[Perspectives of the further improvement of services for burn patients].
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Biomedical subjects
Publications and source records attributed to B S Vikhriev.
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The aim of the operative treatment of IV degree frostbite is not only to save the bone stump, but also to achieve its functional fitness after primary surgery or in future due to creation of favourable conditions for the following reconstructive operations. Dermo-plastic operations, both well-known and modified ones were used. The experience of the authors includes 347 patients.
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Forms of late lysis of autodermotransplants were studied in 35 burned patients. The authors distinguish a "simple" lysis (20 patients) resulting from autoimmune processes and lysis in acute inflammation (5 patients) due to pathogenic microflora.
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The authors propose a classification of methods of skin plasty. It is based on two main features: the anatomical structure of the autoplasty material and the state of its blood circulation.
The state of immunity was studied in 28 burned patients with deep lesions on skin before and after autodermoplasty. In 23 patients with a complete take of transplants the immune indices were within normality. In 5 patients with a complete on partial lysis of the transplanted skin there was an increased amount of "active" T-lymphocytes, "stable" T-lymphocytes and lymphocytes forming rosettes with autoerythrocytes. After immunodepressive therapy the immune indices became normal and the following autodermoplastic procedures gave a successful grafting.
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The work describes the application of 4 kinds of skin-muscle flaps in 22 patients with wound defects of various localizations. In 13 patients the flap was cut out in immediate proximity to the wound, in 9 patients free skin-muscle transplants with micro-vascular anastomoses were used. Quite satisfactory results obtained demonstrate good prospects for the new method of plasty of wound defects.
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