INTRODUCTION

Pricey colleagues!

It’s a joyful day immediately each in your life and within the lifetime of the division. After you learnt the bases of anatomy, histology and another disciplines, the medical life begins. We’re glad to greet you within the Normal Surgical procedure Division and to share our expertise and expertise with you. We sincerely congratulate you on at the present time — the start of medical disciplines finding out.

The scholars work within the clinic and direct contact with sufferers, in addition to the work in working, dressing and different rooms of the surgical hospital, has options to which college students ought to listen from the primary day of research on the surgical clinic. A few of them are following:

The scholars for the primary time come into skilled contactwith sufferers, get acquainted with numerous ailments and psychology of a sick particular person. It’s mandatory to recollect, that not each affected person with readiness will conform to be an object of research, and in lots of circumstances sufferers reject that college students perform dressings or every other medical and surgical manipulations. That is linked with mistrust to the standard of pupil’s information and care of well being. Subsequently, it is vitally essential that college students, as quickly as doable, purchase theoretical and sensible expertise, have knowledgeable look and deserved the affected person’s belief.

In every surgical clinic there are all the time some severily sick sufferers with numerous pathologies. Some sufferers are nervous, anticipating for operation; others are already recovering from surgical intervention and demand, naturally, intensive remedy, relaxation, and care. Subsequently, silent dialog will get particular significance in surgical clinic, it’s inconceivable to chortle, joke, and behave thoughtlessly, it’s mandatory to watch order whereas transferring as teams of scholars via the corridors and chambers, from one to a different flooring. It’s no much less vital to know that coaching is being carried out on the identical time with right and delicate method to the affected person;

Options of surgical strategies of therapy and risk of woundsinfection demand to stay to particular actions, which directed to preserving sterility of dressing and devices, surgeon’s and operation sister’s garments, safety of postoperative wound towards an infection. On the operation block, dressing and manipulation rooms, particular guidelines of conduct and sure habits, which college students will step by step seize, have been developed. We will acquaint you with them throughout lectures and sensible lessons, through the time of night time obligation within the clinic, throughout sensible coaching, classes within the circle of pupil’s scientific group (SSO). At this time it’s important that you just perform all of those necessities, that are directed in direction of the safety of the affected person towards an infection.

It’s essential to do not forget that a pupil ought to all the time have a tidy look, clear lab coat, medical masks, change of sneakers.

Regardless of of achievements of surgical procedure, surgical strategies of therapy nonetheless now are aggressive and trigger the destructive feelings in individuals which aren’t used to that. Altering a dressing is generally painful and surgical intervention is often accompanied by vital haemorrhage and suppuration. Expertise testifies that through the first attendance of those work websites college students really feel unhealthy, lose consciousness whereas observing surgical operations or manipulations. It’s mandatory to recollect this, and on the first shows of feeling unhealthy college students ought to instantly inform the trainer.

HISTORY OF SURGERY DEVELOPMENT

Surgical procedure is a piece of drugs, which due to totally different social and financial durations developed extraordinarily irregularly. After the interval of prosperity in some historical international locations (2–4 thousand years BС) the interval of its nearly full degradation got here within the center ages when the church domination hindered sharply the event of drugs and surgical procedure. Eventually, from ХІХ–ХХ century as much as the current time, the interval of most intensive and speedy surgical procedure growth has proceeded.

Details about surgical procedure is acquired from archeological excavations of outdated burials, outdated manuscripts, papyruses and books, footage on rocks, vases, vintage sculptures and even from nationwide eposes and legends, proverbs, sayings, and so on. Early individuals struggled with the forces of nature, trusted in evil and type spirits, and used elementary technique of therapy. There isn’t a doubt that essentially the most historical medical instruments have been utilized in case of traumatic damages (whereas looking, at warfare) and in wound issues, within the case of bleeding throughout beginning and different ailments.

By way of the particular person’s importence to the forces of nature animalism and fetishism, shamanism and sorcery received vast spreading. All pure phenomena (fireplace, water, air, floor) and all sicknesses of an individual have been linked with evil spirits (fever, shakes, swelling, and so on.), which ought to be gotten rid of, expelled from the physique of a affected person or deceived (dance with noisy results, masks, horrible garments of shaman). Step by step individuals who had “contact” with these spirits singled out into separate castes of pagan priest and sorcerers.

Such “expert craftsmen” have been largely concentrated within the temples, church buildings, imperial palaces, empirically accumulating expertise for treating ailments and mixing this expertise with demonisms and mysticism. So, step by step being separated, two qualitatively totally different instructions have been developed in medication: temple medication, which was extra good and scientific, and people medication, which was primitive and developed empirically, with none claims for scientific character of information.

