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The treatment of 200 patients with granulating wound of soft tissues was analyzed. A conventional method of treatment was used in 90 patients. In the study group (110 patients) different types of adaptive-reposition devices and the method of extrawound programmed vulnosynthesis were used. This method demonstrated technical advantages compared with standard methods of treatment of festering wounds that permitted to improve the results of complex treatment.

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The authors performed an animal model study of postoperative wound complications using 72 white Wistar rats and 36 mongrel dogs with aseptic cut wounds, granulating wounds, and relaparotomic wounds. In the control group the wounds were closed by a conventional method; in the main group a machine stitch was performed. Wound closure in the main group was performed after approximation of wound edges with specially constructed devices. Morphological and microbiological analysis showed that the key role in development of complications is played by morphofunctional wound substrate, which comprises the degree of paravulnar tissue traumatization with suture when a conventional method is used, and paravulnar tissue ischemia in case of microbial dissemination. The authors conclude that machine stitch is preferable.

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Factors of risk of the appearance of wound complications were studied in experiment on a model of granulating wounds in 18 mongrel dogs. A traditional method (control group) and an apparatus method (main group) were used for suturing the wounds. In the main group of animals suturing the wounds was performed after bringing together the wound edges by specially designed devices. Morphological and microbiological investigations have shown that the leading role in the appearance of complications belongs to the morphological substrate of the wound with the main component including the degree of traumatizing the paravulnerable tissue with a suture thread when connecting the wound edges by a traditional method, ischemia of the paravulnerable tissues under conditions of microbial dissemination. The introduction of the developed method of closing the soft tissue granulating wounds into clinical practice resulted in a statistically significant reduction of pyo-inflammatory complications in the main group of patients. A conclusion is made on a more favorable course of the wound process when using the apparatus method of closing the wounds.

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The results of the treatment of 250 patients with a carbuncle of various location were analyzed retrospectively. A differential approach to choice of surgical method with consideration of the degree, phase and localization of inflammation is preferable. Early and radical surgery, antimicrobic drugs, infusion therapy make base of up-to-date and adequate treatment. In the phase of infiltration deep incision often stops the disease or promotes a decrease of the necrotic zone. In suppurations linear incisions were made only on the face for cosmetic reasons. In other areas a few large connected T-, [symbol: see text]-, [symbol: see text]- or cross-formed incisions were preferable. In 30 cases I-formed incision with two rectangular flaps was used.

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The article deals with bougies (developed by its authors) of various types and sizes designed for gullet bougienage after chemical burns. The suggested bougies ensure less trauma to the esophagus walls during the bougienage procedure, which, in its turn, essentially cuts the time of recanalization and, according to authors' data, prevents ruptures in the internal tissues.

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Information about a surgical treatment of the varicose disease, its description, and the results of practical application, specific features, used drugs and technical appliances is reported. The remote results are indicative of a sufficiently high efficacy of the offered method.

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The authors have devised a technique of consecutive performing the steps of operative interventions for varicose disease of lower extremities. The method includes extirpation after Babcock of the main trunks of the large and, if necessary, the small subcutaneous veins with the help of a spiral-shaped device; preliminary percutaneous-supracutaneous temporary ligation with kapron of sinuous lateral superficial veins; subcutaneous dissection of ligated veins between ligatures with minimal blood loss. For this purpose a phlebotom of simple construction in the shape of a clamp was used. One of its jaws was a cutting element with a point and cutting edge. The instruments proposed allow to make the technique easier, to avoid excessive traumatization of the tissues and to achieve stable obliteration of the injured veins. Recurrence of the disease was noted in 3.5% out of 145 patients with varicose disease within 1-8 years.

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Rational method of surgery for lower extremities varicosis are developed. Method consists of Babkok's extirpation of greater and minor (if it is necessary) saphenous veins with spiral device; preliminary transcutaneous-supracutaneous temporary caprone ligation of changed superficial veins, subcutaneous dissection of ligated veins with minimal blood loss. Original flexible spiral saphenoextractor, inflatable hemostatic device, phlebotoms of simple construction are used. These devices permit to simplify surgery, to decrease tissues trauma and to achieve good cosmetic effect. Recurrence over 1-8 years was seen in 145 operated patients.

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Results of clinical trial of the new pyrimidine derivative--ximedone are presented. The drug was administered per os 0.5 g x 4 times a day (0.5 h before meals). Total course dose achieved 60 g. Ximedone implementation for complex treatment of burns, trophic ulcer of lower limbs, different inflammations demonstrated positive results. Prophylaxy administration of the drug in abdominal surgery at acute appendix resulted with lower incidence of postoperative complications. High efficacy and good tolerability of the drug allows to recommend it for wide medical use.

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Treatment of extensive tissue defects should be complex, whose basis is an early free skin plastic repair with obligatory addition of agents that enhance the reparative capacities of tissues. For this, the authors propose a number of original appliances (forceps, variants of dermoperforators, bandage, etc.) and drugs, such as ximedon (tablets, 5-10% aqueous solution, lanolin-vaseline-based ointment, talc-based powder), whose clinical trials in 300 patients have shown their high therapeutical effect. The time of preparation of the wound surface for dermatoplastic interventions became shorter and the frequency of poor outcomes of operations reduced.

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A method of prophylaxis and treatment of eventrations after relaparotomy using apparatus of transtissue fixation was fested clinically. The apparatus was used in 24 patients with acute abdominal surgical disease subjected to relaparotomy. The apparatus of transtissue fixation permits to shorten time of operation, to make easier the work of surgeon and assistants, to minimize damage to sutured inflamed tissues. Lethality was 16.7%. There were no eventrations.

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Pharmacotoxicological properties of ximedone, a new pyrimidine derivative, were studied experimentally on animals of various species. In the enteral regimen the drug had a favourable effect on thermal burns and postoperative cutaneous and gastric wounds. The results enabled to recommend ximedone for the clinical practice.

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