about the authors:
Androshchuk U.U., PhD, a cardiac surgeon of the 2nd cardiac surgery department of SE "Republican Scientific and Practical Center" Cardiology", a fellow worker of the Laboratory of Cardiac Surgery.
Ostrovsky Y.P., MD, professor, an academician of the National Academy of Sciences, a head of the Department of Cardiac Surgery SEE "Belarusian Medical Academy of Postgraduate Education", a chief peripatetic heart surgeon Ministry of Health of the Republic of Belarus.
Zharkov V.V., MD., professor, a head of the surgical department of SE "Republican Scientific-Practical Center of Oncology and Medical Radiology. N.N. Aleksandrova".
Kurganovich S.A., a specialist on ultrasonic diagnosis of SE "Republican Scientific and Practical Center Cardiology", the Laboratory of Cardiac Surgery.
Gevorgyan T.T. a specialist, department of functional diagnosis of SI "Republican Scientific and Practical Center Cardiology".
Shashuro M.M., an assistant of surgical department of SE "Republican Scientific-Practical Center of Oncology and Medical Radiology. N.N. Aleksandrova".
Novitskaya N.M., an assistant of laboratory heart surgery SE "Republican Scientific and Practical Center "Cardiology".

V.J. KHRYSHCHANOVICH1,2, I.P. KLIMCHUK1, A.V. EMELYANENKO2, S.S. KALININ1,2

THE RESULTS OF TREATMENT OF PATIENTS WITH INFERIOR VENA CAVA THROMBOSIS

EE "Belarusian State Medical University"1, EH "The 4th City Clinical Hospital named after Savchenko"2,
Minsk
The Republic of Belarus

Objectives. To determine the most common causes, frequency of thromboembolic complications (TEC), results of diagnostics and treatment of patients with inferior vena cava thrombosis (IVC).
Methods. A retrospective study in resident patients (n=22) with the inferior vena cava thrombosis has been carried out. The average age of twenty two patients was 53 ± 2 years. In cases of suspicion for a deep vein thrombosis (DVT) in the IVC system, its causes, character, localization, prevalence and complications were determined by ultrasonography and phlebocavagraphy. IVC thrombosis management included anticoagulants, elastic compression, and phlebotonics. Four (18.2%) patients with embolo-dangerous thrombosis had undergone surgical procedures – inferior vena cava thrombectomy with its implication (2 cases), isolated IVC plication, cava-filter implantation.
Results. The reason of the IVC thrombosis in 21 of 22 patients was an upward iliofemoral DVT on the background of cancer pathology (35%), chronic inflammatory diseases (10%) after surgery and childbirth (10%). In two (10%) cases, there was a DVT of the lower extremities in anamnesis. In six (30%) cases the cause of IVC thrombosis has not been established. Infrarenal, renal and suprarenal IVC thrombosis were diagnosed in 19 (86%), 2 (9%) and 1 (5%) patients, respectively. Thrombus flotation with a head length of 2-8 cm in IVC was identified in 4 cases. TEC occurred in three (13,6%) patients. Such complication as cava-filter thrombosis occurred in one case.
Conclusion. In all patients with proximal DVT of the lower extremities IVC involvement in the thrombotic process should be suspected. Early diagnosis and proper treatment of IVC thrombosis is considerd to be guarantee of a favorable outcome of the disease and to prevent complications. It’s necessary to continue an examination of compression hosiery and phlebotonics in rehabilitation of patients undergoing IVC thrombosis.

Keywords: aetiology, diagnosis, inferior vena cava, prognosis, thrombosis, compression hosiery, complications, treatment
p. 525-532 of the original issue
References
  1. McAree BJ, O'Donnell ME, Fitzmaurice GJ, Reid JA, Spence RA, Lee B. Inferior vena cava thrombosis: a review of current practice. Vasc Med. 2013 Feb;18(1):32-43. doi: 10.1177/1358863X12471967.
  2. Takeuchi M, Maruyama K, Nakamura M, Chikusa H, Yoshida T, Muneyuki M, Nakano T. Posttraumatic inferior vena caval thrombosis: case report and review of the literature. J Trauma. 1995 Sep;39(3):605-8.
  3. Savel'ev VS./red., Gologorskii VA, Kirienko AI. Flebologiia [Phlebology]. Rukovodstvo dlia vrachei. Mosñow, RF: Meditsina; 2001. 664 p.
  4. Farber SP, O'Donnell TF Jr, Deterling RA, Millan VG, Callow AD.The clinical implications of acute thrombosis of the inferior vena cava. Surg Gynecol Obstet. 1984 Feb;158(2):141-44.
  5. Jackson BT, Thomas ML.Post-thrombotic inferior vena caval obstruction. A review of 24 patients. Br Med J. 1970 Jan 3;1(5687):18-22.
  6. Marshall FF, Dietrick DD, Baumgartner WA, Reitz BA. Surgical management of renal cell carcinoma with intracaval neoplastic extension above the hepatic veins. J Urol. 1988 Jun;139(6):1166-72.
  7. Eivazi Ziaei J. Inferior vena cava thrombosis in a patient with essential thrombocytemia. MJIRI. 1998;12(2):167-69.
  8. Nordback I, Sisto T. Peripancreatic vascular occlusions as a complication of pancreatitis. Int Surg. 1989 Jan-Mar;74(1):36-39.
  9. Ma SK, Kim SW, Kim NH, Choi KC.Renal vein and inferior vena cava thrombosis associated with acute pancreatitis. Nephron. 2002 Oct;92(2):475-77.
  10. Ohta H, Hachiya T.A case of inferior vena cava thrombosis and pulmonary embolism secondary to acute exacerbation of chronic pancreatitis: a rare finding in radionuclide venography. Ann Nucl Med. 2002 Apr;16(2):147-49.
  11. Houman H, Lamloum M, Ben Ghorbel I, Khiari-Ben Salah I, Miled M. [Vena cava thrombosis in Behçet's disease. Analysis of a series of 10 cases]. Ann Med Interne (Paris). 1999 Dec;150(8):587-90. [Article in French].
  12. Takeuchi M, Maruyama K, Nakamura M, Chikusa H, Yoshida T, Muneyuki M, Nakano T.Posttraumatic inferior vena caval thrombosis: case report and review of the literature. J Trauma. 1995 Sep;39(3):605-8.
  13. Kraft C, Hecking C, Schwonberg J, Schindewolf M, Lindhoff-Last E, Linnemann B. Patients with inferior vena cava thrombosis frequently present with lower back pain and bilateral lower-extremity deep vein thrombosis. Vasa. 2013 Jul;42(4):275-83. doi: 10.1024/0301-1526/a000288.
  14. McAree BJ, O'Donnell ME, Boyd C, Spence RA, Lee B, Soong CV. Inferior vena cava thrombosis in young adults--a review of two cases. Ulster Med J. 2009 May;78(2):129-33.
  15. Giordano P, Weber K, Davis M, Carter E. Acute thrombosis of the inferior vena cava. Am J Emerg Med. 2006 Sep;24(5):640-42.
  16. Baeshko A., Zhuk H., Ulezko E. Congenital Anomalies of the Inferior Vena Cava and their Clinical Manifestation. EJVES Extra. 2007;(14):8-13. DOI:10.1016/j.ejvs.2007.02.027.
Address for correspondence:
210024, Respublika Belarus',
g. Minsk, ul. Kizhevatova, d. 58,
UZ "Gorodskaia klinicheskaia bol'nitsa skoroi meditsinskoi pomoshchi",
2-ia kafedra khirurgicheskikh boleznei,
UO "Belorusskii gosudarstvennyi meditsinskii universitet".
tel. mob.:+375 29 624 55 78,
e-mail: vladimirkh77@mail.ru,
Khryshchanovich Vladimir Ianovich
Information about the authors:
Khryshchanovich V.J. MD, an associate professor of the 2nd chair of surgical diseases of EE "Belarusian State Medical University ", Minsk.
Klimchuk I.P., PhD, a head of vascular and phlebological surgery department of "The 4th CCH named after N.E. Savchenko”, Minsk
Emelianenko A.V., a physician-intern of department of vascular and phlebological surgery EH "The 4th CCH named after N.E. Savchenko", Minsk.
Kalinin S.S., an angiosurgeon of Department of Vascular and phlebological surgery EH "The 4th CCH named after N.E. Savchenko", Minsk.

V.A. SERGEEV 1, A.A. GLUKHOV 2

METHOD FOR PROGRAMMED IRRIGATION-ASPIRATION SANATION IN THE COMBINED TREATMENT OF PATIENTS WITH CHRONIC POSTTRAUMATIC LONG BONE OSTEOMYELITIS

SBEE HPE "Voronezh State Medical University named by N.N. Burdenko",
BME "Orel region clinical hospital"
The Russian Federation

Objectives. To study the efficiency of method for programmed irrigation-aspiration sanation in the combined treatment of patients with chronic posttraumatic long bone osteomyelitis.
Methods. Results of treatment for 112 patients (21-62 yrs old) with chronic posttraumatic long bone osteomyelitis have been analyzed. Depending on the method of suppurative focus sanation after radical osteonecrectomy, the patients were divided into two groups. In the control group drainage and sanation of the osteomyelitic focus were performed by conventional surgical method. In the main group the combined treatment was added by a new method of programmed sanation with the original AMP-01 device. The sequential programmed inclusion of cycles of pumping antiseptic solution into the pus pocket, its exposure and aspiration of spent solution has been applied.
Results. Application of the method for programmed irrigation-aspiration sanation in the combined treatment proved to exactly conforms to the principles of active surgical approach. Good short-term results were observed in the main group in 88,1% cases, in the control group – in 73,6% cases, including relevant 2,2-fold reduction of the number of purulence in the main group compared to the control one. After 2-year follow-up the long-term results of the treatment showed a 2-fold reduction of the number of recurrent osteomyelitis. Extremity function in the main group was recovered in 68,5% cases and was limited in 31,5% cases; in the control group – in 58,3% and 41,7%, respectively (p<0,05). The number of favourable outcomes increased by 12,3%.
Conclusion. The study conducted confirmed the efficiency of applying the method for programmed irrigation-aspiration sanation in the combined treatment of patients with chronic posttraumatic long bone osteomyelitis, since this method reliably improves the sanation quality, allowing adequately enhancing efficiency of the treatment.

