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The paper describes the results of examination carried out by the Sankt-Peterburg school of lymphologists, pertaining to the structure, physiological properties and function of lymphangions responsible for active lymph transport. The problems of the pathogenesis, diagnosis and treatment of lymphedema of the lower extremities used in clinical practice are reviewed from the standpoint of the new theory. The data obtained as a result of the clinico-morphofunctional studies allowed to delineate the stages of lymphedema as dependent on the degree of lymphocytic structure and function integrity. Based on the aforesaid the new approaches to the diagnosis and selection of the treatment methods for lymphedema of the lower extremities have been formulated.

Extracorporeal methods of hemosorption and detoxication were used in treatment of 293 patients with purulent surgical infection of soft tissues complicated by sepsis. In 35 patients with the same nosology the methods in question were not employed. An analysis of the clinical observations has shown that lethality in the main group was reduced to 23.6%. The sorption technologies were shown to be most effective for normalization of leukocytosis, lekocytic index of intoxication, middle mass molecules in this group of patients.

Investigations of the lymphatic bed of lower extremities by the method of rentgen-contrast lymphography were performed in 64 patients with trophic ulcers of lower extremities and postthrombotic disease. The data obtained by lymphography allowed formation of a group of patients perspective for treatment by lymphotropic antibacterial therapy. The lymphotropic therapy using Gentamycin and Cefazolin resulted in a more rapid arresting of local inflammatory alterations and development of reparative processes in the trophic ulcer area and in normalization of the main clinico-laboratory parameters.

The results of using recombinant interleukin-2 from yeast for the treatment of patients with the sepsis syndrome are discussed. It is noted that there was a marked immunomodulating effect, the amount of endogenous interleukin-2 increased. The patients' state was shown to become less severe (according to the SAPS criterion), the patients felt better. A conclusion is made of the possibility in principle and expediency of using cytokines for the treatment of patients with the sepsis syndrome.

An original method of endolymphatic therapy with the stimulation of the lymph outflow was developed and used in 108 patients with peritonitis. The dynamics of intoxication parameters was studied during the endolymphatic therapy, indirect electrochemical oxidation of blood, photochemotherapy and traditional treatment. The method proposed has been found to be most efficient. The method of endolymphatic therapy with the lymph stimulation allowed lethality from peritonitis to be decreased to 7.4%.

The skin electric resistance in the representative points was measured by the Nakatani technique in 86 surgical patients during resuscitation. Two most informative indices were established: the average electric resistance of the skin and the renal index. A significant correlation (r = 0.78) was obtained between the average electric resistance of the skin and score sum SAPS. Changes of the renal index allow the dynamics of the patient's state to be estimated, and along with the electric resistance of the skin--the degree of traumatic consequences of the operative intervention. The method is simple and not dangerous for the patients.

At examination of 120 patients with lymphedema of the lower extremities, in 70% of them, structure and function of lymphangion were preserved. State of lymphangion is of great importance in substantiation of the tactics of treatment. In preserved morphofunctional properties of lymphangion, the operation of lymphovenous shunting is effective in 83% of the patients. Stimulation of contractile activity of the lymphatic vessels at the stages of in-patient, out-patient treatment and that in sanatoria and health resorts contributes to improvement of a result of treatment of the patients.

Based on the experience with the treatment of 144 patients the authors recommend to use transfusions of autologous blood subjected to UV irradiation in the complex treatment of lymphostasis of lower extremities.

The work presents results of treatment of 1019 patients aged from 20 to 89 with postinjectional phlegmons. Operations were made on 1003 patients. Main causes of the appearance of the disease, choice of anesthesia and modern methods of treatment are discussed. The application of drugs of a composite effect in addition to early operation, the ultrasonic treatment of the purulent cavity, vacuum drainage followed by early secondary sutures make the terms of treatment of patients with postinjectional phlegmons shorter.

On the basis of the experience with treatment of 632 patients with purulent diseases of the fingers and hand, it is shown that in local treatment of panaritium and hand phlegmons, the adequate drainage of an abscess and excision of the necrotized tissues, the use of laser- and roentgenotherapy, vacuum drainage, ultrasonic cavitation of wounds are of importance. The complex treatment permitted to achieve good results in most patients; exarticulation of the fingers III-IV in pandactylitis associated with diabetes mellitus was performed in 1 patient, amputation of the fingers II--III--also in 1.

A combined clinico-morpho-physiologic investigation was conducted in 98 patients with primary and secondary lymphatic edema. All patients underwent lymphography by means of electron and light microscopy; biopsy specimens obtained from a lymphatic vessel at lymphography were investigated histologically, and contractility records were made. Pronounced disorders were demonstrated in the lymphatic vessels and their myocytes. New rational schedules of pathogenetic treatment for lymphedema of the lower limbs are outlined on the basis of the reported findings.