Oleynik V. Features of process of wound and surgical tactic at the combined termo-mechanic defeats of extremities (experimental-clinical research)

Subject of inquiry: - wound processes at the combined termo-mechanic damages of extremities; The aim of the research: to improve the results of treatment of the extremities injured with termo-mechanic damages due to development of principles of surgical treatment of this pathology based on application of early simultaneous surgical interferences concerning both constituents of trauma with the use of modern surgical technologies; Methods - experimental, clinical, morphological, cytology, instrumental, statistical; Scientific novelty: the burdening on each other action of two damaging agents is well-proven - thermal and mechanical with identical localization at the termo-mechanic damages of extremities, that shows up in more expressed what at the isolated burns of endogenous intoxication, more considerable increase of inrafascial pressure and more expressed violations of processes of microcirculation, that results in deceleration of processes of cicatrization both ambustial and bone wounds; the differences of flow of wound process are educed at the termo-mechanic damages of extremities from the flow of wound process at the isolated burns, that show up in prolongation of phase of inflammation, deceleration of processes of cellular proliferation and later completion of phase of regeneration; classification of termo-mechanic damages of extremities is offered, that takes into account the depth of burn, type of break of bone and allows to estimate weight of damage; efficiency of implementation of fascial necretomy is reasonable with the use of method of ultrasonic cavitation and by a laser Doppler floumetry as a method of estimation of full value of excision of nonviable fabrics; Results: the use of the worked out principles of surgical treatment of termo-mechanic damages allows to create terms for optimization flow of wound process, to attain the satisfactory results of treatment at 95,5% of victims, to decrease the amount of the complications related to secondary necrosis of fabrics in an ambustial wound in 3,1 time, by the lysis of free autodermotransplantats in 4,1 time and by development of festering-necrotizing processes of bone-joint structures in 4,6 time; It is inculcated - in medical practice, in an educational process; Sphere - medical practice.