Khirurgiia
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The authors work is based on experience in the study of 56 patients with acute mediastinitis of various origin who were treated in the period from 1981 to 1990. There were 33 males and 23 females whose ages ranged from 16 to 65 years, Odontogenous mediastinitis was diagnosed in 23, tonsillogenous in 2, and mediastinitis resulting from injury to the esophagus in 31 patients. Instrumental injuries prevailed. ⋯ Diffuse anterior mediastinitis was managed by tunneling and drainage of the mediastinum through the seat of the removed xiphoid process. Prophylactic treatment of the mediastinal space and intensive therapy including active detoxification were applied in the 56 patients who underwent operation died, 26 of them were admitted to the clinic 24-72 hours after the onset of the disease in a state of severe intoxication caused by violently developing mediastinitis. The remaining 27 patients recovered.
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The authors discuss the surgical tactics in multiple burn contractures of the palmar surface of the hand from experience in the treatment of 45 patients. The operation is conducted in one stage, with the manipulations performed in a definite order, which makes it much easier. ⋯ Plastics with trapeziform grafts in combination of the palm. Plastics with trapeziform grafts in combination with free skin grafting makes it possible to correct all contractures in one stage and restore the function of the hand.
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The authors had 21 patients with a rare disease, Madelung's lipomatosis. Vegetative disorders of segmental and suprasegmental levels were revealed in all patients. ⋯ The accompanying secondary scalenus syndrome produces a peculiar clinical picture of neuropathy. The existence of neurological disorders dictates the need for complex (surgical and medicamentous) treatment of patients with Madelung's lipomatosis.