Keywords: pus pocket, active surgical approach, chronic osteomyelitis, osteomyelitic focus, programmed irrigation-aspiration sanation, favourable outcomes, efficiency
p. 533-538 of the original issue
References
  1. Amiraslanov IA, Svetukhin AM, Borisov IV. Sovremennye printsipy khirurgicheskogo lecheniia khronicheskogo osteomielita [Modern principles of surgical treatment of chronic osteomyelitis]. Infektsii v Khirurgii. Moscow, RF: 2004;(2):8-13.
  2. Vinnik IuS, Shishatskaia EI, Markelova NM, Shageev AA, Khorzhevskii VA, Per'ianova OV, Shumilova AA, Vasilenia ES. Primenenie biodegradiruemykh polimerov dlia zameshcheniia kostnykh polostei pri khronicheskom osteomielite [The use of biodegradable polymers to replace the bone cavities in chronic osteomyelitis]. Vestn Eksperim i Klin Khirurgii. 2013;(4)1:51-57.
  3. Gostishchev V.K. Osnovnye printsipy etiotropnoi terapii khronicheskogo osteomielita [The basic principles of causal treatment of chronic osteomyelitis]. Khirurgiia. 1999;(9):38-42.
  4. Amiraslanov IA, Svetukhin AM, Borisov IV, Ushakov AA. Vybor khirurgicheskoi taktiki pri lechenii bol'nykh osteomielitom dlinnykh kostei v zavisimosti ot kharaktera [The option of surgical approach in the treatment of patients with osteomyelitis of the long bones depending on the origin]. Khirurgiia. 2008;(9):46-50.
  5. Sonis AG. Rezul'taty primeneniia gravitatsionnoi terapii v lechenii patsientov s osteomielitom nizhnikh konechnostei [Results of application of gravitational therapy in the treatment of patients with osteomyelitis of lower extremities]. Vestn Eksperim i Klin Khirurgii. 2010;(3)4:377-83.
  6. Privalov VA, Krochek IV, Abushkin IA. i dr. Lazernaia osteoperforatspia v lechenii vospalitel'nykh i destruktivnykh zabolevanii kostei [Laser osteopunching in the treatment of inflammatory and destructive bone diseases]. Vestn Eksperim i Klin Khirurgii. 2008;(2)1:19-28.
  7. Lazzarini L, De Lalla F, Mader JT. Long Bone Osteomyelitis. Curr Infect Dis Rep. 2002 Oct;4(5):439-45.
  8. Goriunov SV, Romashov DV, Butivshchenko IA. Gnoinaia khirurgiia [Purulent surgery]: atlas/ red. Abramov IS. Moscow, RF: BINOM; 2004. 558 p.
  9. Nikitin GD, Rak AV, Linnik SA, Saldun GP, Kravtsov AG, Agafonov NA, Fakhrutdinov RZ, Khaimin VV. Khirurgicheskoe lechenie khronicheskogo osteomielita [Surgical treatment of chronic osteomyelitis]. Saint-Petersburg, RF: Russkaia Grafika; 2000. 288 p.
  10. Zaitsev AB, Mitrofanov VN. Sistemnyi podkhod k rekonstruktivno-vosstanovitel'nomu lecheniiu khronicheskogo osteomielita goleni [A systematic approach to reconstructive treatment of chronic osteomyelitis of the tibia]. Travmatologiia i Ortopediia. 2010;(2):215-18.
  11. Cierny G 3rd, DiPasquale D. Treatment of chronic infection. J Am Acad Orthop Surg. 2006;14(10 Spec No.):S105-10.
  12. Feltsan T, Mracna J, Holly D.Use of thrombocyte concentrates in treatment of bone defects. Bratisl Lek Listy. 2011;112(11):655-57.
  13. Filardo G, Kon E, Pereira Ruiz MT, Vaccaro F, Guitaldi R, Di Martino A, Cenacchi A, Fornasari PM, Marcacci M. Platelet-rich plasma intra-articular injections for cartilage degeneration and osteoarthritis: single- versus double-spinning approach. Knee Surg Sports Traumatol Arthrosc. 2012 Oct;20(10):2082-91.
  14. Greenfield EM, Bechtold J; What other biologic and mechanical factors might contribute to osteolysis? Implant Wear Symposium 2007 Biologic Work Group. J Am Acad Orthop Surg. 2008;16 (Suppl 1):S56-62.
Address for correspondence:
394000, Rossiiskaia Federatsiia,
g. Voronezh, ul. Studencheskaia, d. 10,
GBOU VPO "Voronezhskii gosudarstvennyi meditsinskii universitet im. N.N. Burdenko",
kafedra obshchei khirurgii,
tel.mob.: 8 905 165-09-92,
e-mail: sergeevdoc60@yandex.ru,
Sergeev Vladimir Anatol'evich
Information about the authors:
Sergeev V.A., PhD, a surgeon of coloproctological department of BME "Orel Regional Hospital".
Glukhov A.A., MD, professor, a head of the department of general surgery, Director of the Institute of Surgical Infection of SBEE HPE "Voronezh State Medical University named after NN Burdenko".

REVIEWS

L.M. CHERNUKHA, O.V. KASHYROVA, A.V. TODOSYEV

CLASSIFICATION STRATEGIC APPROACHES IN THE TREATMENT OF CONGENITAL VASCULAR MALFORMATIONS: A VIEW OF A VASCULAR SURGEON

SE "National Institute of Surgery and Transplantology named by O.O. Shalymov" NAMS of Ukraine, Kiev.
Ukraine

The article is devoted to the problems of terminology, classification of different forms of congenital vascular malformations (CVM) or angiodisplasias, basic principles of diagnostics and treatment. The aim of this paper is to improve the classification of congenital vascular malformations and the establishment of diagnostic and therapeutic algorithms to optimize tactics and treatment outcomes.
The advantages and disadvantages of basic preceding domestic and foreign classifications are analysed in details, the necessity of acceptance of uniform terminology, classification with the purpose of providing of universal diagnostic and treatment tactics is marked. On the basis of long-term clinical experience the authors offer their own classification of congenital vascular abnormalities “vasc+t” and algorithms of diagnostics and treatment of the most widespread forms of CVM.
The offered classification includes points, allowing to define the form of CVM, prevalence of disease, presence of complications with indications to operative treatment: I. Vascular defect of CVM; II. Anatomic defect of CVM; III. Localisation of defect; IV. Complications being absolute and relative indications to treatment; V. Congenital vascular tumours. Possibility of differential diagnostics of congenital vascular tumours is taken into account letting to avoid fatal errors on the stage of diagnostics.