“Surgical procedure” (from Greek cheіr — hand, еrgon — motion) means “hand motion”. This title occurred within the historical occasions and was additionally used for contraposition of surgical procedure as a commerce to inside medication, which was not investigated sufficient but, complicated and mysterious science. Individuals who had full coaching in temples or in particular medical faculties have been engaged in inside medication. Any particular person had a possibility to be engaged in hand motion, i. e. dressing of wounds, cease of exterior bleeding, setting of dislocations and therapy of fractures. Extra usually this work was carried out by the uneducated barber, chiropodist or soldier-sorcerers, sorcerers.

For a lot of 1000’s of years, individuals with numerous ailments, which had exterior attributes of sickness — wounds, trophic ulcers, abscesses, inflammatory ailments of the eyes and exterior genitals, parasitic sicknesses and tumours, visited such “surgeons”. Thus, the circle of pathological situations wherein the surgeons have been engaged was very huge, however the degree of theoretical grounding of those docs — very low.

However, there was a fast lower in tradition, science and medication, which was noticed through the Center Ages and that for two–4 thousand years BC in lots of international locations of the traditional world there was sufficient developed and effectively organized medication and surgical procedure.

Regardless of the elementary view concerning the world (recognition of the 4 parts — floor, water, air and fireplace), in historical Egypt and Iran, Assyria and Babylon, India and China there have been superior grain husbandry, complicated irrigational methods have been buit, arithmetic, mechanics and bronze, of which knifes and different medical instruments have been developed.

In these international locations with a scorching local weather and a whole lot of pores and skin and parasite ailments the priest of temple medication gave a whole lot of consideration to hygiene, physique cult, water procedures and bodily workout routines. Our bodies of the lifeless reasonably often have been embalmed, due to this fact docs of temple medication had some conception of anatomy and human physiology, knew concerning the motion of the blood in vessels and distinguished the lighter “blood of the day” and darker, venous blood, which they named “blood of the night time”.

For docs and army docs coaching, the particular faculties have been created, and in Egypt — the “Home of Life,” the place younger males studied nature, veterinary science and medication. Among the many docs that have been engaged in follow, some specialization was even noticed, as a result of somebody turned well-known for expertise within the therapy of eye and pores and skin ailments, others — within the therapy of exterior genitals, others — within the therapy of psychological ailments.

Probably the most notable docs specialised in inside ailments, which they handled with herbs, weight-reduction plan, bodily workout routines or councils. Surgeons have been engaged in “hand motion”, that’s handled wounds and wound issues, bleedings, fractures and dislocations, superficially situated purulent ailments and tumours. Thus, they differed from docs of inside ailments, which developed the so-called “medication of herbs” — surgeons gave extra consideration to sensible habits and enchancment of “knife medication”. Thus, for the discount of painful sensations docs gave wine, opium, mandragora extract to their sufferers. Whereas performing surgical interventions, they used bronze knifes and a giant set of different surgical instruments.

However, understanding the extent of complexity and duty of surgical operations, reasonably extreme legal guidelines have been declared in some international locations, which, undoubtedly, restricted a large growth of surgical procedure. The fullest thought of drugs and docs of that point we acquired from the so-called code of legal guidelines of tsar Hammurapy from Babylon and the legal guidelines of Asbestos from Iran, the place the questions of cost and compensations for the profitable therapy, a sure diploma of punishment for an unsuccessful operation and penalties of unhealthy therapy have been very exactly decided.

It’s mandatory to notice, that solely individuals who proved their qualification thrice and efficiently handled sufferers have been admitted to medication and surgical operations. After profitable surgical therapy a “knife proprietor” was allowed to get cost or payment, which, relying on the affected person’s social degree and well-being, was paid in cows, sheep, cash, ornaments from treasured metals or as a mould of the organ which was efficiently cured.

On the identical time if the knife medication was utilized in an unqualified manner, and the surgical therapy was poorly performed and had destructive penalties, the physician was judged and severely punished — one or each eyes have been put out, a finger, wrist or complete hand have been reduce off.

Medical doctors had comparatively honorable and really excessive social standing in society, however Assyrian legal guidelines, however, specified that the physician ought to seek for any alternative to bettering his private information, to be well mannered, to maintain medical secrets and techniques, to not afflict sufferers with unanswerable conjectures, and to talk solely of possible issues. Any trendy physician can use this clever recommendation.

