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There was summarized experience of surgical treatment of 88 patients with narcotic dependence, in whom the hemorrhage have occurred due to postinjection injury of the main vessels. Reconstructive-restorational operations were conducted in acute period in the absence of sepsis, hemorrhagic shock and vast focus of infection, using auto vein and in the remote period--synthetic prostheses. All the patients, suffering narcotic dependence, admitted to the clinic, are considered as probably AIDS-infected. Medical staff, performing medicinal care in such patients, must be provided with the individual defense facilities.

The growth factors, cytokines, adhesive molecules and extracellular matrix components play the leading role in the processes of intercellular interactions. Literary data on structure and mechanisms of functioning of the growth factors and their receptors are summarised in the present review. Some aspects of regulatory functions of such growth factors as EGF, TGFalpha, TGFbeta, FGF, KGF, AR, and HGF in these processes in epidermis keratinocytes both in vivo and in vitro as example were also considered.

The results of treatment of 43 patients with chronic ischemia of extremities with application of preparation endotelon were summarized. Stable positive effect, preserved during 2-4 month was noted in 34 patients. Lowering of regional venous pressure, at average for the first week by (1.3 +/- 0.31) kPa, or (10 +/- 2.3) mm Hg, was observed after the first course of treatment conduction.

The experience of treatment of patients with deep burns measuring 20% and more of the body surface was summarized. In the principal group 29 injured persons were operated on the 5-7th days after trauma, in the control one in 28 burned persons the skin transplantation was accomplished on granulating wounds. In the principal group lethality was 24.1%, in a control one--42.9%.

Hospital mortality analysis in patients with different kinds of bradyarrhythmias after electrocardiopacemaker implantation operation performance was conducted. Significant haemodynamics improvement did not occur, if the patients had the pronounced coronary atherosclerosis. It was concluded that combined surgical correction of this pathology is needed.

A technique for cryotherapy of the postburn hypertrophic scars, and a method for protection of the surrounding tissues from damaging effect of the low temperatures have been suggested. In 76.4% of patients, a good cosmetic result has been obtained.

Possibilities to prognose the effect of reconstructive operation on the lower extremity vessels are shown on the basis of transcutaneous of oxygen on the dorsal surface of the foot in complex with ultrasonic Dopplerometry in patients with severe ischemia of lower extremities. Effectiveness of the test with the orthostatic growth of Po is proved. An examination of 60 patients with severe ischemia of lower extremities and 10 patients without pathology of main vessels (control group) was performed. Operations were performed on 48 patients, in 35 of them reconstructive operations were made. No correlation was found between preoperative value of Po and a result of the reconstruction. A correlation was found between the value of the orthostatic growth of Po and outcome of the reconstructive operation. The average growth of Po in the group of patients with a negative outcome of the reconstruction made up 9.93 + 2.78 mm Hg, with a positive outcome it was 14.137 + 2.30 mm Hg (p < 0.05). In patients with malleolus index of the regional systolic pressure > 0.3 with the orthostatic growth of Po > 20 mm Hg the probability of positive prognosis of the reconstruction made up 88.8%.

The initial experience with surgical treatment of aortic coarctation at the cardiosurgical centre in Donetsk has been summarized. Operated on were 24 patients with hypoplasia of the proximal aorta. Waldhausen's isthmoplasty, placing of an end-to-end anastomosis, grafting of the aorta and creation of an oblique anastomosis were performed. Co-operation with therapeutics, pediatrics and neonatologists, as well as thorough examination of the patients, monitoring permit to achieve the results which are compatible to those of the large clinics.