Keywords: ñongenital vascular malformations, angiodysplasia, new classification of vascular abnomalities «vasc+t», congenital vascular tumours, complications, terminology, algorithms of diagnostics and treatment
p. 539-551 of the original issue
References
  1. Dan VN, Sapelkin SV. Angiodisplazii (vrozhdennye poroki razvitiia sosudov). Moscow, RF: Verdana; 2008. 199 p.
  2. Dan VN, Shchegolev AI, Sapelkin SV. Sovremennye klassifikatsii vrozhdennykh porokov razvitiia sosudov (angiodisplazii) [Modern classification of congenital malformations of vessels (angiodysplasias)]. Angiologiia i Sosud Khirurgiia . 2006;(12)4:28-33.
  3. Al'tman IV, Chernukha LM, Guch AA. Sosudistye anomalii kak sledstvie narusheniia embrional'nogo angiogeneza [Vascular anomalies as a result of violations of embryonic angiogenesis]. Kl³n Flebolog³ia. 2008;(1)1:46-48.
  4. Yakes WS, Parker SH. Diagnosis and management of vascular anomalies. in: castaneda-zuniga wr, Tadavarthy SM, edit. Interventional radiology. Baltimore: Williams and Wilkins. 1992:152-89.
  5. Lee BB, Do YS, Yakes W, Kim DI, Mattassi R, Hyon WS.Management of arteriovenous malformations: a multidisciplinary approach. J Vasc Surg. 2004 Mar;39(3):590-600.
  6. Lee BB. Critical issues in management of congenital vascular malformation. Ann Vasc Surg. 2004 May;18(3):380-92.
  7. Persky MS, Yoo HJ, Berenstein A. Management of vascular malformations of the mandible and maxilla. Laryngoscope. 2003 nov;113(11):1885-92.
  8. Duffy K. Genetics and syndromes associated with vascular malformations. Pediatr Clin North Am. 2010 oct;57(5):1111-20. doi: 10.1016/j.pcl.2010.07.001.
  9. Eerola I, Boon LM, Mulliken JB. Capillary malformation arteriovenous malformation, a new clinical and genetic disorder caused by rasa1 mutations. Am J Hum Genet. 2003;(73):1240-49.
  10. Malan E, Puglionisi A. Congenital angiodysplasias of the extremities. II. Arterial, arterial and venous, and haemolymphatic dysplasias. J Cardiovasc Surg (Torino). 1965 Jul-Aug;6(4):255-45.
  11. Szilagyi DE, Smith RF, Elliott JP, Hageman JH.Congenital arteriovenous anomalies of the limbs. Arch Surg. 1976 Apr;111(4):423-29.
  12. Rutherford RB, Anderson BO, Durham JD. Congenital vascular malformations of the extremities. In Moore WS (ed): vascular surgery: a comprehensive review, 5th ed. Philadelphia, WB Saunders; 1998:191-202.
  13. Rosen RJ, Riles TS.. Congenital vascular malformations. RB Rutherford (ed.), Vascular Surgery. (5th ed) Saunders WB. Philadelphia. 2000:1451-65.
  14. Gloviczki P, Noel AA, Hollier LH. Arteriovenous fistulas and vascular malformations. In: Ascher E, editor. Haimovici's Vascular Surgery. 5th ed. Malden (ma): Blackwell publishing, inc.; 2004:991-14.
  15. Eerola I, Boon LM, Mulliken JB, Burrows PE, Dompmartin A, Watanabe S, Vanwijck R, Vikkula M. Capillary malformation-arteriovenous malformation, a new clinical and genetic disorder caused by rasa1 mutations. Am J Hum Genet. 2003 Dec;73(6):1240-49.
  16. Collins PS, Han W, Williams LR, Rich N, Lee JF, Villavicencio J.Maffucci's syndrome (hemangiomatosis osteolytica): a report of four cases. J Vasc Surg. 1992 Sep;16(3):364-71.
  17. Lublin M, Schwartzentruber DJ, Lukish J, Chester C, Biesecker LG, Newman KD. Principles for the surgical management of patients with proteus syndrome and patients with overgrowth not meeting proteus criteria. J Pediatr Surg. 2002 Jul;37(7):1013-20.
  18. Tasnádi G. Epidemiology and etiology of congenital vascular malformations. Semin Vasc Surg. 1993 Dec;6(4):200-3.
  19. Forbes G, Earnest F, Jackson IT, Marsh WR, Jack CR, Cross SA. Therapeutic embolization angiography for extra-axial lesions in the head. MAYO CLIN PROC. 1986 Jun;61(6):427-41.
  20. Milovanov AP. Patomorfologiia angiodisplazii konechnostei [Pathomorphology of limb dysplasia]. Moscow, USSR. Meditsina; 1978. 143 p.
  21. Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg. 1982;(69)3:412-22.
  22. Noel AA, Gloviczki P, Cherry KJ, Rooke TW, Stanson AW, Driscoll DJ. Surgical treatment of venous malformations in klippel-trénaunay syndrome. J Vasc Surg. 2000 Nov;32(5):840-47.
  23. Kohout MP, Hansen M, Pribaz JJ, Mulliken JB. Arteriovenous malformations of the head and neck: natural history and management. Plast Reconstr Surg. 1998 Sep;102(3):643-54.
  24. Lee BB. Consensus document of the international union of angiology on av malformation/ international angiology. 2012;31(suppl.1)3:108-109.
  25. Lee BB, Baumgartner I, Berlien HP, Bianchini G, Burrows P, Do YS, Ivancev K, Kool LS, Laredo J, Loose DA, Lopez-Gutierrez JC, Mattassi R, Parsi K, Rimon U, Rosenblatt M, Shortell C, Simkin R, Stillo F, Villavicencio L, Yakes W. Consensus document of the international union of angiology (iua)-2013. current concept on the management of arterio-venous management. Int Angiol. 2013 Feb;32(1):9-36.
  26. Blei F. Medical and genetic aspects of vascular anomalies. Tech Vasc Interv Radiol. 2013 Mar;16(1):2-11. doi: 10.1053/j.tvir.2013.01.002.
  27. Liu AS, Mulliken JB, Zurakowski D, Fishman SJ, Greene AK. Extracranial arteriovenous malformations: natural progression and recurrence after treatment. Plast Reconstr Surg. 2010 Apr;125(4):1185-94. doi: 10.1097/PRS.0b013e3181d18070.
  28. Strohschneider T, Lange S, Hanke H. Parkes-Weber-syndrom. Gefässchirurgie April 2009;(14)2:129-33.
  29. Burrows PE, Mulliken JB, Fishman SJ, Klement GL, Folkman J. Pharmacological treatment of a diffuse arteriovenous malformation of the upper extremity in a child. J Craniofac Surg. 2009 Mar;20( Suppl 1):597-602. doi: 10.1097/SCS.0B013E3181927F1E.
  30. Visser A, FitzJohn T, Tan ST. Surgical management of arteriovenous malformation. J Plast Reconstr Aesthet Surg. 2011 Mar;64(3):283-91. doi: 10.1016/j.bjps.2010.05.033.
Address for correspondence:
03680, Ukraina, g. Kiev, ul. geroev Sevastopolia,
d. 30. GU "Natsional'nyi institut khirurgii i
transplantologii im. A.A. Shalimova"
NAMNU otdel khirurgii magistral'nykh sosudov,
Tel. rab.:+3 8 050 193-05-04,
E-mail: aristosha@list.ru,
Kashirova Elena Vladimirovna
Information about the authors:
Chernuha L.M., MD, a leading researcher of the department of surgery of the great vessels of the National Institute of Surgery and Transplantation named after A.A. Shalimov NAMSU.
Kashirina E.V., a junior researcher of the department of surgery of the great vessels of the National Institute of Surgery and Transplantation named after A.A. Shalimov NAMSU.
Todos'ev A.V., an anesthesiologist-resuscitator of the department of surgery of the great vessels of the National Institute of Surgery and Transplantation named after A.A. Shalimov NAMSU.

I.S. VINNIK1, N.M. MARKELOVA1, N.S. SOLOV'EVA1, E.I. SHISHATSKAIA3, M.N. KUZNETSOV2, A.P. ZUEV1

THE CURRENT DRESSINGS FOR WOUND CARE IN THE TREATMENT OF PURULENT WOUNDS

SBEE HPE "Krasnoyarsk State Medical University” named by prof. V.F. Voyno-Yasenetsky1"
MSH "Road Clinical Hospital on the station Krasnoyarsk "JSC" Russian Railways"2,
FSEI HPE "Siberian Federal University",
Institute of Biophysics of Siberian Branch of the Russian Academy of Sciences, Krasnoyarsk3
The Russian Federation

Currently, the patients with purulent wounds account for about 40% of the patients of surgical profilt. Since the treatment of septic wounds under the bandage remains the main method, as it is the most convenient and economically beneficial, but not effective enough, the development of new advanced coatings possessing simultaneously by multiple properties, is considered to be relevant. In the process of wound healing a physician faces with many problems including the issue of the selection option of a wound dressing, as they differ significantly in their design and properties. A disadvantage of many wound dressings for wound care is the adherence to wound. This results in the regenerating tissue injury and the dressings become sore. Many of the positive properties of dressings reduced as a result of damage caused by daily dressings. In recent years the biocompatible materials for injuries and wounds contribute to more effective healing and regeneration. In this regard, the paper presents the main types of current wound dressings used in the treatment of purulent wounds, their properties, indications and methods of application.

