Гоні С. Optimization of surgical treatment of local radiation injuries of the covering tissue.

The aim of the thesis is to improve the results of surgical treatment of patients with radial damage of the covering tissues by the differential choice of the treatment program taking into account the bacterial contamination of the affected tissues, various types of plastics, photodynamic and plasma therapy. The dissertation consists of two parts - experimental and clinical. Experimental complex bacteriological and morphological research with the use of bacteriological, histological, histochemical, immunohistochemical and morphometric methods of research was conducted. That allowed to give an objective assessment of the structural and functional state of the wound defect caused by radiation damage, with its epidermis, the dermis, hypodermis and subarachnoid membranes affected and to determine the effect of photodynamic therapy on healing and elimination of infection by Pseudomonas aeruginosa. The clinical section of the dissertation is based on the study of the results of treatment of 59 patients with local radiation damage of the covering tissues. The efficiency of use in the surgical treatment of LRD methods of determining the viability of tissues, PDT, plasma therapy and the features of wound defect wicking have been analyzed. The development and implementation of the proposed methods in the practice of surgical treatment of radial ulcers, justification of their effectiveness through the experiment and their inclusion in clinical practice, allowed to conduct an effective surgical treatment of major ulcerative defects of soft tissues with satisfactory results in 90% of cases (main group) in comparison with 80% (in the comparison group) (p> 0.05).