He began his most famous surgical work — “Sketcheses of purulent surgery” — MUDr. V. F. Vojno-Jaseneckij, later a professor of surgical sciences and sainted Archbishop Luka, a confessor, Archbishop of Simferopol (1877–1961), in 1916 in Pereslavl – Zalesskiy. At the hospital, that was a military one at those times, he was working as a head physician and a surgeon. The materials for the book were taken from the time of Russo-Japanese war 1904–1905. The first variant of the work was ready in 1920–1923, but due to repressions of the author the publishing house “Biomedgiz” released “The Sketches” in 1934 only after the second Archbishop’s and surgeon’s deportation was over, V. F. Vojno-Jaseneckij began to work under the second publication but a new deportation allowed him to finish it only in 1943 and in 1946 he had the honor of winning Stalin Award, after that the book went out in the publishing house “Medgiz”. The third publication of “The Sketches” was released by the same house in 1956. In 2000, the year of his canonization, the fourth book went out in publishing house “Binom”, which was mistakenly called the fifth one. In 2016 in Simferopol “The Sketches” was released again. It was found out that due to author’s deportations the most unique book is the first one of 1934, and the most detailed is the second (1946). Some information about antibacterial treatment of purulent diseases was added to the third book, the fourth one was not published in 1955, and the fifth work (the fourth in reality) was added with introduction, editors’ notes, theological work of the author “Science and Religion” and the essay of his life and work with illustrations. There is an introduction from the Patriarch of Moscow and all Russia Kirill in the publication of 2016, which is the same as the second one. There is also a two-volume book of ‘The sketches” in Greek published in 2014 in Athens.

Introduction: Treatment of patients with incomplete intestinal fistula remains an actual problem of modern surgery. Incomplete intestinal fistula is 1-2 % of all post-surgical complications after surgery in abdominal cavity organs. Mortality with incomplete intestinal fistula gets to 20-90 % and patients with high small intestine fistula are at the biggest risk.

Study purposes: Analysis of vacuum therapy (negative pressure wound treatment or NPWT) in cases of incomplete intestinal fistula.

Materials and methods: NPWT was applied at 14 patients with incomplete intestinal fistula after different surgeries in abdominal cavity organs. The age of patients was from 18 till 81, the average was 56,9 years. In general, there were females in the study group – 9 ones (64 %).

Results: NPWT at patients with external incomplete intestinal fistula allows to stop inflammatory complications two-three times quicker, then other methods. Vacuum therapy also increases the possibility of independent intestinal fistula closure, or the timelines of reformation into formed tube fistula with lower level of intestinal loss is 1,5-2 times less.

Conclusion: The use of NPWT in incomplete intestinal fistula treatment allows to stop purulent-inflammatory complications within a short time, increases reparative potential of surrounding tissues, stimulates the growth of granulation bank, due to that this method increases the possibility of incomplete intestinal fistula closure. 

There is work analysis of pediatric team (Roshal’s Pediatric Team) while rescuing specialized surgical operation for earthquake-stricken in Nepal 25.04.20015.

Materials and methods. Team of Russian doctors of GBUZ NII NDHiT DZ of Moscow rescued specialized medical operation for earthquake-stricken in Nepal from 30.04.2015 to 18.05.2015. The team consisted of 7 doctors: 2 surgeons, 2 traumatologists, 1 neurosurgeon and 2 anesthesiologists. During that period the team performed: 621 patients’ consultation, among which 184 are children. 59 patients needed complex surgical treatment. 32 of them were adults and 27 children. The age of patient was from 3 to 80 years. Open traumas of soft tissues and bones were complicated with purulent infection at all patients. Close traumas were represented by limb injuries and back bone trauma. The most often cases were lower limb injuries - 39 (49,3 %) patients. Among them the most part was with lower leg injuries – 21 (53,8 %). The second place took upper limbs traumas – 13 (19,7 %) with localization in shoulder area – 6 (46,2%).