Medication and, significantly, surgical procedure obtained the best growth in historical China and India. Well-known creations of Indian literature are the Ayurveda (“E-book of Life”) the place centuries-old expertise of Indian docs is generalized, which testifies that surgeons of historical India handled wounds with success and nearly sewed them tightly after the withdrawal of international objects, grounded cosmetic surgery (“Indian manner”), with success carried out plastic of the nostril, ears, lips. Some historians mark that in addition they carry out belly intervention throughout intestinal obstruction and suturing the intestines.

At least in India successes of drugs have been noticed in historical China. Knife medication was thought-about as essentially the most accountable manner of therapy which docs used, who efficiently handled sufferers with “knife incision” at least thrice. In China surgical procedure was very extremely appreciated and characterised as a “treasured heaven present and an everlasting supply of glory”. Chinese language surgeons Huato, Ben-tsao used bamboo trunk for fixing fractures, studied anatomy on corpses, carried out laparotomy and Cesarean part, used a variety of medical vegetation and accupuncture.

Such sciences as “ pulse research”, “research concerning the home windows of a human physique”, “research concerning the organism juices” (urine, blood, bile, and so on.) have been created in historical China. Even in these outdated occasions, clever recommendation, which has not misplaced its actuality even immediately, have been provided for younger docs. For instance: “He who hid an sickness from the physician has deceived himself”, or “Don’t deal with solely the top if the top is sick, or solely the leg if the leg is sick”, or “The physician ought to deal with solely that which is feasible to remedy, but when the illness can’t be cured — attempt to facilitate the sufferings of the affected person”. Sadly, it’s mandatory to notice that in some international locations the place medication typically is a supply of enrichment for the physician, even the affected person who doesn’t want an operation, is prescribed therapy which prices quite a bit and in addition which isn’t helpful to the affected person, however solely serves making the physician wealthier.

Particularly wealthy heritage is left by docs of historical Greece and Rome. In these superior international locations, books, collections, that are written by Hippocrates, Celsus, Galen, turned a supply of medical information and influenced medication for all peoples of Europe down via the Center Ages.

Hippocrates (459–377 BC) is an excellent doctor-physician, proficient surgeon and tutor. He attentively collected anamnesis of his sufferers, intimately described the medical signs of ailments, studied anatomy on corpses. Utilizing numerous surgical technique of therapy, he payed a lot consideration to psychotherapy as effectively, suggesting bodily workout routines and pure therapy (solar, air, water). “Hippocrates’ Oath” gained the best fame, which younger docs give earlier than starting skilled work.

The event of historical Rome decided the drugs heart switch from Greece to Rome, although the Roman docs have been followers of Hippocrates. Probably the most excellent representatives of Roman medication have been Celsus (І century AD) and Galen (ІІ century AD). The works of Celsus and the treatises of Galen have been the essential supervising guids for docs of the West Europe right down to ХV–XVІІІ century.

Celsus for the primary time used ligature for vessels ligation in wounds with the aim of bleeding stoppage, used lead tubes for draining wounds. In his works we discover the primary detailed description of the medical course of the uncared for most cancers of the decrease lip.

In the course of the first interval of his exercise Galen was the gladiators’ physician. He noticed the course of processes which occurred in wounds, tried to suture wounds with silk, used bronze tubes for draining wounds. He thought-about that pus was an compulsory part of the therapeutic course of, complicated wound issues with the regeneration course of (therapeutic via pyesis). Finding out anatomy and human physiology, he thought-about that the middle of blood circulation isn’t the guts however the liver. He admired very a lot additionally the trying to find medical herbs and manufacturing healing preparations and “miracle technique of therapy”.

Regardless of the achievements of some representatives of the medical career, it’s mandatory to emphasise that there have been a number of docs, they handled primarily the palace individuals and excessive officers they usually have been inaccessible for the easy individuals. A recognized historical Greek historian Gerodot described a customized that sick individuals have been dropped at crowded areas or markets and other people, who have been passing by, might give recommendation regarding therapy.

Numerous the surgical achievements have been forgotten after the dawnfall of the Roman empire. Surgical procedure confronted with a violent resistance on the a part of church, attendants of a cult and spiritual followers who forbade post-mortem, the efficiency of any operation linked with bleeding. Makes an attempt of finding out anatomy on corpses resulted in accusation of heresy and the scientist was threatened with the fireplace of inquisition. The domination of the church through the gloomy centuries of the Center Ages put virtually insuperable obstacles for the event of surgical procedure, which turned more and more less complicated to rework into craft.

