Biomedical subjects
Publications and source records attributed to S A Linnik.
The occurrence of cross infections in osteomyelitis patients has been proved by clinical, microbiological, and epidemiological methods. The patients are infected mainly in the dressing room for patients with purulent processes; the working conditions in this dressing room do not preclude the possibility of cross infections.
Plasty of osteomyelitic cavities with demineralized bone transplants was performed in 55 patients. Different methods of the bone cavity plasty were used with regard for the state of soft tissues surrounding the pathological focus, changes in the purulent focus. In most of the patients (41) the cavity was filled up with the demineralized bone transplant formed with special reference to the size of the bone wound. In the other 14 patients with false joints complicated by osteomyelitis the bone allotransplant was put in the area of the defect as a duplicator. Good results were obtained in 53 (96.4%) patients.
The only method of preoperative visualization of spread of the process in the soft tissues (phlegmons, abscesses etc.) is the ultrasonic examination which was used in 32 patients. The diagnostic significance of echography in chronic osteomyelitis was 50%, suppuration in the soft tissues was 92.3%.
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An analysis of causes of the appearance of postoperative osteomyelitis in 537 patients treated in the clinic has shown that in 82% they resulted from errors made by surgeons during operations, in 16% from insufficient examination of the patient during the preoperative period and erroneous management of the patients after operation. Strict observation of the requirements during the preoperative period, good organization, supply and performing the operation and postoperative managements, as well as the elevation of immune reactivity of the macroorganism allowed the percentage of postoperative osteomyelitis to be considerably reduced.
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An experience with the treatment of purulent coxitis in 56 patients is described. Acute coxitis was treated by arthrotomy, sequestrectomy and antibacterial therapy. Chronic forms of osteoarthritis consisted in the surgical treatment of the purulent focus and filling the cotyloid cavity with a muscular flap or the proximal end of the femoral bone.
The substitution of osseous cavities by fat pedicle flaps was performed in 29 patients with chronic osteomyelitis after radical surgical treatment of the osteomyelitic focus. Recovery was achieved in 24 patients after a single operation. Five patients were subjected to reoperations. The authors consider the fat tissue to be a reserve plastic material for surgery of chronic osteomyelitis.
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Transmyoplasty was used in the operative treatment of 118 patients with chronic osteomyelitis of the lower extremity bones in the muscle-free zones and with scarry regeneration of the muscles. Good outcomes were obtained in 92% of the patients.
Allogenic tendotransplants were used in the treatment of different lesions and diseases of the locomotor apparatus in 410 patients. Good anatomical and functional results were obtained in 84% of the patients. Unsatisfactory results were noted in 7% of cases. The method of preservation of allogenic tendons had no influence upon the results.
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Clinical observations of 31 patients have shown that levamisole promotes the improvement of immunological indices in patients with chronic postoperative osteomyelitis. In a group of patients treated with levamisole good results were obtained in 84%, while in the group of patients treated without levamisole good results were obtained in 63,9%.
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Osseous autoplasty of osteomyelitic cavities was used in 138 patients with different forms of chronic osteomyelitis. Complications were found in 8 patients. These patients had suppurations of the wound with sequestrations of osseous transplants.