All articles - Surgery
Number of articles: 568
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EFFECTIVENESS OF AN AMNIOTIC MEMBRANE IMPLANTATION IN THE PROCESS OF VITREORETINAL SURGERY OF LARGE MACULAR HOLESPurpose of the study. To evaluate the effectiveness of amniotic membrane implantation in cases of large macular holes. The study included 86 eyes with a rupture of the macula of more than 500 pm. Implantation of the amniotic membrane in the case of large macular holes is provides anatomical success in 96.51% of cases and functional success in 91.86% of cases. Macular holes as a complication of vitreomacular traction syndrome was the prognostically least favorable situation compared to traumatic (p <0.01) and myopic macular holes (p <0.05).
Medicine and innovations -
НАШ ОПЫТ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ ВРОЖДЕННОГО ВОЗВЫШЕНИЯ ЛОПАТКИ У ДЕТЕЙ РАННЕГО ВОЗРАСТАВрожденная высокая деформация лопатки, широко известная как деформация Шпренгеля, редкая врожденная деформация неизвестной этиологии возникает из-за прерывания каудальной миграции лопатки в раннее развитие плода, приводящее к приподнятой и гипоплазированной лопатке. Оставленная без лечения деформация Шпренгеля часто приводит к функциональным и косметическим нарушениям, таким как ограничение движений плеча и выраженная ипсилатеральная перепонка шеи. В данной работе мы представляем несколько клинических случаев лечения детей с деформацией Шпренгеля, где рекомендовано при планировании хирургической коррекции врожденного высокого стояния лопаточной кости необходимо учитывать высоту расположения лопатки, сопутствующие изменения в костях грудной клетки, позвоночника, патологические изменения формы и размеров лопаточной кости. А при наличии деформации формы лопаточной кости после полной мобилизации лопатки целесообразно полная коррекция патологической формы для достижения равномерного прилегания ее к поверхности грудной клетки и равномерного скольжения при движениях верхней конечности.
Medicine and innovations -
REHABILITATION OF PATIENTS AFTER ENDOPROSHETICS OF THE HIP JOINT IN ASEPTIC NECROSIS OF THE FEMORAL HEADWe have carried out the rehabilitation of all 64 patients with total arthroplasty from 2015 to 2021, surgery for aseptic necrosis of the femoral head. After EP, the hip joint was divided into two stages: Of these, from the moment of surgery to 3 weeks, this is the early stage. From 3 weeks to 10 weeks - late stage. It is necessary to efficiently perform tasks and exercises for rehabilitation after EPHT by a surgeon and a rehabilitation therapist. At the sanatorium-resort stage, every year patients get physical therapy and physiotherapy for 3 years in a sanatorium-resort environment. Before and after the operation, the difference in the number of movements in 10 seconds was assessed. When performing the test with the operated and unoperated leg, the index of hip abduction increased the most after the operation. The data of the coordination test showed that on the 14th day, it is necessary to productively perform tasks and exercises for rehabilitation after EP while the indicator on the operated leg in the main group was equal to 12.2 m, and in the control group - 11.2 m of movement, which is 25.3% better than the control.
Medicine and innovations -
THE EFFECTIVENESS OF SURGICAL TREATMENT FOR POST- TRAUMATIC DEFORMITIES OF THE NOSERelevance. The aesthetic and functional significance of the external nose gives special relevance to the treatment of its injuries. The establishment of an accurate diagnosis is necessary to determine the tactics of treatment, issue a reliable conclusion
Medicine and innovations -
MORPHOLOGICAL SUBSTANTIATION OF THE POSSIBILITY OF APPLICATION OF INTRAOPERATIVELY STRETCHED TISSUES IN PLASTIC OF FACE AND NECK SCAR DEFORMATIONSThis article presents reasonable recommendations on the use of intraoperative balloon stretching of tissues to eliminate cicatricial deformities resulting from bums to the face and neck. The obtained morphological results show that the method of intraoperative balloon stretching of tissues ensures the viability of the flap. Output. Thus, intraoperative stretching of soft tissues according to the scheme developed in the clinic does not cause pathological changes in the general architectonics of the skin, does not violate the surface microrelief and the reticular structure of the fiber base of the skin.