However many daredevils and proficient docs continued to review and develop surgical procedure, overcoming the backwardness of spiritual prejudices and gained sure successe. There are a lot of excellent docs: an Arabian physician Ibn Sina (Avicenna), who left over 100 scientific works about totally different questions of drugs and surgical procedure; A. Visalus — a founding father of regular anatomy; V. Harvey opened the legal guidelines of the blood circulation in an individual: Ge De Sholiak, A. Pare′, Bruno De Longenburg, Paracelsus and different surgeons. The entire epoch within the historical past of surgical procedure was created by M. I. Pyrogov who was not solely a effective anatomist, good surgeon, but in addition a proficient scientist, innovator and statesman.

Nearly until XVІІІ century progress of surgical procedure was insignificant, that largely linked with a poor social standing of surgeons. An overturn passed off within the XVІІІ century, when a surgeon Lafrangi from Milan for the primary time was allowed to lecture in surgical procedure on the medical school of Sorbona College (1719). In 1731 the French Surgical Academy was based.

Thus, regardless of the truth that surgical actions belong to essentially the most historical habits of medical commerce, surgeons for a very long time didn’t discover recognition in official medication and even didn’t rank amongst docs. It’s mandatory to notice additionally that even when surgical procedure was ultimately acknowledged because the official medical specialty, it couldn’t be improved sufficiently till scientists of the entire world didn’t discovered a technique to overcome three important obstacles:

Shock, which was often noticed throughout an operationbecause of the shortage of anesthetizing means.

Infections, which sophisticated all surgical interventions becauseof lack of aseptic and antiseptic means.

Bleeding and its penalties which docs couldn’t fightwith due to a nonetheless unsolved drawback of isohemagglutination and there have been no research of blood teams.

Additional we will be satisfied that every one these important obstacles in surgical procedure growth obtained scientific explanations solely on the finish of the XІX century and primarily within the XX century. Many questions of surgical procedure haven’t been answered even immediately and demand finding out. However the fundamental methods in regards to the additional growth of surgical procedure have been already decided and introduce into life actively.

Surgeons of Ukraine, following the well-known traditions of M. I. Pyrogov, B. A. Karavayev, S. M. Kolomnin, M. V. Sklifosovski, O. S. Yatsenko, V. F. Grube, A. G. Podrez and different excellent surgeons, which labored in Ukraine, achieved nice successes. Names of M. M. Volkovich, Okay. M. Sapezhko, M. P. Trinkler have been recognized far exterior of Ukraine. They united one of the best surgeons, directing their exercise by sensible software of surgical achievements. The colleges of M. M. Volkovich, M. P. Trinkler, and Okay. M. Sapezhko have been inseperably linked with superior rural surgeons. This connection to an ideal extent was assisted by M. I. Pyrogov each by his works and by direct participation in artistic exercise of Ukrainian surgeons. “Pyrogov linked the college, tutorial surgical procedure to the agricultural one”, — wrote V. A. Oppel. The shut hyperlinks of the educational surgical procedure with the agricultural one was one among options of surgical faculties in Kiev, Kharkov and Odessa within the first twentieth anniversary of the XX century. M. M. Volkovich, M. P. Trinkler and Okay. M. Sapezhko’s faculties assisted within the affiliation and enchancment of one of the best forces of rural surgical procedure.

Such excellent Ukrainian surgeons as A. T. Bogayevsky, O. A. Yutsevich, V. G. Kozlovsky, Ya. V. Silberberg, L. I. Malinovsky, and so on. have been born within the depths of rural surgical procedure. They along with different excellent surgeons solved numerous main issues in surgical procedure. The profitable growth of belly surgical procedure is obliged to an ideal extent to A. T. Bogayevsky, M. P. Trinkler, O. A. Yutsevich, M. M. Volkovich, Okay. M. Sapezhko, V. G. Kozlovsky, L. I. Malinovsky, and so on. Apart from belly surgical procedure, Ukrainian surgeons contributed a lot to orthopaedics. I. F. Sabaneyev, A. G. Podrez, M. M. Volkovich, Okay. F. Vegner and different surgeons instructed new osteoplastic operations, developed a practical methodology for treating bone fractures and different rational methods of treating pseudoarthrosis, contractures, and osteoarticulate tuberculosis. The operations of I. F. Sabaneyev have been included into the arsenal of classical operations, and operative receptions and therapeutical methods of treating tuberculosis of the bones, instructed by A. G. Podrez, M. M. Volkovich, N. I. Kefer and different surgeons, haven’t misplaced its worth even immediately.

