Khirurgiia
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The analysis of treatment of 452 victims with wounds of extremities for the period from 1984 to 1994 years was carried out. 171 patients had fire-arm wounds in local conflicts. Surgical wound management in 43% of victims was carried out under local infiltration anesthesia, in 28.3%--under conduction and prolonged conduction anesthesia, 27.8%--under general anesthesia and in 0.9%--under intraosseal anesthesia. ⋯ In multiple and combined wounds, damages and tearing off the extremities, followed by shock, blood loss, general anesthesia would be indispensable. Conduction, prolonged anesthesia is quite reliable in mechanical cleansing of wound in process of surgical treatment, in early postoperative period, promotes improvement of regional hemodynamics and favours uneventful wound healing.
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The experience in surgical treatment of 1027 patients with perforated gastroduodenal ulcer was assessed. Particular attention was paid to the most arguable problems of surgical treatment of this disease. ⋯ It has been convincingly proved, that in spite of all known risk factors (age of patients above 60 years, accompanying diseases, preoperative shock and duration of the perforation over 24 hours, disseminated peritonitis, etc.), truncal vagotomy with excision of the ulcer and pyloroplasty provides lower lethality rate in comparison with any other surgical operation. The operation is recommended not only for saving of patients life, but for receiving in great majority of cases favourable long-term results in patients of young as well as old age irrespective of the presence of ulcer in the anamnesis.