Kosul'nykov S. New methods of treatment of purulent inflammatory processes of soft tissues.

The dissertation to be awarded the Higher Medical Degree is devoted to the investigation of clinical, immunological, microbiological, biochemical аnd pathohisto-logical changes in 104 patients with extensive purulent-necrotic processes of soft tissues including a set of Fournier syndrome. The new complex method of surgical treatment of extensive necrotic fasciitis has been worked out. Cutting out and separating the skin grafts together with taking into consideration the anatomic fields and blood supply make it possible to perform radical processing and sanation of the focus with the mixture of oxidizers (hydrogen peroxide and spirituous iodine solution). The method preserves the vitality of cutaneous integument as much possible and differs from the stripe incisions, which are in general use. The method preserves a wound from many plasma and lymph losses, which may cause wound exhaustion, and provides with visual observation after necrotic process spreading. Owing to the full-thickness skin plastic of a wound, the patient's sensation of pain decreases during the period from sanation to sanation. The whole thickness graft fixation prevents its shortening and as a result the good cosmetic effect is being noted after wound healing. The analysis of immunological and histological changes in patients with extensive necrotic fasciitis has every reason to consider that the leading role in pathogenesis of extensive purulent-necrotic processes belongs to the mechanisms of infectious-allergic reactions, development of second immune deficiency condition as a result of prolonged antigenic influence of the factors of bacterial origin and necrotic tissues.