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Wounds and wound infections. The prof. B.M. Kostyuchenok journal

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Vol 8, No 4 (2021)
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REVIEWS, LECTURES, HISTORY OF WOUNDS AND WOUND INFECTIONS

6-23 345
Abstract

Semen Semenovich Girgolav was born on February 2, 1881 in Tiflis, Georgia, Russia. In 1904 he graduated from the Imperial Military Medical Academy with honors. Under the guidance of Prof. M.S. Subbotin, Dr. S. Girgolav prepared and in 1907 successfully defended his doctoral dissertation “Experimental findings on the use of isolated omentum in the abdominal surgery”. Later, he headed the chairs of general surgery, hospital surgery of the Military Medical Academy; he also was a scientific director of the Leningrad Research Institute of Traumatology and Orthopedics, head of the surgical department of the medical faculty of the 2nd Leningrad Medical Institute.

In the 30s. Prof. Girgolav started a comprehensive work on thermal injuries and continued it until the last days of his life, while basic efforts of the staff of departments and laboratories which he headed were focused on studying local and general effects of low temperatures. From the first to the last days of the Great Patriotic War, he was the Deputy Chief Surgeon of the Red Army, and when Academician Burdenko (Chief Surgeon) fell ill (from October 1941 to May 1942 and in 1945) he acted as Chief Surgeon. During the Great Patriotic War, Prof. Girgolav regularly underlined the priority of the issues of military field surgery management as well as the issues of collecting and sharing the battle experience in surgery.

Academician Girgolav’s list of works includes more than 140 scientific papers, which can be schematically divided into the following topics: “Military field surgery”, “Wounds”, “Frostbites”, “Issues of Special Surgery”, “Traumatology”, “Asepsis and antiseptics”, “Pain relief”, “Neurosurgery”, “Endocrinology and oncology”, “Manuals and Guidelines”. Professor V. G. Weinstein (an outstanding Soviet traumatologistorthopedist who worked under Acad. Girgolav’s guidance) suggests the following sections: 38 works are devoted to comprehensive researches on wounds, 17 – to infections, 16 – to military field surgery, 14 – abdominal and thoracic surgery, 13 – traumatology, 12 – problems of low-temperature injuries. Fewer works in urology, plastic surgery, asepsis and antiseptics, vascular and operative surgery, history of medicine.

As a result of Acad. Girgolav’s research and educational activities, one of the largest surgical schools in the USSR has been created. More than 20 doctoral and 45 candidate dissertations were prepared and defended under his supervision. Academician, Lieutenant-General of the Medical Service .S. Girgolav, was awarded the Stalin Prize, two Orders of Lenin, three Orders of the Red Banner, Order of the Red Banner of Labor, Order of the Red Star as well as many medals and honorary prizes for his outstanding contribution to the medical sphere of the Motherland in peacetime and wartime.

ORIGINAL RESEARCH

24-29 435
Abstract

An open wound on the head is an injury (skin tear) of all scalp external layers including dermis, subcutaneous fatty tissue, aponeurosis, muscles, vessels and nerves with intact skull bones and intact neurological reactions [1].

Extensive wounds of the external head layers, in addition to a standard threat to the human health, bear an additional risk due to their close localization to the brain. Because of the abundant blood supply to scalp soft tissues, high rate of volumetric blood flow (50–60 milliliters per 100 g of brain tissue), numerous extra-, intracranial arterial and venous anastomoses, there is a real danger of spreading the infection inside the skull and developing meningitis or encephalitis.

Problems of care of patients with extensive head wounds, risk of complications that can cause severe consequences determine the relevance of the issue presented in this work.

Objective. To analyze treatment results of patients admitted to the emergency department of Mariinskaya State City Hospital in St. Petersburg within three months in 2021 and to develop an optimal tactics for treating patients with extensive wounds of the scalp.

Material and research methods. 2245 patients with various types of head injury were admitted to the hospital; 610 (27.2 %) of them had damage of the external scalp layers. Each patient had standard clinical and laboratory examination and multislice computed tomography (MSCT) examination of the head at 64-slice Definition AS (Siemens, Germany) CT scanner. In the emergency department, all patients who were injured by high-energy traumatic objects had the primary surgical debridement; all patients who were injured by low-energy traumatic objects had wound toilet and wound suturing. Three most representative cases with extensive wounds of the external scalp (over 10 cm) with illustrations are presented in the article as clinical examples.

Results. All patients had good outcomes. There were no any signs of wound infection either.

Conclusion. A thorough primary surgical debridement of scalp wounds with their drainage followed by observation and treatment in the hospital is a necessary condition for successful healing of large scalp wounds.

CASE REPORTS

30-33 240
Abstract

The article describes the complex surgical treatment of a patient with a bilateral hip phlegmon complicated by severe sepsis, multiple organ failure syndrome (cardiac, respiratory), as well as deep pressure ulcers of various depths and localization under the primarily diagnosed diabetes mellitus.

CONGRESSES, CONFERENCES, SYMPOSIA

INFORMATION FOR AUTHORS



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ISSN 2408-9613 (Print)
ISSN 2500-0594 (Online)
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