Results. 115 operartions were done for 59 patients, 362 bandages and 235 anaesthetic support were done. 52 surgical d-bridements were performed at purulent-necrotic wounds treatment, and 30,7 % needed repeated surgical d-bridement. For local treatment polypharmaceutical ointments based on polyethyleneglycol were used — 69,4 % and iodiphor solutions — 30,6 %. Wounds were ready for final phase of surgical treatment 10-14 days later after surgical d-bridement of purulent-necrotic places, which appeared due to one-time impact of traumatic agent, and 14-18 day later at crush syndrome. For substitution of wound defects and closing of wound surfaces different reparative and plastic operation were used: local tissues plasty of wound (48,1 %), dosed tissue stretching plasty of wound (29,7 %), fasciocutaneous flap with axial type of blood supply (3,7 %), free split autodermotransplantate plasty of wound (18,5 %). In all cases of patient treatment with open soft tissue and bone injuries a positive result was achieved. Only 2 (3,4 %) patients had some marginal flap necrosis, which was neutralized during next bondages. One patient had humid gangrene and sepsis of lower leg and it was decided to perform amputation at the level of upper third part of lower leg.

Conclusions.The use of both methods: active surgical treatment and conveyor belt method of anesthesia providing (on two tables simultaneously) allowed to decrease timelines for recovering and improve treatment quality. Despite some organizational difficulties they could managed with purulent-inflammatory complications, refused from amputations planned by local surgeons and did reparative and plastic operation even in emergency conditions. 

Objective. Retrospective analysis of anesthesia service while rescuing specialized surgical and traumatological operation for earthquakestricken in Nepal (2015).

Materials and methods. Team of Russian doctors of GBUZ NII NDHiT DZ of Moscow rescued specialized medical operation for earthquake-stricken in Nepal from 30.04.2015 to 18.05.2015. The team sonsisted of 7 doctors: 2 surgeons, 2 traumatologists, 1 neurosurgeon and 2 anesthesiologists. The last ones performed 235 anesthesia at 59 patients (32 adults at the age of 36 ± 14 years and 27 children at the age of 7,5 ± 4 years with different surgical pathology).

Results. From the whole number of anesthesia, there were 98 (41,7 %) inhalational anesthesia; 44(18,7 %) intravenous anesthesia; 39 (16,6 %) combined (intravenous and inhalational with regional anesthesia); 36 (15,3 %) regional anesthesia; 18 (7,7 %) endotracheal anesthesia. At the phase of wound process preparation to plastic closing at children, mostly intravenous and inhalational anesthesia were used, and regional anesthesia at adults. At the phase of plastic closing of soft-tissue defects endotracheal or combined anesthesia were used. In presence of orthopedic trauma and reposition with osteosynthesis combined anesthesia was used - intravenous or inhalational anesthesia with regional anesthesia, endotracheal anesthesia in combination of epidural one. Infusion therapy, antibacterial therapy, anticoagulation reversal and anaesthesis were provided to all patients. Complications at anesthesia: arterial hypotension – 12 (5,1 %), “agitation” after anesthesia with Sevoflurane – 32 (13,6 %), long postanesthesia respiratory depression – 2 (0,9 %). No lethal outcomes.

Conclusions. It’s up to anesthesiologist to choose the type of anesthesia, it depends on timelines of surgical help, seriousness of the case, combination, extensiveness and trauma localization. 

The usage of home-made narcotic in RF, the main variant of which is intravenous administration, has increased greatly for the last ten years. According to such poor statistics a number of patients with pyoinflammatory complications after injections is increasing as well. The results of group of patients with complex treatment are significantly improving while using additional physical methods in management of wound, and here plasma technology has a special place. The described case shows a successful usage of plasma flows from different sources in dissection and stimulation in difficult clinical situations.

14-16 November 2017 RPO "Surgical society – Wounds and wound infections", A.V. Vishnevsky Institute of Surgery of Ministry of Health of Russia, Endocrinology research center, Research Institute of Urgent Pediatric Surgery and Traumatology, LLC “Russian Society of Surgeons”, International Foundation for Children in Catastrophes and Russian Peoples Friendship University, Ministry of Education and Science of Russia are planning the 3rd International Congress "Diabetes mellitus and surgical infection".