No. 1 (2000)

The problem of preventive maintenance of wound infection remains by an actual problem of modern surgery. In emergency surgery this parameter achieves up to 48.7%.
Per the last years in medicine with success the surgeries of liver, thoracic surgery, and so on are used electrolysis water solutions (EWS) sodium hypochlorite, in particular in purulent surgery. However, the expediency of application EWS sodium hypochlorite for preventive maintenance of wood infection is not enough investigated.
The author with the purpose of decrease of weight and frequency of wound complications has developed methods the express train - processing of surgical suture EWS sodium hypochlorite in modes 0.2%-10 minutes and 0.01%-60 minutes. Has studied the modification of mechanical strength of various kinds of surgical suture for want to processing in the developed modes.
The morphological researches reasonable a mode sanation of soft fabrics of operational wound in a mode 0.2 % - 5 minutes. The outcomes of comparative morphological study of slices of skin fabrics of experimental animals sutured by silk treated by conventional method and after processing EWS sodium hypochlorite have shown, that of differences in healing of wounds and response of enclosing fabrics it is not marked.
For warning of bacterial contamination the method of a guard of the operational wound is developed which consists in suturing of peritoneum to the skin on all stretch of operational wound and between them the gauze napkin moistened 0.2 % EWS sodium hypochlorite is kept. In an extremity of operation the 5-minute processing 0.2 % EWS sodium hypochlorite the ambassador suturing of each stratum of the operational wound is conducted.
The clinical material includes the inspection and operating treatment 831 patients, of them 502 have made of control groups and 329 patients were included in main group. The comparative analysis of outcomes has shown high efficiency of the developed complex of preventive maintenance, which promoted decrease of frequency of wound complications from 14.8 % up to 5.1%.

The preventive wound infection remains by an actual problem of modem surgery, that is connected to high frequency aftcropcration wound of complications, which reaches up to 48.7 % in emergency surgery.
Per the last years the increasing application find electrolysis of water solutions sodium hypochlorite, which arc successfully used of purulent surgery, for want of treatment peritonitis, cavities formations of a liver and other.
However, this antiseptics about today was not applied in prophylaxys wound infection.
The author for the first time uses electrolysis of water solutions sodium hypochlorite in preventive wound infection and offers a method aftcropcration of processing of hands of the surgeon in a regime 0.4%-5 minutes, methods intraopcration the express train -processing of surgical gloves in regimes 0.4%-3 minutes and 0.6%-2 minutes, methods intraopcration the express train - processing of surgical tools in regimes 0.3 % during 7 minutes, 0.4 % during 5 minutes, 0.6 % during 3 minutes and processing in a regime 0.05 % during 45 minutes.
For estimation of clinical efficiency of the developed complex intraopcration of preventive wound infection the author develops clinical mark scales on distribution of operations to groups of risk of development wound infection, mark scale of estimation of a condition postopcration wound and scale of estimation of outcomes of healing of wounds.
The clinical material includes an inspection and treatment 643 patients. From them control group included 453 patients and in the basis group included 190 patients. The developed complex intraopcrctation of preventive wound infection has shown high efficiency. Use of the developed complex of preventive wound infection has allowed to reduce frequency wound of complications from 15.3 % up to 8.9%.

The treatment of obliterative diseases of the lower limb vessels remains a significant challenge in modern vascular surgery. The high frequency of postoperative complications, high mortality, and progression of atherosclerotic processes after reconstructive interventions on the vessels of the lower limbs have led to a search for pathogenetically justified ways and means of preventing complications of reconstructive surgeries.
The author employed hypolipidemic agents, namely glyrofam and colestid, to develop a conservative prophylaxis regimen for postoperative complications of obliterating atherosclerosis. The regimen was based on the study of platelet aggregation activity indices and lipid metabolism state. It consisted of a course of treatment with hypolipidemic drugs, administered in 1-month cycles with a 3-month periodicity.
The clinical material comprises the examination and treatment of 138 patients. The control group included 61 patients. The main group comprised 77 patients, 39 of whom took colestid and 38 patients used glyrofam.
The study of long-term outcomes demonstrated a reduction in the incidence of postoperative thrombosis from 8.1% to 1.3% and a decrease in mortality from 13% to 2.6% in patients undergoing hypolipidemic therapy.
These findings suggest that hypolipidemic drugs that affect lipid metabolism may prevent the progression of atherosclerotic processes and that drugs that affect the rheological properties of blood may reduce the incidence of postoperative thrombosis.