Medicine and innovations -
УСОВЕРШЕНСТВОВАНИЕ ТАКТИКИ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ БОЛЬНЫХ С ТРАВМОЙ СРЕДНЕЙ ЗОНЫ ЛИЦААннотация. Синдром взаимного отягощения повреждений, возникающий в результате множественной травмы, приводит к значительному увеличению общей тяжести состояния пострадавшего. Для определения времени каждого из этапов лечения ЦФТ, снижения количества осложнений нами был разработан и внедрен в клиническую практику алгоритм оказания помощи при данной травме. Тактика лечения пациентов с ЦТФ, согласно разработанного алгоритма, имеет несомненное преимущество перед ранее применявшейся -процент воспалительных осложнений сведен к минимальному: с 17% до 1,5%. Такойкомплексный подход повышает важность сортировки пострадавших в целях достижения лечебного эффекта и экономического результата.
Medicine and innovations -
FUNCTIONAL JUSTIFICATION OF THE POSSIBILITY OF APPLICATION OF INTRAOPERATIVELY STRETCHED TISSUES IN PLASTIC OF FACE AND NECK SCAR DEFORMATIONSThis article presents reasonable recommendations on the use of intraoperative balloon stretching of tissues to eliminate cicatricial deformities resulting from bums to the face and neck. The studies were carried out in 57 patients. The results obtained show that the method of intraoperative balloon stretching of tissues ensures the viability of the flap. Output. Thus, the conducted studies of the state of microcirculation in intraoperatively stretched and displaced tissues by measuring oxygen tension (tcpO2) proved the possibility of a safe and controlled implementation of the proposed method in the plasty of post-bum cicatricial deformities of the face and neck area.
Medicine and innovations -
«TUMOR AND TUMORLIKE FORMATIONS OF THE MAXILLOFACIAL REGION AMONG CHILDREN STRUCTURE MODERN METHOODS OF DIAGNOSIS AND TREATMENT»Annotation.Tumor and tumorlike formations of the maxillofacial region among children are very diverse. Most of them are of disontogenetic origin, combined with malformations of other organs and manifest in newborns or in the first years of life (up to 5 years). This article provides data on planned surgical interventions for tumors and tumor- lice formations of the maxillofacial region in children based on data from the departments of maxillofacial surgery in the CCH ()City Clinical Hospital) and the department of the ARCC (Almaty Regional Childrens Clinical Ho spital) for 5 years. The authors conducted an analysis of nosological units, diagnostic methods multidisciplinary approaches to the treatment of children.
Medicine and innovations -
TRAINING OF A RESIDENT ON THE EXAMPLE OF THE ELECTIVE "FUNDAMENTALS PLASTIC, RECONSTRUCTIVE AND AESTHETIC FACIAL SURGERY AND NECK"Resume. The component of the resident's choice "Fundamentals of plastic, reconstructive and aesthetic surgery of the face and neck" includes the following main sections: the subject and tasks of aesthetic plastic surgery of the face; features of the development of the vascular system of this area; features of the formation of skin flaps on the face and their nutrition; reconstructive operations, indications for them; anti-aging operations, indications and preparation for them; specific operations a) cheiloplasty, uranostaphyloplasty, rhinoplasty, otoplasty, blepharoplasty.
Medicine and innovations -
THE USE OF POLYOXIDONIUM IN PATIENTS WITH COMBINED TRAUMA, DEPENDING ON THE TRAUMA OF THE FACIAL AREA.Anotation: The main attention in this review is paid to immunocorrection of patients with combined trauma with the use of the drug polyoxidonium, depending on the trauma of the facial area and its results.
Medicine and innovations -
FEATURES OF THE COURSE AND MANAGEMENT OF PATIENTS WITH PURULENT-INFLAMMATORY DISEASES OF THE SOFT TISSUES OF THE HEAD AND NECK AGAINST THE BACKGROUND OF DIABETES MELLITUSThe features of the course and treatment of purulent-inflammatory diseases of the soft tissues of the head and neck against the background of diabetes mellitus have been studied. It has been established that purulent-inflammatory diseases of the soft tissues of the head and neck occur with the aggravation of the underlying pathology. The results of complex treatment with the use of plant-derived proteolytic enzyme cucumazim, ultrasonic cavitation and autotransfusions of ultraviolet irradiated blood were evaluated. It was found that the chosen integrated approach accelerates the time of wound cleansing from necrotic masses by 3.4 ± 0.4 days, promotes dilution and removal of purulent contents, activates regeneration processes, reduces the time of complete wound healing by 5.6 ± 0.8 days. After the combined use of the proteolytic enzyme cucumazim with ultrasonic cavitation and autotransfusion of irradiated blood with ultraviolet light in the treatment of purulent-inflammatory diseases of the soft tissues of the head and neck, complications or side effects were not observed.
