[Pelvic ostheomyelitis: diagnostics and treatment].

Results of treatment of 223 patients with ostheomyelitis of various etiology and localization were analyzed. Such aspects as diagnostic difficulties, polifocal type of the disease, sepsis development on the background of pelvic ostheomyelitis were discussed. Ostheoscintygraphy, magnetic resonance imaging and computed tomography proved to be of highest diagnostic value by pelvic ostheomyelitis.

[Basic principles of the treatment of chronic pelvic osteomyelitis].

The results of treatment in 177 patients with chronic osteomyelitis of the pelvis are reported. The diagnosis was clarified and the patients' general status was assessed by comprehensive examination (roentgenography, tomography, fistulography, scintigraphy, bacteriological, immunological, and laboratory studies). A procedure of complex preoperative preparation, rational detoxication and immunocorrection, intraoperative blood loss replenishment (autohemotransfusion) and volemic disturbances correction was developed.

[Immune system defence and its correction in patients with chronic inflammatory disorders of lower extremities].

The factors of immune defense were studied in 83 patients. Chronic osteomyelitis of foot and shin was in 48 patients (hematogenic osteomyelitis in 36 patients, posttraumatic osteomyelitis-in 12 patients). Trophic ulcers were in 25 patients: in 36% in the presence of diabetes mellitus; diabetic angiopathy complicated with diabetic gangrene was in 10 patients.

[Immunopathology and morphology of chronic inflammation].

Biopsies from 40 patients with chronic trophic ulcers of lower limbs or osteomyelitis were investigated. Combination of immunopathological processes in the form of immune deficiency, unbalance of T-lymphocyte subpopulations and immunoglobulins, increased levels of circulating immunocomplexes and T-active lymphocytes, high functional T-lymphocyte activity. Moreover, there is a decrease of both chemotaxis and spontaneous motility of neutrophil leukocytes and phagocytosis.

[Computed tomography in the diagnosis of suppurative sacroiliitis in chronic pelvic osteomyelitis].

The object of the investigation was to study the possibilities of CT diagnosis of purulent sacroiliitis and evaluate the effect of its results on the choice of the volume of the surgical intervention and the operative tactics. The pelvis was examined in 15 patients with chronic hematogenic osteomyelitis of the pelvic bones; clinical signs of involvement of the sacroiliac articulation were encountered in 11 of them. There were 5 men and 6 women whose ages ranged from 18 to 62 years.

[Computed tomography in the comprehensive radiologic diagnosis of chronic osteomyelitis of the lower extremities and pelvis].

The role of computed tomography in multimodality radiation diagnosis was assessed in the treatment of chronic osteomyelitis of the lower extremity and pelvis in 218 patients (128 with posttraumatic osteomyelitis, 46 with hematogenic osteomyelitis of long bones, and 19 with chronic pelvic osteomyelitis) aged 16-78 years. Computed tomography was used to specify the symptomatology of chronic osteomyelitis, to define indications for radical surgical treatment. The soft tissues of the shin were studied in patients with chronic osteomyelitis versus lymphedema in 103 patients, post-thrombophlebitic syndrome in 17, acute wound infection in 9.

[A comparative evaluation of hyper- and normovolemic hemodilution in the complex treatment of chronic hematogenic osteomyelitis].

The article deals with the comparative analysis of the results of treatment of 98 patients with chronic hematogenic osteomyelitis of the long tubular and pelvic bones with the use of hypervolemic and normovolemic hemodilution as a method of infusion-transfusion therapy of intraoperative blood loss and its compensation with donor blood. It is shown on the basis of clinical evaluation and the study of hemodynamic, hematological, and rheological blood values, the values of the blood coagulation system and the acid-base balance that the use of hypervolemic hemodilution is limited and can be applied in blood loss not exceeding 10% of the circulation volume. The use of the method of normovolemic hemodilution makes the transfusion of donor blood unnecessary and thus allows the complications associated with it, infectious among others, to be avoided.

[Autologous blood transfusion in the complex surgical treatment of chronic hematogenic osteomyelitis].

The article analyzes results of complex surgical treatment of 109 patients with chronic hematogenic osteomyelitis of long tubular bones and pelvis, 53 of them were subjected to correction of intraoperative blood loss with autogenic blood. Autohemotransfusion with procurement of 400-600 ml of blood immediately before operation in combination with normovolemic hemodilution allows to correct intraoperative blood loss up to 20% of the circulating blood volume. Autohemotransfusion with the preliminary taking of blood as much as 800 ml allows to correct intraoperative blood loss more than for 20% of the circulating blood volume.