Kuzmenko A. Experimental and morphologic bases of the origin of secondary bleeding from main trunks of the gluteal arteries

The investigation object: the anatomy of the human blood vascular system. The investigation goal: to obtain findings on variant anatomy of vessels and collaterals taking part in formation of secondary bleeding from the injured main trunks gluteal arteries and to provide practical recommendations pertaining to perfection of operative procedures which are utilized in such injuries. Methods of research: preparation and morphometry, injections of vessels, hystologic, experimental and statistic ones.The theoretical and practical importance of the received results: the obtained findings deepen widen the current notion about the participation of the gluteal arteries in the pelvis peripheral circulation and can be used in the teaching process of medical schools in publishing of monographs on human anatomy, in surgery dealing with human being's blood vascular system. Data about variant anatomy and sizes of external diameters of the collaterals cited in the work are important to the pelvis peripheral circulationare necessary when assessing the compensatory potentials of the blood channel following the ligation of the great parietal arteries of this cavity. Techniques of treating the gluteal arteries injuries were developed and a procedure of primary surgical treating of the gluteal region was developed as well.Regularities of intrapelvic anastomoses branching of the gluteal arteries were established. This opens new prospects in development of operative procedures aimed at prevention of secondary hemorrhages from the injured main trunks of the gluteal arteries.The scientific novelty of the investigation results: for the first time the regularities of collaterals branching which directly takes part in formation of secondary hemorrhages from the injured main trunks of the gluteal arteries were determined. It was established that the superior and inferior gluteal arteries tend to formation of intrapelvic anastomoses within 2,3±0,4 cm and 2,1±0,3 cm from the site of their branching, respectively. Along the further spaceintrapelvic anastomoses are absent. The experiment showed that the intrapelvic anastomoses and arterial collector joining the beds of the internal and external iliac arteries are the main vessels causing secondary hemorrhage from the injured main trunks of the gluteal arteries.It was established that a bilateral ligation of the arterial iliac collector in combination with ligating of the internal iliac arteries leads to dystrophic, sclerotic, prolifirative processes as well as to degeneration and death of the nerve elements in the walls of the small pelvis organs.The new data on variant anatomy of the gluteal and a number of the pelvis which should be taken into consideration for their search during surgical intervention in order to stop hemorrhage from in injuries of these vessels. The degree of implementation: the results of the research are implemented in the teaching process at the departments of operative surgery and topography anatomy of National Medical Bogomolets University, Bukovinian, Lugansk StateMedical Universities, Vinnitsia, Donetsk National Medical Universities, Dnepropetrovsk Medical Academy. Branch of usage: medicine, human anatomy, surgery.