Medicine and innovations -
DAMAGE TO THE III BRANCH OF THE TRIPLE NERVE IN A FRACTURE OF THE LOWER JAWThis article reflects the results of the study of 549 patients with fractures of the lower jaw who received inpatient treatment at the Osh Interregional United Clinical Hospital from 2018 to 2020 in the Department of Maxillofacial Surgery. In the first days of admission to the hospital, 307 (55.9%) people had a violation of sensitivity of the skin and oral mucosa. The results of the treatment of 307 patients showed that after 30 days there was already a violation of the sensitivity of the soft tissues of the face and teeth in 96 (31.2%) patients. The remaining 211 (68.8%) patients recovered completely, and after 6 months 96 (31.2%) of the 74 (77.1%) patients examined had a normalization of sensitivity, and 22 (22.9%) continued to have symptoms of trigeminal nen e damage.
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BLOOD VASCULAR FACTOR AND ITS IMPORTANCE IN THE HEALING PROCESS POSTOPERATIVE FACIAL SCARSAnnotation. The article presents the results of an immunobiochcmical blood test in people with postoperative facial scars in order to study the reparative changes in the skin wound during injections of the succinate-containing preparation HYALUAL. The objective of the research was a comparative description of the structural hemostasis in the control and main groups of patients.
Medicine and innovations -
Annotation.The problem of treatment of purulent-inflammatory diseases of the neck continues to be relevant. The number of patients with inflammatory diseases of the neck does not tend to decrease. The number of patients with neck phlegmon, spread over several cellular spaces, is growing, most often accompanied by the development of such severe complications as sepsis, mediastinitis, thrombosis of the cavernous sinus of the dura mater, etc. The article analyzes the results of the observation of the treatment of purulent-inflammatory processes of the neck in 53 patients aged 18 to 75 years. -
FEATURES OF THE IMMUNE STATUS IN PATIENTS WITH PURULENT-INFLAMMATORY DISEASES OF THE NECKAnnotation. In connection with the development of unfavorable outcomes in patients with pyoinflammatory diseases and their complications, an immunological examination of patients of this category was carried out. As a result of the study, defective links of the immune system were identified - suppression of the T-cell link of immunity, an increase in the CEC, in 94.4% of cases there was an increase in the indices of the spontaneous NBT test and in 33.3% a decrease in the stimulated test. The data obtained indicate the temporary immunosuppression of patients with pyoinflammatory diseases (HID), which requires correction and additional administration of immunomodulatory therapy.
Medicine and innovations -
SIMULTANEOUS IMPLANTATION IS A MODERN SOLUTION IN DIFFERENT CLINICAL SITUATIONS IN THE PRACTICE OF AN IMPLANTOLOGISTIn clinical situations when it is planned to install dental implants immediately after tooth extraction, various surgical protocols of implantation and postoperative management are possible. Achieving primary stability of dental implants is a key factor for further osscointegration and the success of the entire treatment. Another problem with immediate implantation is the correct positioning of the implant, due to the discrepancy between the shape and size of the well, the size and shape of the implant. Considering the above, it is important to have a clear algorithm for direct implantation, which will be optimal for ensuring osseointegration and subsequent functional load and achieving aesthetic results. This review article analyzes modem approaches for simultaneous dental implantation into the hole of a removed tooth, describes methods for solving these problems
Medicine and innovations -
Prevention and treatment of increased intra-abdominal pressure in patients with peritonitisThe article deals with the treatment of patients with acute widespread peritonitis, which is one of the most important problems of modern abdominal surgery. At the time of admission in a critical condition and requiring resuscitation. a significant increase in intra-abdominal pressure is found in more than 50% of cases, clinical signs of abdominal compartment syndrome are detected in about 4% of cases. The aim of the study: Evaluate and improve the results of treatment of patients with peritonitis by using surgical methods aimed at preventing ACS in complex treatment. Material and research methods. We analyzed the clinical data of 112 patients operated on for common peritoni-
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The combination of gynecological and surgical diseases in 29-42% of women indicates the need for simultaneous surgery, i.e. carrying out combined operations [1]. Carrying out such interventions undoubtedly has advantages both in the therapeutic plan and in the economic aspect (for the patient and even for the state) in comparison with the performance of sequential operations in patients. -
Optimization of tactical and technical aspects of complex surgical treatment of acute purulent cholangitis in cholelithiasisThe results of surgical treatment of 144 patients with acute purulent cholangitis as a consequence of cholelithiasis have been analyzed. In the main group of patients (83), staged surgical treatment taking into account the severity of acute purulent cholangitis with the use of minimally invasive decompressive interventions made it possible to arrest the phenomena of cholestasis and purulent intoxication, and significantly improve the results of radical operations. Excessive sanitation of the biliary tract with 0.06% activated sodium hypochlorite solution contributed to the early relief of cholangitis. Achieved a decrease in postoperative complications from 24.5% to 12.1% mortality from 8.2% to 2.4%.
