Notwithstanding advances in modern surgery, the problem of surgical infection continues to remain relevant and fully unsolved. Streptococcal necrotizing soft tissue infection does not belong to a category of specific infections; however, it is characterized by a number of substantial clinical features, requiring a special approach to its diagnosis and treatment. The paper gives the current concept in the diagnosis and treatment of streptococcal necrotizing infection and discusses the topical issues of early diagnosis and the general principles of surgical policy.

The article highlighted the issue of selecting an effective antimicrobial agent for the treatment of surgical infections of skin and soft tissue in surgical practice. A critical analysis of the available drugs containing antiseptics and local forms of antibiotics is presented. It is concluded on the benefits of certain drug forms of antibacterials and a rationale for the choice of drugs based on a combination of bacitracin and neomycin is provided.

It is well-known that multidisciplinary approaches allow to heal foot ulcers in 70–95 % of diabetic patients. In order to make an effective, local treatment, it is important to consider all pathogenic components of the wound healing process. Foot ulcers in diabetic patients tend to be chronic. The main objective of the local treatment is to create an optimal environment for tissue regeneration. The management of exudating, infected wounds usually represents the biggest difficulties in terms of selecting an optimal dressing. An overview of the results of the research shows that a new silver alginate dressing Fibroclean Ag has high strength and absorbency, which allows changing the bandage less and by this reducing the risk of spontaneous trauma. An additional atraumatic quality of the dressing is specified by the presence of the hyaluronic acid in the structure. The results of the research show that the antibacterial activity Fibroclean Ag corresponds to the spectrum of microorganisms most frequently encountered in diabetic foot ulcers. At the same time the bandage is effective against strains in the form of a biofilm, and outside of it. The important quality of this dressing is a reasonable cost. Thus, we can talk about a feasibility of using Fibroclean Ag in the local treatment of heavily exudating diabetic foot ulcers. At the same time, it should be remembered that the local treatment of wounds can be just as effective as part of a comprehensive treatment. For the detailed study of the properties of the dressing, it is necessary to conduct an additional research about the effectiveness of its usage in different groups of patients with diabetic foot ulcers.

The paper presents the results of a multicenter postmarketing study of Oflomelid ointment versus levosin and levomecol ointments in 301 patients with different purulent diseases of the skin, soft tissues, and bones, diabetic foot syndrome, trophic ulcers of different etiologies, postoperative purulent wounds, chronic posttraumatic osteomyelitis, burns and frostbites, acute and chronic purulent diseases of the skin and soft tissues. Oflomelid ointment shows a high clinical and bacteriological efficacy in stages I and II wound process along with good analgesic activity for the topical treatment of purulent processes of different etiologies and sites. Objectivization of the findings is based on the results of qualitative and quantitative microbiological analyses, wound imprint cytology, and trends in the systemic and local clinical picture.

The paper gives the experience with successful surgical treatment for scrotal traumatic avulsion and extensive penal scalping wound. A 28-year-old patient with an agricultural injury was taken to the central district hospital that performed three steps of Vitsin,s operation: primary surgical debridement, penile skin restoration, and scrotoplasty. This injury is extremely rare and the literature and media resources mainly report general information on the problem, the specific cases are sporadic; and this information has not been found in the Russian sources. Some reports deal with restoration of scrotal skin defect resulting from cancer treatment or Fournier ,s phlegmon, but these communications are few. Our case shows that stepwise treatment for such defects, stepwise scrotoplasty in particular, may be easily feasible at a general surgery hospital, even at a district hospital.

The paper describes a rapid method to diagnose the hemostatic and fibrinolytic system, which is based on the Lee–White method modified by E. P. Ivanov. The procedure does not require complex laboratory and diagnostic equipment; it gives a pictorial view of the hemostasis at the bedside and can define a therapy vector to correct the hemostatic and fibrinolytic system.