Indications for applying of primary seam:

a) lack of plentiful pollution of a wound,

b) possibility of excising of all impractical tissues,

c) safety of blood supply of a wound,

d) possibility of rapprochement of edges of a wound without rasping tension,

e) the condition of the wounded isn't burdened by starvation, blood loss, an infectious disease,

e) the wounded has to be under observation of the surgeon,

g) wounds of abdominal and thoracic cavities. First aid includes: a) temporary stopping of bleeding, b) applying of a bandage, c) transport immobilization.

The help at a hospital stage: tasks – prophylaxis and treatment of wound complication, adhesion acceleration, restoration of functions of the damaged organs and tissues.

Basic principles of modern treatment: strict observance of an asepsis, a surgical treatment, an active drainage, early closing of wounds (primary and primary delayed and secondary seams, an auto skin plastic), purposeful antibacterial and an immunotherapy.

Primary seams are imposed before development of a granulation tissue, secondary – after.

In all cases the contamination of wounds (except small superficial damages) carrying out primary surgical treatment of wounds is obligatory.

The surgery field after processing is delimited sterile linen. After anesthesia by an acute scalpel excise edges of a wound from 0,5 to 2 cm within healthy tissues, delete the tissues all damaged, polluted and impregnated with a blood. If a wound chipped, it is dissected. After excising of the polluted tissue all tools replace pure, a wound delimits a fresh sterile sheet and change gloves. Further stop bleeding with layer-by-layer sew up a wound.

Primary surgical seam is applied as the final stage of primary surgical treatment of a wound on purpose:

a) restoration of an anatomic continuity of tissues

b) preventions of secondary microbial pollution of a wound

c) creation of conditions for primary wound repair

Indications for applying of primary seam:

a) lack of plentiful pollution of a wound,

b) possibility of excising of all impractical tissues,

c) safety of blood supply of a wound,

d) possibility of rapprochement of edges of a wound without rasping tension,

e) the condition of the wounded isn't burdened by starvation, blood loss, an infectious disease,

e) the wounded has to be under observation of the surgeon,

g) wounds of abdominal and thoracic cavities.

Primary delayed seam is imposed in 4-5 days after operation (before emergence of granulations); in the absence of suppuration signs.

It can be applied in the form of provisional (situational seams) which impose during operation, and tighten some days later, having convinced that there is no danger of a suppuration of a wound.

For the purpose of decrease of an contamination of a wound it is expedient to supplement with microorganisms a surgical treatment of a wound:

1) a lavage its pulsing liquid stream under pressure;

2) pumping out of a surface of a wound with a simultaneous lavage;

3) impact on the wound filled with antiseptic solution ultrasound with a frequency of 20-50 kHz

4) processing of the most polluted sites a beam of a laser scalpel.

From terms of carrying out primary surgical treatment distinguish: 1) early, 2) delayed and 3) late primary surgical treatment of wounds.

The early surgical treatment of wounds is made in the first 24 hours after wound, it is the most effective in the first 6-12 hours – before clinical implications of an inflammation in a wound, comes to an end with applying of primary seams.

The delayed primary surgical treatment is carried out from 1 to 2 days from the moment of wound under cover of antibiotics, in the period of an initial inflammation.

Late primary surgical treatment (PST) – after 3 days when the inflammation is close to maximum and begins already infectious process – in this situation the wound isn't taken in, allowed only applying of secondary seams for 7-20 days.