Keywords: purulent wound, wound covering, wound dressing, biocompatible materials, treatment of wounds, wound process, healing and regeneration
p. 552-558 of the original issue
References
  1. Kuzin MI, Kostiuchenok BM, Kolker I. Obshchie printsipy lecheniia gnoinykh ran [General principles of treatment of purulent wounds]. Vestn AMN USSR.1983;(8):45-49.
  2. Falanga V. The chronic wound: Failure to heal. In: Falanga. Vincent, editor. Cutaneous wound healing. London: Martin Dunitz. Publishers; 2001. p 155-64.
  3. Schultz G, Mozingo D, Romanelli M, Claxton K. Wound healing and time; new concepts and scientific applications. Wound Repair and Regeneration. 2005;13(Suppl s4): S1–S11. doi: 10.1111/j.1067-1927.2005.1304S1.x.
  4. Leaper D. Evidence-based wound care in the UK. Int Wound J. 2009 Apr;6(2):89-91. doi: 10.1111/j.1742-481X.2009.00581.x.
  5. Fedorov BD, Chizha IM./ red. Biologicheski aktivnye pereviazochnye sredstva v kompleksnom lechenii gnoino-nekroticheskikh ran [Biologically active dressings in treatment of necrotic wounds]. Moscow, RF: 2000. 36 p.
  6. Kostiuchenok BM, Karlov VA, Medetbekov IM. Aktivnoe khirurgicheskoe lechenie gnoinoi rany [Active surgical treatment of purulent wound]. Nukus: Karakalpakstan; 1981. 207 p.
  7. Lutsevich OE, Tamrazova OB, Shikunova AI, Pleshkov AS, Ismailov GO, Vorotilov IV, Tolstykh PI. Sovremennye vzgliady na patofiziologiiu i lechenie gnoinykh ran [Modern views on the pathophysiology and treatment of purulent wounds]. Khirurgiia. Zhurn im NI Pirogova 2011;(5):72-77.
  8. Minchenko AN. Rany. Lechenie i profilaktika oslozhnenii: uch posobie [Treatment and prevention of complications]. Saint-Petersburg, RF: SpetsLit; 2003. 207 p.
  9. Nechaev EA./red. Khirurgicheskaia infektsiia - klinika, diagnostika, lechenie [Surgical infection - clinical picture, diagnosis, treatment]. Ruk dlia voen vrachei. Moscow, RF. 1993. 296 p.
  10. Tumanov VP, German GS. Metodicheskoe rukovodstvo po lecheniiu ran [Methodological guidelines for the treatment of wounds]. Moscow, RF: Paul Khartmann; 2000. 123 p.
  11. Shablin DV, Pavlenko SG, Evglevskii AA, Bondarenko PP, Khuranov AA. Sovremennye ranevye pokrytiia v mestnom lechenii ran razlichnogo geneza [Modern wound dressings in local treatment of wounds of various origins]. Fund Issledovaniia. 2013;(12)2:361-65.
  12. Privol'nev VV, Karakulina EV. Osnovnye printsipy mestnogo lecheniia ran i ranevoi infektsii [The basic principles of local treatment of wounds and wound infections]. Klin Mikrobiol Antimikrob Khimioter. 2011;13(3):214-22.
  13. Nazarenko GI, Sugurova IIu, Gliantsev SP. Rana. Poviazka. Bol'noi [A wound. A bandage. A patient.]. Ruk-vo dlia vrachei i medsester. Moscow, RF: Meditsina; 2002. 472 p.
  14. Abaev IuK. Pereviazochnye materialy i sredstva v khirurgii [Dressings and means in surgery]. Vestn Khirurgii im II Grekova. 2004;(163)3:83-87.
  15. Frykberg RG, Driver VR, Carman D, Lucero B, Borris-Hale C, Fylling CP, Rappl LM, Clausen PA. Chronic wounds treated with a physiologically relevant concentration of platelet-rich plasma gel: a prospective case series. Ostomy Wound Manage. 2010 Jun;56(6):36-44.
  16. Andreev DIu, Paramonov BA, Mukhtarova AM. Sovremennye ranevye pokrytiia Ch. I. [Current wound dressings]. Vestn Khirurgii im II Grekova. 2009;(168)3:98-102.
  17. Dronov AM./red. Gnoino-vospalitel'nye zabolevaniia miagkikh tkanei i kostei [Purulent-inflammatory diseases of soft tissues and bones]: Atlas. Moscow, RF: GOETAR-Media; 2008. 257 p.
  18. Kaskaev AV, Cherdantsev DV, Bol'shakov IN. Perspektivy primeneniia sovremennykh ranevykh pokrytii u ozhogovykh bol'nykh [Prospects for the use of modern wound dressings in burn patients]. Sib Med Obozrenie. 2011;(68)2:3-6.
  19. Efimenko NA, Shin FE, Tolstykh MP, Tepliashin A.S. Sovremennye tendentsii v sozdanii biologicheski aktivnykh materialov dlia lecheniia gnoinykh ran [Current trends in the creation of biologically active materials for the treatment of purulent wounds]. Voen Med Zhurn. 2002;(323)1:48-52.
  20. Novikova NF, Mordovtsev VN, Paren'kova TV. Novye vozmozhnosti lecheniia troficheskikh iazv, ran kozhi i miagkikh tkanei, prolezhnei i svishchei [New possibilities of treatment of venous ulcers, wounds, skin and soft tissues, bedsores and fistula]. Retsept. 2005;(2):51-54.
  21. Nakabaiasi N. Polimery meditsinskogo naznacheniia, ispol'zuemye dlia razdeleniia i diffuzii veshchestv [Polymers of medical devices used for the separation and diffusion of substances]. Polimery Med Naznacheniia: per s iap. Moscow, USSR: Meditsina; 1981. 67 p.
  22. Adamian AA, Dobysh SV, Kilimchuk LE. Biologicheski aktivnye pereviazochnye sredstva v kompleksnom lechenii gnoino-nekroticheskikh ran [Biologically active dressings in treatment of purulent necrotic wounds]: metod rekomend. Moscow, RF: 2000. 40 p.
  23. Marissa JC, Fylling CP, Parnell LK Use of platelet rich plasma gel on wound healing: a systematic review and meta-analysis. Eplasty. 2011;(11):e38.
  24. Pham C, Greenwood J, Clelandc H, Woodruff P, Maddern G. Bioengineered skin substitutes for the management of burns: A systematic review. Burns 2007;(33)8:946-57. DOI:10.1016/j.burns.2007.03.020.
  25. Adamson R. Role of macrophages in normal wound healing: an overview. J. Wound Care.2009;18(8):349-51.
  26. Shamova EC, Bol'shakov IN, Gorbunov NS, Nasibov SM. Zazhivlenie kozhi pri ispol'zovanii ranevykh pokrytii na osnove kollagen-khitozanovogo kompleksa [The healing of skin wound using coatings based on collagen-chitosan complex]. Sib Med Obozrenie. 2003;4(29):25-27.
  27. Kong M, Chen XG, Xing K, Park HJ. Antimicrobial properties of chitosan and mode of action: a state of the art review. Int J Food Microbiol. 2010;(144)1:51-63.
  28. Jayakumar R, Prabaharan M, Kumar PT, Nair SV, Tamura H. Biomaterials based on chitin and chitosan in wound dressing applications. Biotechnology Advances. 2011;(29)3:322-37.
  29. Beliakov NA, Korol'kova SV. Adsorbenty. Katalog-spravochnik [Adsorbents. Catalogue]. Saint-Petersburg, USSR: SPbMAPO; 1997. 80 p.
  30. Vinnik IS, Markelova NM, Tiuriumin VS, Baranov SA, Per'ianova OV, Konovalenko AN. Primenenie sorbtsionnogo transmembrannogo dializa v lechenii poverkhnostnykh gnoinykh ran [Application of sorption transmembrane dialysis in the treatment of superficial wounds festering]. Krasnoiarsk, RF: Verso; 2011. 24 p.
  31. Efimenko NA, Nuzhdin OI. Primenenie sorbtsionnykh materialov v lechenii gnoinykh ran [The use of sorption materials in the treatment of purulent wounds]. Voen Med Zhurn. 1998;(7):28-32.
  32. Larichev AB, Shishlo VK, Lisovskii AV, Chistiakov AL, Vasil'ev AA. Profilaktika ranevoi infektsii i morfologicheskie aspekty zazhivleniia asepticheskoi rany [Prevention of wound infection and morphological aspects of wound healing aseptic]. Vestn Eksperim i Klin Khirurgii. 2011;(4):728–33.
  33. Griaznov VN, Cheredniakov EF, Chernykh AV. Ispol'zovanie gelevykh sorbentov v eksperimental'noi i klinicheskoi khirurgii [Using gel sorbents in experimental and clinical surgery ]. Voronezh, RF: 1990. 88 p.
  34. Meylan G, Tschantz P. Pansement ou absence de pansement sur les plaies opératoires. étude prospective comparative. Ann de Chirurgie. 2001;(5)126:459-62.
  35. Lacci KM, Dardik A. Platelet-Rich Plasma: Support for Its Use in Wound Healing. J Biol Med. 2010 Mar; 83(1):1-9.
  36. Hanna JR, Giacopelli JA. A review of wound healing and wound dressing products. J Foot Ankle Surg. 1997;(36):2-14. DOI: 10.1016/S1067-2516(97)80003-8.
  37. Vuorisalo S, Venermo M, Lepantalo M. Treatment of diabetic foot ulcers. J Cardiovasc Surg. (Torino). 2009;(3)50:275-91.
  38. Leahy PJ, Lawrence WT. Biologic enhancement of wound healing. Clin Plast Surg. 2007 Oct;34(4):659-71. DOI: 10.1016/j.cps.2007.07.001.
  39. Jones V, Grey JE, Harding KG Wound dressings. BMJ. 2006 Apr 1;332(7544):777-80. doi: 10.1136/bmj.332.7544.777.
  40. Thomas S. Alginate dressings in surgery and wound management: Part 1. J Wound. 2000;(9):2:56-60. doi: 10.12968/jowc.2000.9.2.26338.
  41. Thomas S. Alginate dressings in surgery and wound management: Part 2. J Wound. 2000;(9)3:115-19. doi: 10.12968/jowc.2000.9.2.26338.42.
  42. Ajay VS, Aditi AS, Gade NW. Nanomaterials: New generation therapeutics in wound healing and tissue repair. Current Nanoscience. 2010;(6)6:577-86. doi: 10.2174/157341310793348632.
  43. Han T, Wang H, Zhang YQ. Combining platelet-rich plasma and tissue-engineered skin in the treatment of large skin wound. J Craniofac Surg. 23(2):439-447, March 2012. DOI: 10.1097/SCS.0b013e318231964a.
  44. Mi FL, Shyu SS, Wu YB, Lee ST, Shyong JY, Huang RN. Fabrication and characterization of a sponge-like asymmetric chitosan membrane as a wound dressing. Biomaterials. 2001 Jan;22(2):165-73. DOI: 10.1016/S0142-9612(00)00167-8.
  45. Fonseca AP. Biofilms in wounds: An unsolved problem? EWMA Journal. 2011;(11)2:10-23.
  46. Chen GQ, Wu Q (2005). The application of polyhydroxyalkanoates as tissue engineering materials. Biomaterials 26 (33): 6565-78. doi: 10.1016/J.BIOMATERIALS.2005.04.036.47.
  47. Bugnicourt1 E, Cinelli P, Lazzeri A, Alvarez1 V. Polyhydroxyalkanoate (PHA): Review of synthesis, characteristics, processing and potential applications in packaging. eXPRESS Polymer Letters. 2014;(8)11:791-808. doi: 10.3144/expresspolymlett.2014.82.
  48. Christopher JB, Sinskey AJ. Applications of polyhydroxyalkanoates in the medical industry. International Journal of Biotechnology for Wellness Industries, 2012;(1)1:53-60.
  49. Shishatskaya EI, Volova TG. Poligidroksialkanoaty kak matriks v kletochnykh tekhnologiiakh [Polyhydroxyalkanoates as a matrix in cell technology]. Klet Transplantol i Tkan Inzhen. 2010;(5)3:55-56.
  50. Shyshatskaya IS, Kamendovc IV, Starosvetskyc SI, Vinnikd YS, Markelovad NN, Shageevd AA, Khorzhevskyd VA, Peryanovad OV, Shumilova AA. An in vivo study of osteoplastic properties of resorbable poly-3-hydroxybutyrate in models of segmental osteotomy and chronic osteomyelitis. An International Journ Artificial Cells, Nanomedicine, and Biotechnology. 2014;(42)5:344-55. DOI: 10.3109/21691401.2013.816312.
Address for correspondence:
660022, Rossiiskaia Federatsiia,
g. Krasnoiarsk, ulitsa Partizana Zhelezniaka, dom 1,
GBOU VPO "Krasnoiarskii gosudarstvennyi meditsinskii universitet im. prof. V.F. Voino-Iasenetskogo",
kafedra obshchei khirurgii,
tel: +7 913 538-38-36,
e-mail: markelova_nadya@mail.ru,
Markelova Nadezhda Mikhailovna
Information about the authors:
Winnick Y.S., MD, professor, a head of a chair of general surgery named after prof. M.I. Gulman Medical University "Krasnoyarsk State Medical University named by prof. V.F. Voyno-Yasenetsky."
Markelov N.M., MD., an assistant professor of a chair of general surgery named prof. M.I. Gulman Medical University "Krasnoyarsk State Medical University named after prof. V.F. Voyno-Yasenetsky".
Shishatskaya E.I., MD (B), professor, a researcher FSEIHPE "Siberian Federal University", the Institute of Biophysics, Siberian Branch of the Russian Academy of Sciences, a head of the department of medical biology in Krasnoyarsk.
Kuznetsov M.N., PhD, a physician of second surgical department MSH "Road Clinical Hospital on the station Krasnoyarsk "JSC" Russian Railways".
Soloviev N.S., a graduate student of the chair of general surgery named prof. M.I. Gulman Medical University "Krasnoyarsk State Medical University named after prof. V.F. Voyno-Yasenetsky".
Zuev A.P., a graduate student of the chair of general surgery named prof. M.I. Gulman Medical University "Krasnoyarsk State Medical University named after prof. V.F. Voyno-Yasenetsky".

