Khirurgiia
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Results of surgical treatment of 25 patients with arrhosive bleedings were analyzed. All of them had functioning shunts and severe infectious complications of the wounds in the region of Scarp's triangle. Infected wounds existed from 15 days to 18 months. ⋯ Arrhosive bleeding from anastomosis of the synthetic graft with aorta or common iliac arteries was in 8 (32%) cases, insufficiency of distal anastomosis of femoral-tibial bypass was seen in 2 (8%) patients. Various extrafocal surgeries are method of choice in the treatment of arrhosive bleedings. These surgeries may be performed simultaneously (at first bypass, then removing of graft) or during 2-3 stages in lengthy purulent-inflammatory process.
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Short and long-term results of revascularizing osteotrepanations by Zusmanovich's method performed in 80 patients with lower limb critical ischemia were analyzed. The operation is effective in distal and diffuse forms of atherosclerosis and inflammatory diseases if it is impossible to perform reconstruction. Isolated revascularizing osteotrepanation is indicated for patients with recurrence of critical ischemia who earlier have undergone conventional surgical procedures. Duplex sonography is the main method for diagnosis and determination of indications for surgery which provides an objective criterion of the treatment failure - the index of tibial arteries resistance.