Khirurgiia
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Operations were conducted on 22 patients with defects in soft tissues and trophic ulcers of cicatrix in the region of the calcaneal tendon. In 16 patients with extensive cicatricial lesions occupying two distal thirds or the whole region, an L-shaped flap of skin and fat was used, it was formed on the postero-lateral distal third of the leg, in the zone of the lateral malleolus and the lateral surface of the foot. The flap measured 20-22 cm in length and 6-7 cm in width. ⋯ Necrosis of the end of the flap occurred in 2 among 16 patients, in obliteration of the leg arteries (1) and cutting of tissues in the zone of the flap base (1) during previous surgical intervention. Complete healing was achieved in all cases; there were no recurrences in follow-up periods of 6 months to 8 years. The L-shaped flap retained its normal properties, the deformity of the donor site was negligible.
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The article analyses ultrasonic symptomatology of textile foreign bodies which were left in the abdominal cavity and retroperitoneal space during surgical interventions in 10 cases. An intensive distal acoustic shadow behind a space-occupying echogenic structure in the main sign of a foreign body. ⋯ It is shown that the picture depends on the degree of the exudative reaction. The authors claim ultrasonic examination to be an effective method for detecting foreign bodies and determining their exact localization.
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In the period from 1977 to 1987, after 13,306 operations carried out on the abdominal organs in the clinic, intra-abdominal hemorrhages occurred in 34 (0.25%) patients which had to de managed by emergency relaparotomy. From analysis of case records (28 taken from the archives and 6 of patients who were under observation) of the relationship between the large number (195) of signs represented by a block of clinico-laboratory and radiological data, an integral diagnostic criterion of intra-abdominal hemorrhages was obtained. ⋯ Its practical application comes to recognition of intra-abdominal hemorrhage by identifying the symptoms and syndromes found in the patient with this early postoperative complication with the symptoms and syndromes composing the integral criterion. A revealed integral diagnostic criterion is a concrete indication for undertaking emergency relaparotomy.
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Biography Historical Article
[The ideas of N. I. Pirogov in their historical evolution].