V.I. LOGINOV1, V.V. PARSHIKOV2, R.R. KASIMOV1, A.B. BABURIN1

CURRENT MECHANICAL METHODS OF INTRAOPERATIVE PREVENTION OF SURGICAL SITE INFECTIONS

FSCE "422 Military Hospital"1 the Defense Ministry of Russia, Nizhniy
Novgorod,
Medical University "Nizhny Novgorod State Medical Academy of
Ministry of Health"2
The Russian Federation

To present the current mechanical methods of prevention of intraoperative surgical site infection and to evaluate their effectiveness. The frequency of inflammatory complications after laparotomy may reach 9,4-27,3%. The lack of the reduction in the number of postoperative complications associates with an increase of the total volume of the complex surgical interventions, against the background of resistance and virulence of nosocomial microflora, as well as the application of synthetic grafts in clinical practice. Intraoperative correction of laparotomic wound using a compensating device showed that has a significant positive effect on the healing process. Suturing wounds after laparotomy with continuous mattress overlay continuous seam and simultaneous formation dublication create the optimal conditions to ensure the formation of an elastic scar. For the prevention of wound complications in prosthetics repair of abdominal wall ventral hernias the new methods of suturing wounds and types of sutures, various techniques of adhesive, spoke, needle, rod, liquid-gel tension of edges of wound from surgical incisions and skin flap have been presented. The necessity of obligatory vacuum wound drainage using devices of constant aspiration after surgery on the postoperative ventral hernia with synthetic implants is confirmed by numerous works of Russian and foreign scientists. The conducted analysis shows the efficiency of various mechanical devices for stretching and drawing wound edges together, adaptive stitches, advanced methods of vacuum drainage to prevent infectious complications of the surgical site and the development of incisional hernias.

