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A total of 4664 bacteriological analyses of the wound and purulent discharge from orthopedo-traumatological patients were performed within a 6-year period, i.e. from 1971 to 1976. Staphylococci were the dominating microbes of the purulent-inflammatory foci. Its part in the monoculture amounted to 64.5--82 per cent. The specific weight of the monocultures of various microbes decreased during the last 3 years, while the number of the microbial associations increased from 11.6 to 25.4 per cent Staph. aureus predominated in the inflammatory processes (65.8 to 86.5 per cent). Still, during the last 3 years the number of Staph. epidermidis increased from 16.8 to 26.2 per cent. The number of the so called "intermediate" or dissociated type of Staphylococcus, i.e. Staph. albus usually amounted to 7.5--8.1 per cent. In 1976 its number was 12.5 per cent. The pathogenic microbes of the coccal group were usually sensitive to erythromycin, monomycin, levomycetin and kanamycin. Among these microbes only staphylococci preserved their sensitivity to penicillin. The causative agents of purulent processes, i.e. Escherichia, Proteus, Pseudomonas were resistant to most of the antibiotics. Sensitivity to monomycin was preserved by 50 per cent only in Proteus. The microbial associations were mainly sensitive to monomycin and kanamycin.

In 172 patients with open fractures of long tubular bones the wound bacterial flora was studied on their admission to the clinic and in occurrence of suppurative complications. There were no cases of "outdoor" microorganisms being the cause of suppuration. Pathogenic agents of suppurative infection differed from "outdoor" strains in their species content, signs of pathogenicity, sensitivity to antibiotics. As a rule, suppuration was preceded by soft tissues necrosis. Since wound suppuration was produced not by the initial or changed "outdoor" microorganisms but hospital strains, which penetrate in the wound due to inadequate observation of the rules of asepsis and antisepsis in surgical treatment or subsequent dressing, then prophylactic antibioticotherapy should cover mostly sensitivity of hospital bacterial strains. To this end, the study of bacteriological background for each surgical department seems to be absolutely necessary. In a small zone of the soft tissues injury under conditions of secure fixation of bone fragments with Ilizarov apparatus a limited use of antibiotics is believed to be permissible.

Investigations carried out in 60 patients with open fractures of long tubular bones in osteosynthesis with the Ilizarov apparatus indicated that alkaline phosphatase (AP) of granulocytes fully reflects the postoperative course. 10--24 hours following the trauma the level of AP in patients with grave injuries exceeds that in patients with slight ones. The differences are found to be reliable from the 1st to the 5th day after the injury.

Changes in the proliferative activity and in the number of bone marrow stromal precursor cells (SPC) in the dog long bone fixed with Ilizarov's apparatus were studied by cloning in monolayer cultures over a period of leg lengthening. It was demonstrated that in 1-1 1/2-year-old dogs the number of dividing SPC in the tibia increased up to 95% by termination of the distraction (60 days). Concurrently, the colony-forming efficiency (CFE) increased 11-fold. In the contralateral tibia (CFE significantly rose during the distraction, while in the humeri it decreased 2.5-fold as compared to control. A conclusion is drawn about participation of SPC in bone regeneration.