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Maxillary sinus cysts most often result from a blockage of the mucus-secreting gland and swelling of the mucous membrane. The method of choice in the treatment of patients with a cyst of the maxillary sinus remains surgical. In rhinology, sparing methods of surgical interventions are increasingly used, the atraumatic nature of which practically does not affect the further formation of the anatomical structures of the nose, paranasal sinuses and their physiological functions. We applied the technique of sparing endonasal removal of the cyst of the maxillary sinus through the lower nasal passage, with intact structures of the ostiomeatal complex, using a port guide. The gentle surgical intervention we have proposed is easier to tolerate than radical surgery on this sinus. Patients stayed in the hospital for 2 to 5 days. -
The article discusses the issues of surgical treatment of patients with patellar instability. The choice of many surgical methods for treating patellar instability is an urgent problem. Not all are pathogenetically good and do not address the root cause of the problem. Based on clinical practice and the experience of the authors, pathogenetic surgery is recognized as an advantage of the proposed method. -
OPTIMIZATION OF THE MAIN ASPECTS OF ANATOMICAL, FUNCTIONAL AND SOCIAL REHABILITATION OF PATIENTS WITH MANDIBULAR FRACTURESPost-traumatic osteomyelitis is a very common complication of a fracture of the mandible: 10-12% of patients with fractures of the mandible develop tissue suppuration in the area of bone damage, accompanied by necrosis of the wound surfaces of the fragments with the formation of sequesters. To solve this problem, a significant number of methods and means are used, however, the number of infectious and inflammatory processes in the post-traumatic period continues to remain high, which significantly complicates the treatment of victims.
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Postoperative adhesions are a pathological condition that occurs in more than 90% of patients who have undergone abdominal surgery and in 45-70% after thoracic surgery, and remains one of the most difficult problems in general surgical practice [5, 26]. Indirectly, the frequency of damage to pleural leaflets by the adhesive process can be judged by the detection of pleural adhesions at autopsy, which, according to various authors, range from 48 to 80.5%. In a significant part of cases, pleural fusion detected at autopsy is an accidental finding and proceeds asymptomatically [7]. -
uieeuing occurs not oniy wnn ordinary uicers. oui ai me same lime otner complications sucn as uicer malignancy can develop, in which the choice of surgical tactics places great responsibility for saving the patient's life. Operation gastrectomy is one of the most extensive operations, which is divided into many complex stages and can develop various formidable complications. The article analyzes the clinical data of 6 patients operated on in the surgical departments of the Samarkand branch of the RSCEMP for bleeding from malignant stomach ulcers. -
DAMAGE TO THE STRUCTURE OF THE LOWER LIMBS IN PERSONS, PEDESTRIANS INJURED BY CAR INJURYRepublican Scientific and Practical center of forensic medical examination of the Navai branch Analyzed the results of forensic medical examinations in relation to 215 corpses of persons who died in collisions with moving cars. Among the dead there were 173 men and 42 women. The victims were between 14 and 75 years old. It was found that in the composition of PT in pedestrians, trauma of two or more parts of the body with fractures of the limb bones (120) - 55.8% and PT of the head, chest, and abdomen (76) - 36.4% prevailed. Fractures of the limb bones were the most common in collisions with pedestrians. Most of the injured pedestrians in collisions with moving modern ones have fractures of the shin bones, mainly diaphyseal with localization in the middle third, formed in the 1st phase of an automobile injury. Combined fractures of the bones of both legs, as well as combined fractures of the bones of one hip and one lower leg were the most frequently observed injuries in pedestrians. When colliding with modem cars, there is practically no specific contact damage from the skin and soft tissues. Damage to the structure of soft tissues in the area of the primary impact by protruding parts of the bodies of modem cars and in the area of bumper fractures is characterized by the fact that abrasions and bruises in the thigh and lower leg area are observed quite often and almost to the same extent. At the same time, skin wounds are more marked in the lower leg area than in the thigh area. Damage to soft tissues in the primary impact zone by protruding parts of modem ears was characterized by the presence of loose hemorrhage, in the absence of signs of crush injuries, muscle ruptures and other tissues, in some cases - by the presence of a small amount of liquid blood and its clots.
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