Keywords: ventral hernias, wound complications, wound infection, mechanical devices for drawing together the edges of wounds, drainage, draining device, adaptive suture
p. 559-565 of the original issue
References
  1. Pleshkov VG, Golub AV, Moskalev AP, Galkin DV, Bedenkov A.V, Kozlov RS. Vliianie infektsii oblasti khirurgicheskogo vmeshatel'stva na dlitel'nost' gospitalizatsii patsientov khirurgicheskikh otdelenii mnogoprofil'nykh statsionarov [Influence of surgical site infections on the duration of hospitalization of surgical patients in multidisciplinary hospitals]. Al'manakh Klin Meditsiny. 2007;(16):158-64.
  2. Fedorov VD, Svetukhin AM. Izbrannyi kurs lektsii po gnoinoi khirurgii [Chosen course on contaminated surgery]. Moscow, RF: Miklosh; 2010. 365 p.
  3. Gostishchev VK, Khachatrian NN, Omel'ianovskii VV, Dibirov MD, Evseev MA. Novye vozmozhnosti profilaktiki posleoperatsionnykh oslozhnenii v abdominal'noi khirurgii [New in the prevention of postoperative complications in abdominal surgery]. Khirurgiia. Zhurn im NI Pirogova. 2011;(5):56-60.
  4. Leshchishin IaM, Baranov AI, Konovalov AA, Solovenko SS. Chastota vstrechaemosti i struktura gnoinykh oslozhnenii oblasti operativnogo vmeshatel'stva v neotlozhnoi khirurgii [The incidence and structure suppurative complications in the surgical site in emergency surgery]. Biull VSNTs SO RAMN. 2011;4(80):96-98.
  5. Kukosh MV, Vlasov AV, Gomozov GI. Profilaktika rannikh posleoperatsionnykh oslozhnenii pri endoprotezirovanii ventral'nykh gryzh [Prevention of early postoperative complications at ehndoprotezirovanii ventral hernias]. Novosti Khirurgii. 2012;20(5):32-37.
  6. Malkov IS, Shakirov MI, Garaev RK, Nizamutdinov VN, Kozlov S. Intraoperatsionnaia profilaktika ranevykh gnoino-vospalitel'nykh oslozhnenii [Intraoperative wound prevention of inflammatory complications] Kazan Med Zhurn. 2006;(2)87:108-10.
  7. Sørensen LT, Hemmingsen U, Kallehave F, Wille-Jørgensen P, Kjaergaard J, Møller LN, Jørgensen T.Risk factors for tissue and wound complications in gastrointestinal surgery. Ann Surg. 2005 Apr;241(4):654-58.
  8. Visokai V, Lipská L, Bergmann P, Trubac M, Mrácek M, Martinu V. [Re-laparotomy for complications of urgent abdominal disorders]. [Article in Czech] Rozhl Chir. 2006 Apr;85(4):180-85.
  9. Beschastnov VV, Riabkov MG, Malakhova NI, Moskovskaia AA, Kleiment'ev EV. Rezul'taty mikrobiologicheskogo monitoringa vozbuditelei infektsii oblasti khirurgicheskogo vmeshatel'stva u bol'nykh s tolstokishechnoi neprokhodimost'iu opukholevogo geneza [The results of microbiological monitoring of infectious agents in the surgical site in patients with colonic obstruction of tumor genesis]. Izvestiia vysshikh uch zav. Povolzhskii region. Med Nauki. 2013;(4):61-69.
  10. Abdollahi A, Maddah GH, Mehrabi BM, Jangjoo A, Forghani MN, Sharbaf N. Prosthetic incisional hernioplasty: clinical experience with 354 cases. Hernia. 2010 Dec;14(6):569-73. doi: 10.1007/s10029-010-0685-9.
  11. Abo-Ryia MH, El-Khadrawy OH, Abd-Allah HS. Prophylactic preperitoneal mesh placement in open bariatric surgery: a guard against incisional hernia development. Obes Surg. 2013 Oct;23(10):1571-74. doi: 10.1007/s11695-013-0915-1.
  12. Zhukovskii VA. Sovremennye tendentsii i podkhody k razrabotke polimernykh endoprotezov dlia gernioplastiki [Current trends and approaches to the development of polymer implants for hernia repair] Vestn Khirurgii. 2011;(1):102-105.
  13. Dambaev GTs, Khokhlov KS, Gabidulina NV, Shcheglov AV. Nenatiazhnaia gernioplastika pri lechenii bol'nykh s posleoperatsionnymi ventral'nymi gryzhami [Tension free hernioplastics in patients with postoperative ventral hernias]. Sib Med Zhurn. 2011;(26)1-2:121-24.
  14. Kaoutzanis C, Leichtle SW, Mouawad NJ, Welch KB, Lampman RM, Cleary RK. Postoperative surgical site infections after ventral/incisional hernia repair: a comparison of open and laparoscopic outcomes. Surg Endosc. 2013 Jun;27(6):2221-30. doi: 10.1007/s00464-012-2743-0.
  15. Patel KM, Bhanot P, Franklin B, Albino F, Nahabedian MY. Use of intraoperative indocyanin-green angiography to minimize wound healing complications in abdominal wall reconstruction. J Plast Surg Hand Surg. 2013 Dec;47(6):476-80. doi: 10.3109/2000656X.2013.787085.
  16. Shakirov MI, Garaev VN, Birial'tsev VN, Tagirov MR, Gabigov IM, Zakirov AM, Malkov IS. Kompensiruiushchee ustroistvo [The compensating device]. Patent RF ¹ 40163.2004.
  17. Izmailov SG, Izmailov GA, Podushkina IV, Loginov VI. Lechenie ran [Treatment of wounds]. Kazan', RF: Kazan Gos Tekh Un-t; 2003. 92 p.
  18. Saraev VV, Vlasov AP, Deriabin AM. Sposob ushivaniia laparotomnoi rany [The method of suturing the laparotomic wounds]: Patent RF. ¹2314049. 2006.
  19. Wysocki A, Strzałka M, Budzyński P. [Tension-free technique for the repair of strangulated abdominal hernias]. [Article in Polish]. Przegl Lek. 2011;68(3):154-56.
  20. Beschastnov VV, Maramokhin VN. Sluchai tiazhelogo ognestrel'nogo pronikaiushchego mnozhestvennogo raneniia zhivota, oslozhnennogo razvitiem mestnogo i generalizovannogo infektsionnogo protsessa [The case of multiple severe gunshot wounds penetrating the stomach, complicated by the development of local and generalized infection]. Sovr Tekhnologii v Meditsine. 2011;(1):146-48.
  21. Abbott DE, Dumanian GA, Halverson AL Management of laparotomy wound dehiscence. Am Surg. 2007 Dec;73(12):1224-27.
  22. Kuznetsov AV, Kuznetsov IuV. Vybor sposoba alloplastiki pri gryzhevykh defektakh bol'shikh razmerov [The choice of alloplasty at large hernial defects]. Vestn NGU. Seriia: Biologiia, Klin Meditsina. 2011;(9)2:186-91.
  23. Semenov GM, Petrishin LV, Kovshova MV. Khirurgicheskii shov [Surgical suture]. Saint-Petersburg, RF: Piter; 2001. 256 p.
  24. Izmailov SG, Izmailov GA. Novye tekhnologii v khirurgii ran [New technologies in surgery wounds]. Nizhnii Novgorod, RF: NGMA; 2004. 340 p.
  25. Ovchinnikov VA, Abelevich AI. Soedinenie tkanei v khirurgii [Compound tissues in surgery]. Rukovodstvo. Nizhnii Novgorod, RF: NizhGMA; 2014. 152 p.
  26. Subramania KJ, Mohit S, Sasidharan PR, Abraham MK, Arun P, Kekatpure V. Sure closure - skin stretching system, our clinical experimence. Indian Iplast Surg. 2005;(38)2:132-37. DOI:10.4103/0970-0358.19782.
  27. Narezkin DV, Sergeev EV. Metody profilaktiki razvitiia gnoino-vospalitel'nykh oslozhnenii pri gryzhesechenii ushchemlennykh posleoperatsionnykh ventral'nykh gryzh [The preventing methods of the development of inflammatory complications in herniotomy strangulated postoperative ventral hernias]. Novosti Khirurgii. 2014;(6)22:743-49.
  28. Bessa SS, Abdel-Razek AH.Results of prosthetic mesh repair in the emergency management of the acutely incarcerated and/or strangulated ventral hernias: a seven years study. Hernia. 2013 Feb;17(1):59-65. doi: 10.1007/s10029-012-0938-x.
  29. Aleksandrenkov NV, Mukhin AS, Rebtsovskii VA., Leont'ev A.E. Sposob ushivaniia rany pri nadaponevroticheskoi plastike polipropilenovoi setkoi bol'shikh posleoperatsionnykh ventral'nykh gryzh [The method of suturing the wounds in plasty by polypropylene mesh of large postoperative ventral hernias]. Novosti Khirurgii. 2013;(21)1:88-93.
  30. Kotov IG, Ershov EG, Kramynin VB. Sposob fiksatsii podkozhnoi zhirovoi kletchatki posle gerniolastiki setchatym protezom [The method of fixing the subcutaneous fat after hernia repair by mesh prosthesis]. Patent RF ¹2385675. 2010.
  31. Felcht M, Koenen W, Weiss C, Weina K, Geraud C, Faulhaber J. Delayed closure of complex defects with serial tightening of loop sutures - clinical outcome in 64 consecutive patients. J Eur Acad Dermatol Venereol. 2014 Apr;28(4):454-60. doi: 10.1111/jdv.12122.
  32. Topaz M, Carmel NN, Silberman À. The TopClosure® 3S System, for skin stretching and a secure wound closure. Eur J Plast Surg. 2012 Jul; 35(7): 533–543. doi: 10.1007/s00238-011-0671-1PMCID.
  33. Bogos'ian RR, Beschastnov VV. Kompleksnoe ispol'zovanie sposobov dozirovannoi spitsevoi i ekspandernoi dermotenzii [Complex use of methods of dosage-spoke and expander dermotension]. Annaly Plasticheskoi, Rekonstruktivnoi i Esteticheskoi Khirurgii. 2012;(4):51-57.
  34. Parfenov IP, Dolzhikov AA, Mishustin AM, Iarosh AL, Soloshenko DV, Bitenskaia EP, Molchanova DS. Puti profilaktiki posleoperatsionnykh oslozhnenii v khirurgii gryzh perednei briushnoi stenki [Ways to prevent postoperative complications in surgery of the anterior abdominal wall hernias]. Nauch Vedomosti Belgorod Gos Uni-ta. Seriia: Meditsina. Farmatsiia. 2011;(14)10:93-97.
  35. Wormer BA, Walters AL, Bradley JF 3rd, Williams KB, Tsirline VB, Augenstein VA, Heniford BT. Does ventral hernia defect length, width, or area predict postoperative quality of life? Answers from a prospective, international study. J Surg Res. 2013 Sep;184(1):169-77. doi: 10.1016/j.jss.2013.04.034.
  36. Ismavel R, Samuel S, Boopalan PR, Chittaranjan SB. A simple solution for wound coverage by skin stretching. J Orthop Trauma. 2011 Mar;25(3):127-32. doi: 10.1097/BOT.0b013e318206f556.
  37. Mishustin AM, Dolzhnkov AA, Iarosh AL, Soloshenko AV, Bitenskaia EP, Lin'kov NA. Sposob lecheniia ventral'nykh gryzh [A method of treating ventral hernias.]. Fund Issledovaniia. 2012;(1):68-72.
  38. Mohan HM, McDermott S, Fenelon L, Fearon NM, O'Connell PR, Oon SF, Burke J, Keane E, Shields C, Winter DC. Plastic wound retractors as bacteriological barriers in gastrointestinal surgery: a prospective multi-institutional trial. J Hosp Infect. 2012 Jun;81(2):109-13.
  39. Shcherbatykh AV, Sokolova SV, Shevchenko KV. Sravnenie effektivnosti razlichnykh sposobov khirurgicheskogo lecheniia posleoperatsionnykh ventral'nykh gryzh [Comparing the effectiveness of different methods of surgical treatment of postoperative ventral hernias]. Vestn Eksperiment i Klin Khirurgii. 2012;(5)1:80-82.
  40. Izmailov SG, Garaev VN. Eksperimental'no-klinicheskoe obosnovanie apparatnogo sposoba lecheniia posleoperatsionnykh eventratsii [Experimentally-clinical substantiation hardware method of treating postoperative eventrations ]. Khirurgiia. Zhurn im NI Pirogova 2004;(2):23-27.
  41. Beschastnov VV, Pevnev AA. Mikrobiologicheskii monitoring gnoinykh ran miagkikh tkanei v usloviiakh obshchekhirurgicheskogo statsionara [Microbiological monitoring of purulent wounds of soft tissues in a general surgical hospital]. Infektsii v Khirurgii. 2010;(1):16-17.
  42. Korenkov M, Paul A, Sauerland S, Neugebauer E, Arndt M, Chevrel JP, Corcione F, Fingerhut A, Flament JB, Kux M, Matzinger A, Myrvold HE, Rath AM. Classification and surgical treatment of incisional hernia. Langenbecks Arch Surg. 2001 Jul;386(4):309.
  43. Kuznetsov AV, Shestakov VV, Fedin EN. Sravnitel'noe issledovanie sposobov drenirovaniia rany posle plastiki SUBLAY [A comparative study of wound drainage method after plastic SUBLAY]. Vestn NGU. Seriia: Biologiia, Klin Meditsina 2011; 9(3):83-187.
  44. Mukhtarov ZM, Malkov IS, Alishev OT, Profilaktika ranevykh posleoperatsionnykh oslozhnenii u bol'nykh s posleoperatsionnymi ventral'nymi gryzhami [Prevention of postoperative wound complications in patients with postoperative ventral hernias]. Prakt Meditsina. 2014;(81)5:106-109.
  45. Osintsev EIu, Slobodskoi AB, Mel'sitov VA, Kulinskii AN, Osintsev BE. Optimizatsiia aspiratsionno-promyvnogo drenirovaniia gnoinykh ran [Optimization of aspiration-washing drainage of purulent wounds]. Vestn Khirurgii im II Grekova. 2012;(171)5:61-64.
  46. Poldermans D, Bax JJ, Boersma E, De Hert S, Eeckhout E, Fowkes G, Gorenek B, Hennerici MG, Iung B, Kelm M, Kjeldsen KP, Kristensen SD, Lopez-Sendon J, Pelosi P, Philippe F, Pierard L, Ponikowski P, Schmid JP, Sellevold OF, Sicari R, Van den Berghe G, Vermassen F.. Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery. Eur Heart J. 2009 Nov;30(22):2769-812. doi: 10.1093/eurheartj/ehp337.
  47. Mirzabekian IR, Dobrovol'skii SR. Prognoz i profilaktika ranevykh oslozhnenii posle plastiki perednei briushnoi stenki po povodu posleoperatsionnoi ventral'noi gryzhi [Prediction and prevention of wound complications after plasty of the anterior abdominal wall on the postoperative ventral hernia repair]. Khirurgiia. 2008;(1):66-71.
  48. Malkov IS, Mukhtarov ZM, Malkova MI. Puti uluchsheniia rezul'tatov lecheniia bol'nykh s posleoperatsionnymi ventral'nymi gryzhami [Ways to improve the results of treatment of patients with postoperative ventral hernias]. Kazan Med Zhurn. 2014;(4):543-48.
  49. Easterlin B, Bromberg W, Linscott J. A Novel technique of vacuum-assisted wound closure that functions as a delayed primary closure. Wounds. 2007 Dec;19(12):331-33.
  50. Kuo CK, Li WJ, Tuan RS. Cartilage and Ligament Tissue Engineering: Biomaterials, Cellular Interactions, and Regenerative Strategies. In Ratner BD, Hoffman AS, Schoen FJ, Lemons JE. (eds): Biomaterials Science (Third Edition). Academic Press. 2013;1214-36.
  51. Vlasov AV, Kukosh MV. Problema ranevykh oslozhnenii pri endoprotezirovanii briushnoi stenki po povodu ventral'nykh gryzh [The problem of wound complications in arthroplasty of the abdominal wall on the ventral hernias]. Sovr Tekhnologii v Meditsine. 2013;(5)2:116-24.
  52. Timerbulatov MV, Timerbulatov ShV, Gataullina EZ, Valitova ER. Posleoperatsionnye ventral'nye gryzhi: sovremennoe sostoianie problemy [Postoperative ventral hernia: state of the problem.]. Med Vestn Bashkortostan. 2013;8(5):101-107.
Address for correspondence:
603105, Rossiiskaia Federatsiia,
g. N. Novgorod, ul. Izhorskaia, d. 25, k. 3,
FGKU "422 voennyi gospital"' Minoborony Rossii,
khirurgicheskoe otdelenie,
tel. mob.: +7 (920) 035-06-19,
e-mail: rusdoc77@mail.ru,
Kasimov Rustam Rifkatovich
Information about the authors:
Loginov V.E., PhD, an associate professor, intern of the department of surgical FSCE "422 military hospital" of Russian Defense Ministry.
Parshikov V.V., MD, professor, department of hospital surgery named by B.A. Korolev SBEE HPE Medical University "Nizhny Novgorod State Medical Academy of Ministry of Health."
Kasimov R.R., PhD, Colonel m/s, a head of the surgical department, a leading surgeon FSCE "422 military hospital" of Russian Defense Ministry.
Baburin AB, a resident surgical department FSCE "422 military hospital" of Russian Defense Ministry.

