[Device for treating bone tissue].
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Biomedical subjects
Publications and source records attributed to B S Vikhriev.
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The authors describe their experience of the treatment of burn shock in 124 patients with the square surface of the thermal injury about 20-49% of the body surface with the help of crystalloid solutions. The investigation of a number of parameters of hemodynamics, hemoconcentration, metabolism showed that patients with the Frank index 20-60 could be helped out of burn shock not only without blood and its albuminous preparations but also without infusions of dextran drugs. Transfusions of blood and its albuminous preparations are shown to be necessary in the nearest postshock period in patients with the Frank index 30-60. It is emphasized that the volume of intravenous infusions should be reduced in cases of associated lesions of the skin and the respiratory tracts.
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Actual questions of the treatment of frostbites are considered on the basis of an experience of the treatment of 397 patients. The experience shows that superficial frostbites are healing well when treated by any method of local treatment. High degrees of frostbites are to be operated upon not earlier than the third week after injury, when the injury degree is established and acute inflammation has subsided. It has been established that the use of free and non-free skin plasty for closure of finger stumps and extremity segments improves functional outcomes and shortens the time of the treatment.
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The main principle of the surgical treatment of trophic ulcers of the lower extremities consists in a radical excision of all the pathologically changed tissues around the ulcer and under it and, in case of disorders of the venous reflux, in various surgical restorative and corrective interventions followed with plastic closure of the wound defect. 422 patients were operated upon (462 operations). The choice of the radical method of treatment resulted in a stable healing of ulcers in 84% of cases.
Under study was the dynamics of clinical and morphological changes of 348 portions of the repaired skin in 266 patients in different periods after plasty. Recommendations are proposed to prevent secondary cicatricial deformities.
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The experience of the treatment of 74 burned cases by means of autotransfusion is presented. The application of autotransfusion made it possible to rule out donor blood transfusions in surgical treatment of a considerable group of the burned. There are grounds to believe that different variants of this method will be widely practised in specialized medical installations dealing with the treatment of the burned and with reconstructive surgery.
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Among the burned who died in the clinic of thermal injuries for the last 17 years acute ulcer of the gastrointestinal tract of various localization and number were found in 48 cases. Only in 13 of them the clinical diagnosis had been established. Bleeding from acute ulcers of the digestive tract and their perforation had been found, as a rule, at the 2nd and mainly at the 3rd week from the moment of the burn injury. A high lethality among the Curling's ulcer eases following both conservative and surgical treatment is noted.
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