[Prevention of wound infection in open injuries of the hand].
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Biomedical subjects
Publications and source records attributed to A A Lazarev.
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The results of 59 embolizations of the bronchial and intercostal-bronchial arteries in 33 patients with pulmonary hemorrhage and hemoptysis allow hydrogel emboli to be considered the optimal material for occluding vessels to achieve stable hemostasis. Successive introduction of spherical and then larger cylindrical emboli is the most rational method. Embolization of the bronchial arteries by hydrogel emboli also promotes regression of the inflammatory process in the lung and reduces the time needed for treatment.
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The authors inform about their experience of employing controlled abacterial medium in 30 patients with severe forms of wound infection of the hand which developed after open injuries of the hand. There was a 3-fold reduction of the periods of preparation of the suppurative wounds of the hand for plastic closure and a 10% increase of the area of grafting of skin autotransplants.
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The authors discuss the results of treatment of 56 patients with adduction cicatricial contractures of the thumb which developed after severe mechanical, gunshot and thermal injuries. According to the degree of the deformity, 3 degrees of contractures are distinguished and each cells for certain therapeutic tactics. Various types of free and pedicle dermatoplasty and a method of dosed distraction by means of apparatuses designed in the clinic were employed. Among 40 patients who were examined 35 showed good functional and cosmetic results.
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An experience with the treatment of 63 patients with scalped one or several fingers is analyzed. A classification of such traumas is proposed. Plasty with an "acute" Filatow graft, pocket skin plasty, free skin plasty with a splitted transplant were used for completely scalped fingers. In cases with incompletely scalped fingers the decompression of tissues was performed which prevented circulatory alterations. Long-term results within 1-12 years were studied. Indications for each method are analyzed.
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Early necrectomy followed by skin plasty allows preserving impaired parts of the hand and working capacity of the patients in posttraumatic necrosis of soft tissues of the hand and fingers. The method of skin plasty and time of its fulfilling should be dependent on the character of injuries, their localisation and degree of necrosis. In the absence of wound infection skin plasty must be fulfilled immediately after necrectomy. In necrosis accompanied by suppuration skin plasty is indicated after preparing the wound surface with vacuum and ultrasonic treatment, controlled abacterial environment. Positive results of reestablishing working capacity were obtained in 88.6% of the patients examined in remote periods after treatment.
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Experience with the treatment of 46 patients with syndactylism of the hand is described. In 28 of them operations for liquidation of syndactylism were repeatedly performed in childhood. The operation technique and results of the treatment are presented.
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The authors have studied the results of the treatment of 16 cases with fractures and fracture-dislocations of the hand. The indications for an early and delayed surgical treatment are set forth. The surgical tactics and methods of treatment depending on the type of injury are described.
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