I. Methods of dialysis and filtration.

1. Haemodialysis.

2. Haemofiltration.

3. Haemodiafiltration.

4. Anadiafiltration.

5. Peritoneal dialysis.

II. Plasmapheresis.

III. Sorptive methods.

1. Haemo-, plasmo-, lympho-, liquorosorption.

2. Gastroenterosorption.

3. Vulnerosorption.

IV. Electrochemical oxidization. Ultraviolet irradiation (UVI). Plasmoextraction.

V. Artificial mews. Artificial organs of detoxication.

VI. Spleenoperfusion.

Very perspective is a method of vulnerosorption is treatment of wounds with the use of sorptive preparation. Although this method is known from the oldest times, presently his distribution was provided by the receipt of new materials: nano-dispersed silics, polymethylsiloxane and other.

Essence of this method consists in active extraction from a wound and cavities of microbial mews, bacterial toxins, toxic metabolites, warning of their suction which is instrumental in normalization of flow of wound process.

Prospects of the use of applique materials on the basis of sorptive preparation for vulnerosorption assumes different of their form – to pasture, gels, granules, fabrics; introduction to the structure of sorptive preparation of antiseptics (Flotoxan), antibiotics, metronidasole (Metroxan), enzymes, silver. One of directions are sorptive preparation with magnetcontrolled properties.

Practically all of the tools of surgical operation are anaesthesia, operating wound, blood loss – influence on all of parameters of the immune system: phagocytosis, and humoral cellular immunity. These changes are principal reason of development of postoperative infectious complications. Therefore for treatment and prophylaxis of these complications timely application of immunotropic of medications is expedient, that facilities, directed on renewal of the broken immunity.

Features of care and treatment of hiv-infection

In surgical department

GENERAL INFORMATION ABOUT HIV-INFECTION, AIDS

HIV-infection is a disease, caused the virus of immunodeficit of man; characterized the slowly making progress defect of the immune system which results in death of patient from the second defeats (infectious and tumour processes) described as an acquired immunodeficit syndrome (AIDS) or from a subsharp encephalitis.

CLINICAL CLASSIFICATION OF HIV-INFECTION

І. Stage of incubation.

From a moment an infection to appearance of antibodies.

A diagnosis can be confirmed the method of polymerase chain reaction at the exposure of antigen of НIV-RNA. The selection of antigen of НІV has low specificity the method of enzymoimmunoassay.

II. Stage of primary displays.

Characterized a relative equilibrium between the immune answer of organism and action of virus. Duration from 2-3 to 10-15 years.

ІІ А. Acute infection.

2-3 week lasts usually. Accompanied the fever of different degree of expressed, lymphadenopathy, increase of liver, spleens, skin pouring out, the meningeal phenomena are possible. Then passes to the stage ІІ b or ІІ c.

ІІ B. Symptomless infection.

Characterized absence of clinical displays. The moderate increase of lymph nodes can be marked. Unlike the stage of incubation antibodies are determined to the antigens of HIV.

II C. Persistent infection.

Persistent generalization lymphadenopathy is characterized, which is a clinical display on this stage.

III. Stage of the second displays.

Clinical symptoms, which testify to deepening of defeat of immunity, which characterizes beginning, develop at progress of disease ІІІ stages.

III А. Characterized by the loss of mass of body less 10%, by the bacterial, mycotic, viral defeats of mucous and skin covers, inflammatory diseases.

ІІІ B. Characterized by the loss of mass of body less 5%, by skin defeats which carry more deep character. The defeats of internal organs develop; noncommunicative sarcoma of Kaposhi.

ІІІ C. Characterized by a cachexy, generalization of infectious diseases, disseminative sarcoma of Kaposhi, heavy defeats of central nervous system of different etiology.

IV. Terminal stage.

Characterized the irreversible defeat of organs and systems. Even therapy of the second diseases, which is conducted adequately ineffective and a patient perishes during a few months.

Primary cause of infection HIV-infection in surgical permanent establishment is a professional display to HIV-contain biological millieus of patients.

Most registered cases of professional infection take a place as a result of casual damages of skin covers of medical personnel sharp objects (by injection needles, blades) which are accompanied a parenteral contact with the biological millieus of patient; hit of these environments on the mucous membrane of eyes, to the oral cavity, on the opened areas skins which have the broken epidermis (cuts, scratches). Instead, considerably anymore potential of daily unrealized risk of surgeon is made by the so-called suboperating damages of surgical gloves safety which make from 25 to 75% cases during operative interferences. Besides only surgeons are able to notice third of such damages by sight and to accept necessary preventive measures.

Prevention of infecting HIV of surgeons is based on such principles:

1. Promoted watchfulness of doctor relatively HIV-infecting of patients.

2. Measures of prevention of professional display:

а) barrier facilities of defence (surgical chain «mail» gloves, sun-blinkers, waterproof dressing-gown, sleeve protectors);

б) diminishing of probability of professional display is " distance surgery".

3. Timely exposure of cases of professional display, if such happen.

4. Prevention of consequence of contact with the biological environments of patient is a post-display prophylaxis.