CASE REPORTS

N.M. LEMEKHOVA, A.L. PETRUSHIN

OSTEOPOIKILOSIS – A CLINICAL CASE OF RARE OSTEODISPLASIA

SBEH "Karpogory regional hospital"
Settlement of Karpogory
The Russian Federation

Osteopoikilosis is considered as a rare form of sclerotic osteodysplasia, characterized by the appearance of multiple discrete round or ovoid radio densities in cancellous bones (epiphysis and metaphysis). Osteopoikilosis is symmetrical with a predominant involvement of the hands, feet, pelvis and proximal femur. The disease is usually asymptomatic, benign bone dysplasia; it does not affect the quality of life of the patient and requires no special treatment. Osteopoikilosis may have a hereditary factor, or occurs sporadically. The leading role in diagnostic belongs to the X-ray diagnostic research. The differential diagnosis with metastases is required. The clinical case of osteopoikilosis, genetically determined, in the stage of spreading of lesions in woman (31 yr.) is presented. The disease was suspected in the prophylactic fluorography, revealed some focal changes in the proximal epiphysis of the humerus. Radiographs of hands, hip and shoulder joints are found clearly delineated focal bone compactions (up to 0,8 cm). The foci were located in the epiphysis, metaphysis and apophyses of long and short tubular bones and cancellous bone of the pelvis and wrists, their number ranged from 2 to 60. Subjective and objective clinical examination of pathological changes of the skeleton did not reveal. The similar hand radiographic changes on radiographs of hands were revealed in the mother of a patient.

Keywords: osteopoikilosis, osteodysplasia, osteosclerosis, bone tumors, bone islands, fluorography, radiographs
p. 566-569 of the original issue
References
  1. Il'iushenkova V.V. Lazarikhina L.V. Osteopoikiliia: nabliudenie iz praktiki [Osteopoikilosis: the practical observation]. Tikhookean Med Zhurn. 2007;(3):82-83.
  2. Subbarao Ê. Skeletal Dysplasia (Sclerosing dysplasias - Part I) NJRI. July - Dec, 2013.(3)2:10.
  3. Salikhov IG, Bombina LK, Lapshina SA, Mukhina RG, Chembarisov II, Gaibarian AA. Revmatologicheskie proiavleniia osteopoikilii. Sovremennoe sostoianie problemy [Rheumatologycal manifestations of osteopoikilosis. The current state of the problem. Rheumatology, Neurology, Traumatology]. Revmatologiia, Nefrologiia, Travmatologiia. Prakt Meditsina 2008;(25)1:33-35.
  4. Benli IT, Akalin S, Boysan E, Mumcu EF, Kiş M, Türkoğlu D.Epidemiological, clinical and radiological aspects of osteopoikilosis. J Bone Joint Surg Br. 1992 Jul;74(4):504-6.
  5. Meena S, Saini P, Chowdhary B.Multiple spots on bone: diagnostic challenge or spot diagnosis? Osteopoikilosis. Neth J Med. 2013 Sep;71(7):372, 376.
  6. Osteopoikilosis: a sign mimicking skeletal metastases in a cancer patient Sefidbakht S, Ashouri-Taziani Y, Hoseini S, Ansari M, Ahmadloo N, Mosalaei A. Middle East Journal of Cancer 2011;(2):37-41.
  7. Bansal R, Pathak AC, Sheth B, Patil A.K. Traumatic fracture in a patient of osteopoikilosis with review of literature. J Orthop. Case Report. 2013;(3)2:12-15.
  8. Chigira M, Kato K, Mashio K, Shinozaki T.Symmetry of bone lesions in osteopoikilosis. Report of 4 cases. Acta Orthop Scand. 1991 Oct;62(5):495-96.
  9. Sim E. [Osteopoikilosis--fracture healing]. Unfallchirurgie. 1989 Dec;15(6):303-5.[Article in German].
  10. Siddiqui HQ, Zahid M, Ahmed S, Siddiqui YS. Osteopoikilosis. Saudi Med J. 2011 May;32(5):534-35.
Address for correspondence:
164600, Rossiiskaia Federatsiia ,Arkhangel'skaia obl., p. Karpogory, ul. Lenina, d. 47.
GBUZ AO "Karpogorskaia TsRB", khirurgicheskoe otdelenie
tel.: +7 818 56 2-11-03,
e-mail petrushin.59@mail.ru Petrushin Alexander Leonidodovich
Information about the authors:
Lemekhova N.M., a radiologist of SBEH "Karpogory CRH". Arkhangelsk region.
Petrushin AL, PhD, a surgeon of SBEH "Karpogory CRH". Arkhangelsk region.

EXCHANGE OF EXPERIENCE

Y.V. STRUCHKOV, A.G. KURMANBAEV

ANTEGRADE DRAINAGE OF THE BILIARY TRACT IN PATIENTS WITH UNRESECTABLE TUMORS OF BILIOPANCREATODUODENAL ZONE COMPLICATED BY OBSTRUCTIVE JAUNDICE

SBEE HPE "I.M. Sechenov First Moscow State Medical University",
Moscow
The Russian Federation

Objectives. To evaluate the efficacy of transcutaneous transhepatic biliary drainage in patients with cholestasis of malignant etiology.
Methods. The treatment results of 55 patients with unresectable tumors of biliopancreatoduodenal zone complicated by obstructive jaundice have been analyzed. The antegrade drainage of the biliary tract was performed under ultrasonic and fluoroscopic guidance. The method effectiveness was evaluated according to dynamics of levels of total bilirubin, liver enzymes – alanine transaminase (ALT) and aspartate transaminase (AST) according to multiple organ dysfunction score (MODS II), simplified acute physiology score (SAPS II), and a diameter of the common bile duct. These values were analyzed on admission, on the first, fifth and tenth day after application of transcutaneous transhepatic cholangiostomy.
Results. Since the first day of transcutaneous transhepatic cholangiostomy after antegrade drainage of the bile ducts the total bilirubin level reduced from 185±22 μmol/l to 113±13 μmol/l. On the fifth day the levels of liver enzymes ALT and AST declined from 198±22 U/l to 86±11 U/l and 161±20 U/l to 63±7 U/l, respectively.
On the fifth day the the condition of patients has improved according to the scale MODS II (from 4,2±0,3 to 2,2±0,2 points) and the scale SAPS II (38±1,7 to 26±1,5 points). The reduction of hypertension in bile duct characterized by a decrease of the common bile duct diameter from 14,1±1,2 mm to 8,9±0,6 mm was registered on the fifth day. No complications and deaths immediately related to the use of transcutaneous transhepatic cholangiostomy were noted.
Conclusion. Transcutaneous transhepatic cholangiostomy allows eliminating the signs of hypertension in the biliary tract. Mortality is due directly to the main oncologic disease, cancer intoxication, and comorbidities.