The paper discusses whether the outcome of reconstructive surgery can be predicted by using the orthostatic test in Doppler sonography and transcutaneous polarography. A total of 97 patients with severe lower extremity ischemia were studied, of them 87 were operated on. Reconstructive operations on the vessels were performed in 72 patients. There was no relationship between the value of the humero-mallear index of regional systolic pressure as well as TcpO2 and the outcome of an operation. At the same time there was a correlation between the orthostatic rise in regional systolic pressure on the tibial arteries at the ankle-bone and the orthostatic increase in pO2 in the feet and the outcome of a reconstructive operation. The orthostatic rise in pO2 and regional systolic pressure was 8.06 +/- 4.0 and 58.2 +/- 5.43 mm Hg in patients with poor outcomes and inoperable patients, respectively. In good outcomes, these figures were 17.8 +/- 2.14 and 91.3 +/- 3.64 mm Hg (p < 0.05), respectively. The positive outcome of a reconstructive operations was observed in 88.8 = 92.0% patients with an orthostatic rise of pO2 in the feet by more than 20 mm Hg and that at the ankle-bone by more than 90 mm Hg.

The suggested method for training cutaneofascial flaps is based on the results of histological studies, it can be applied in the early postoperative period, and reduces the intervals between the stages of plastic surgery with flaps. Training is possible in any localization of the cutaneofascial flap.

In the experiment, a sluggish wound of an extremity against the background of chronic ischemia was modelled in white rats. Then, a scapular muscle was transferred onto a wound defect. Free transfer of the latissimus dorsi flap (LDF) aimed at closure of the extensive wound defect and revascularization of the tissue ischemia area was performed in 29 patients: for high-voltage electric burn (12 cases), frostbite (5), radiation ulcer (4) and obliterative diseases of the lower extremities (8). Complications--partial, or total necrosis of a flap--occurred in 11 patients. Risk of free LDF transfer is justified because of absence of the other methods for prevention of amputation of the extremities.

Continuous electrocardiostimulation was applied in 33 patients with the carotid sinus syndrome. Neither fatal outcomes nor complications occurred in the hospital period. Analysis of complications in the late-term period (follow-up from one to 22 months) allowed the conclusion that physiological stimulation of the heart (in the AAI regimen) is the optimal method for the treatment of the cardioinhibitory form of the syndrome. The management of the mixed form is still disputable.

The experience with surgical treatment of 107 patients with severe ischemia of the lower extremities, including 52 with associated lesion of the vessels of the aorto-femoral and femoro-popliteal segments, is summarized. A complex of preoperative and intraoperative assessment of regional hemodynamics was used. This permitted to avoid the amputation of an extremity in 86.6% of the patients.

The experience with operative treatment of 27 patients with cardioinhibitory and mixed forms of the carotid sinus syndrome (CSS) is summarized. Continuous endocardial electrocardiostimulation contributing to effective rehabilitation of the patients is a method of choice in cardioinhibitory form of the CSS. Location of an endocardial electrode in the atrium for avoidance of the cardiostimulator syndrome development is preferable. Use of the method in mixed form of the CSS requires further investigation.

The results of the operative treatment of 277 patients with atrioventricular block and sick sinus syndrome were analysed. The primary implantation of the electrocardiostimulators (ECS) was performed in 211 (73.5%), the repeated one--in 76 (26.5%) patients. The complications of endocardial electrocardiostimulation developed in 58 (17.3%) patients, of them in 39 (14%), the repeated operative intervention was performed. Most frequently, the complications were conditioned by the quality of electrodes and ECG.

According to the results of examination of 170 patients with atherosclerotic lesions of the vessels of the aortofemoral segment and 170 virtually healthy subjects by means of the tetrapolar rheography, the prognostic value of the hypokinetic type of circulation in the development of cardiologic complications after reconstructive operations on the vessels mentioned was established. It is admitted that the value of cardiac index equal to 1.4 l/(min.m2) is a contraindication for the performance of reconstructive-restorative operations on the vessels of the aortofemoral segment.

At the burn centre in Donetsk, from 1979 to 1988, 236 sufferers with a III-IV degree frostbite of the extremities were treated. Operated on were 189 patients, who underwent necrectomy, amputation of the extremity and different types of skin plasty. Of these patients, 49.8% were recognized as invalids. After 1-10 years, all the patients after a III-IV degree frostbite of the extremities make complaints, require different types of treatment, 38.9%--the operative one. For timely and qualitative rehabilitation of this category of the sufferers, their prophylactic medical examination is necessary.