Keywords: malignant tumors, biliopancreatoduodenal zone, transpercutaneous transhepatic drainage of choledoch, scales of severity, hyperbilirubinemia, alanine aminotransferase, aspartate aminotransferase, complications
p. 570-576 of the original issue
References
  1. Sherman M. Hepatocellular carcinoma: epidemiology, surveillance, and diagnosis. Semin Liver Dis. 2010 Feb;30(1):3-16. doi: 10.1055/s-0030-1247128.
  2. Davydov MI, Aksel' EM./red. Statistika zlokachestvennykh novoobrazovanii v Rossii i stranakh CHG v 2012 godu [Statistics of malignant tumors in Russia and the CIS in 2012]. Vestn RONTs; 2014. 226 p.
  3. Karpachev AA, Soloshenko AV, Polianskii VD. Rol' operativnoi endoskopii v diagnostike i lechenii raka bol'shogo sosochka dvenadtsatiperstnoi kishki [The role of surgical endoscopy in the diagnosis and treatment of cancer of the major duodenal papilla]. Endoskop Khirurgiia. 2009;(15)1:21-22.
  4. Karpenko EV, Kachalov SN, Kropacheva EI. Primenenie minimal'no-invazivnykh metodov v diagnostike i lechenii sindrom biliarnoi gipertenzii [The use of minimally invasive techniques in the diagnosis and treatment of biliary hypertension syndrome]. Dal'nevostochn Med Zhurn. 2006;(3):54-57.
  5. Lee SG, Song GW, Hwang S, Ha TY, Moon DB, Jung DH, Kim KH, Ahn CS, Kim MH, Lee SK, Sung KB, Ko GY.Surgical treatment of hilar cholangiocarcinoma in the new era: the Asan experience. J Hepatobiliary Pancreat Sci. 2010 Jul;17(4):476-89. doi: 10.1007/s00534-009-0204-5.
  6. Karpachev AA, Parfenov IP, Polianskii VD. Endoskopicheskie rentgenendobiliarnye vmeshatel'stva pri mekhanicheskoi zheltukhe, vyzvannoi rakom pankreatoduodenal'noi zony [X-rays endoscopic endobiliary intervention in obstructive jaundice caused by cancer pancreaticoduodenal zone]. Fund Issledovaniia. 2011;(1):68-75.
  7. Kiesslich T, Wolkersdörfer G, Neureiter D, Salmhofer H, Berr F. Photodynamic therapy for non-resectable perihilar cholangiocarcinoma. Photochem Photobiol Sci. 2009 Jan;8(1):23-30. doi: 10.1039/b813183j.
  8. Zherlov GK, Koshel' AP, Autlev KM. Mekhanicheskaia zheltukha: nekotorye aspekty diagnostiki i khirurgicheskogo lecheniia [Obstructive jaundice; some aspects of diagnosis and surgical treatment]. Tomsk: Izd-vo Tomsk Un-ta; 2007. 172 p.
  9. Zherlov GK, Karpovich AV, Zykov DV, Krasnoperov AV, Demakov MV. Arefliuksnyi gepatikoeiunoanastomoz pri rake vnepechenochnykh zhelchnykh protokov i golovki podzheludochnoi zhelezy [Reflux free hepaticojejunoanastomoses in cancer of bile duct and the pancreatic head]. Khirurgiia. 2009;(3):17-22.
  10. Singh S, Sachdev AK, Chaudhary A, Agarwal AK. Palliative surgical bypass for unresectable periampullary carcinoma. Hepatobiliary Pancreat Dis Int. 2008 Jun;7(3):308-12.
  11. Yasumoto T, Yokoyama S, Nagaike K. Percutaneous transcholecystic metallic stent placement for malignant obstruction of the common bile duct: preliminary clinical evaluation. J Vasc Interv Radiol. 2010 Feb;21(2):252-8. doi: 10.1016/j.jvir.2009.10.010.
  12. Weber A, Gaa J, Rosca B, Born P, Neu B, Schmid RM, Prinz C. Complications of percutaneous transhepatic biliary drainage in patients with dilated and nondilated intrahepatic bile ducts. Eur J Radiol. 2009 Dec;72(3):412-17. doi: 10.1016/j.ejrad.2008.08.012.
  13. Lysenko MV, Savost'ianov VV, Kuzin VV, Efimenko NA, Sukhorukov AL. Sposob opredeleniia tsentral'nogo venoznogo davleniia [A method for determining central venous pressure]. Patent RF ¹ RU 2214159.
  14. Tsuyuguchi T, Takada T, Miyazaki M, Miyakawa S, Tsukada K, Nagino M, Kondo S, Furuse J, Saito H, Suyama M, Kimura F, Yoshitomi H, Nozawa S, Yoshida M, Wada K, Amano H, Miura F. Stenting and interventional radiology for obstructive jaundice in patients with unresectable biliary tract carcinomas. J Hepatobiliary Pancreat Surg. 2008;15(1):69-73. doi: 10.1007/s00534-007-1282-x.
  15. Nguyen-Tang T, Binmoeller KF, Sanchez-Yague A, Shah JN. Endoscopic ultrasound (EUS)-guided transhepatic anterograde self-expandable metal stent (SEMS) placement across malignant biliary obstruction. Endoscopy. 2010 Mar;42(3):232-6. doi: 10.1055/s-0029-1243858.
Address for correspondence:
109240, Rossiiskaia Federatsiia,
g. Moskva, ul. Iauzskaia d. 11.
str. 1, GKB im. I.V. Davydovskogo,
GBOU VPO "Pervyi moskovskii go
sudarstvennyi meditsinskii universitet
imeni I.M. Sechenova", kafedra obshchei khirurgii
e-mail: azamatkg.88@gmail.com,
Kurmanbaev Azamat Gul'tashyrovich
Information about the authors:
Struchkov Y.V. MD, professor, a senior researcher of the general surgery chair of SBEE HPE "I.M. Sechenov First Moscow State Medical University".
Kurmanbaev A.G. A post-graduate student of the general surgery chair of SBEE HPE "I.M. Sechenov First Moscow State Medical University".

V.P. DEIKALO, A.N. TOLSTIK

THE USE OF CUTANEOUS AUTOPLASTY IN THE REHABILITATION OF PATIENTS WITH AN ACUTE HAND INJURY

EE "Vitebsk State Medical University"
The Republic of Belarus

Objectives. To examine the results, mistakes, and complications, to assess and characterize the capabilities of current methods of skin plasty in hand soft tissue defects.
Methods. In medical rehabilitation the patients who had sustained an acute hand injury accompanied by soft tissue defects, a necessity of skin integrity was occured. In these cases the different methods of autodermoplasty have been used. 289 operations of skin plasty in 248 patients with open hand injuries and (or) their consequences have been performed. There were 218 (87,90%) men and 30 (12,10 %) women. 98,2% of the patients were of working age. 230 (92,74%) patients with the open hand and finger injuries were operated, the dermepenthesis was made to 18 (7,26) patients after repairing of various posttraumatic contracture. In assessing of the long-term results the degree of a flap engraftment, complications and functional outcomes were taken into account.
Results. Analysis of the application of different methods of skin autodermoplasty has allowed to establish that the technique of free skin grafting (64,35%) in specialized care to patients with an acute hand injury was used more frequently. Unsuccessful outcomes (29,50%) after a free skin grafting have associated with mistakes made during surgery and in the postoperative period. To replace the deep defects of an acute hand injury is more expedient to use a non-free skin graft, allowing 100% of engraftment and good cosmetic outcomes.
Conclusion. The application of different skin grafting technique broader and more rational, careful planning and technical performance of operations as well as the proper management in the postoperative period have resulted in improved patient outcomes.

Keywords: hand injury, skin grafting, post-traumatic contracture, skin plasty, medical rehabilitation, engraftment, complications, postoperative period
p. 577-581 of the original issue
References
  1. Nel'zina ZF, Chudakova TN. Neotlozhnaia khirurgiia otkrytykh povrezhdenii kisti [Emergency surgery opf open brush injuries]. Minsk, USSR: Navuka i Tekhnika; 1994.239 p.
  2. Usol'tseva EV, Mashkara KI. Khirurgiia zabolevanii i povrezhdenii kisti [Surgery of diseases and injuries of the hand]. Leningrad, USSR; 1986. 352 p.
  3. Asko-Seljavaara S, Pitkänen J, Sundell B.Microvascular free flaps in early reconstruction of burns in the hand and forearm. Case reports. Scand J Plast Reconstr Surg. 1984;18(1):139-44. doi: 10.3109/02844318409057416.
  4. Milford L. The hand. 2th. ed. St. Louis etc.: Mosby Co. 1982:359.
  5. Zoltan Ia. Peresadka kozhi [A skingrafting]. Budapesht, Vengriia: Akademiia Nauk Vengrii; 1984. 304 p.
  6. Limberg AA. Planirovanie mestnoplasticheskikh operatsii na poverkhnosti tela [Planning of local plastic operations on body surface]. Leningrad, USSR: Medgiz; 1963. 595 p.
  7. Symposium on microvascular surgery. Hand Clin. 1985 May;1(2):195-370. [No authors listed].
  8. Volkova AM. Khirurgiia povrezhdenii kisti [Surgery wrist injury]. Ekaterinburg, USSR: Ural'skii Rabochii. 1996;(3):208.
  9. Mateev M1, Beermanov K, Subanova L, Novikova T.Reconstruction of soft tissue defects of the hand using the shape-modified radial forearm flap. Scand J Plast Reconstr Surg Hand Surg. 2004;38(4):228-31. DOI: 10.1080/02844310410026717.
  10. Koshima I., Moriguchi T, Etoh H, Tsuda K, Tanaka H. The radial artery perforator-based adipofascial flap for dorsal hand coverage. Ann Plast Surg. 1995;35(5):474-79. doi: 10.1097/00000637-199511000-00005.
  11. Dantzer E, Queruel P, Salinier L, Palmier B, Quinot JF.Dermal regeneration template for deep hand burns: clinical utility for both early grafting and reconstructive surgery. Br J Plast Surg. 2003 Dec;56(8):764-74. doi: 10.1016/S0007-1226(03)00366-7.
  12. Kimura N, Saito M, Sumiya Y, Itoh N.Reconstruction of hand skin defects by microdissected mini anterolataral thigh perforator flaps. J Plast Reconstr Aesthet Surg. 2008 Sep;61(9):1073-77. doi: 10.1016/j.bjps.2008.02.014.
  13. Belousov AE, Tkachenko SS. Mikrokhirurgiia v travmatologii [Microsurgery in traumatology]. Leningrad, USSR: Meditsina; 1988. 224 p.
  14. Green DP, Hotchkiss RN, Pederson WC./eds. Operative Hand Surgery. 1998;(1-2):2367. Philadelphia: Churchill Livingstone.
Address for correspondence:
210023 Respublika Belarus',
g. Vitebsk, pr-t Frunze, d. 27,
UO "Vitebskii gosudarstvennyi
meditsinskii universitet", kafedra
travmatologii, ortopedii i voenno-polevoi khirurgii.
tel. 8 0212 57-40-84,
Deikalo Valery Petrovich
Information about the authors:
Deikalo V.P., MD, professor of traumatology, orthopedics and field surgery EE "Vitebsk State Medical University".
Tolstik A.N., PhD., an associate professor, a head of a chair of traumatology, orthopedics and field surgery of VSMU EE "Vitebsk State Medical University".
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