Surgeons Ye. Okay. Istomin, O. O. Abrazhanov, Ya. O. Galperin, O. I. Meshchaninov, I. P. Sklyarov, I. D. Maslov, Ye. Yu. Kramarenko, V. L. Pokatilo, Ya. V. Silberberg, N. I. Kefer performed a giant function within the group of surgical assist to the inhabitants; additionally tutorial surgeons M. M. Volkovich, M. P. Trinkler, O. P. Krimov, I. V. Kudintsev, V. M. Shamov, O. V. Melnikov, and so on. labored along with them. They have been the initiators of convocation of the primary congresses of surgeons.

On the first regional and republican congresses of surgeons (1923; 1927) in Odessa, Kharkov for the primary time within the historical past of surgical procedure the query of enchancment of surgical service to rural inhabitants, concerning the wrestle towards traumatism, the group of pressing assist in acute peritonitis, the issues of most cancers, tuberculosis and coaching of surgical employees have been mentioned. Different essential issues, the answer of which had state significance, mentioned at these congresses. The congresses not solely summed up the outcomes of labor, fastened the achievements, but in addition elaborated this system of additional exercise of surgeons within the close to future.

Surgeons of Ukraine all the time actively participated at work of well being safety our bodies, within the exercise of surgical societies, popularized the medical information. They have been conductors of main state measures directed to the advance of the general public well being care. The surgeons have been the initiators of the creation of the environment friendly system of anticancer and antituberculosis providers, exact group of quick and pressing assist in the republic. Prophylactic medical examination of the inhabitants, which is without doubt one of the fundamental a part of medical prophylaxis, was provided.

Properly-known surgical faculties have been created. V. M. Shamov, O. V. Melnikov, who labored in Ukraine nearly 20 years, performed a giant function within the basis of those faculties. Their quite a few followers created surgical faculties too. The scientific growth of the essential issues of haemotransfusion, introduction into the follow of the cadaveric haemotransfusion, fixing importent issues of neurosurgery, belly surgical procedure, endocrinology, tissue transplantation, malignant tumours, battlefield surgical procedure belong to V. M. Shamov and his faculty. He has revealed extra then 100 huge works, some monographs and a whole lot of collections dedicated to essentially the most precise questions of theoretical and sensible surgical procedure. O. V. Melnikov is without doubt one of the founders of the Ukrainian faculties of oncologists and gastric surgical procedure. He had skilled many followers, who’re growing his concepts. He wrote greater than 10 monographs and 130 works on issues of recent surgical procedure.

It’s tough to overestimate the function of O. P. Krimov, M. I. Sitenko, V. P. Filatov, N. I. Kefer, I. V. Kudintsev, Ya. O. Galperin, I. М. Ishchenko, M. M. Amosov, M. S. Kolomiychenko, O. I. Arutyunov, M. P. Novachenko, I. Ya. Deyneka, M. M. Milostanov, Z. Y. Geymanovich, O. O. Shalimov and plenty of different Ukrainian surgeons within the growth of surgical procedure.

O. P. Krymov created his personal faculty. He revealed over 130 works, together with 10 monographs and a broadly recognized surgical procedure textbook. His work “The Research of Hernias” is essentially the most detailed analysis on this query in world literature. I. V. Kudintsev, the follower of L. V. Orlov, is without doubt one of the first organizers of pressing assist on the acute surgical ailments. The event of essential issues of belly surgical procedure and urology belongs to him and his faculty.

Ya. O. Galperin, a follower of S. I. Spasokukotsky, created his faculty, instructed a whole lot of new concepts in surgical procedure of oesophagus, abdomen and others. I. М. Ishchenko, a follower of O. P. Krymov, one of many founders of the Ukrainian faculty of neurosurgeons, revealed over 100 works dedicated to craniocerebral trauma, shock, bleeding, purulent an infection, battlefield surgical procedure, surgical procedure of the abdomen, spleen, bilious duct, growth of the surgical science and the historical past of surgical procedure. He’s the organizer of many congresses and plenums of surgeons of Ukraine.

The event of the chest surgical procedure initiated by Ukrainian surgeons (B. Yu. Frankenberg, Yu. Yu. Kramarenko, O. P. Krymov) gained in scope in 1948–1951.

A particulary successfull growth chest surgical procedure acquired in 1952, when the primary chair of thoracic surgical procedure headed by M. M. Amosov was based on the Institute of Postgraduate Coaching in Kiev. M. M. Amosov elaborated the indications to surgical therapy of suppurative processes, tuberculosis injury, the strategy of pneumonectomy and lobectomy, methods of anaesthesia throughout these operations. He achieved the bottom lethality after these operations. After the lively participation of M. M. Amosov, many thoracic surgeons have been ready in Ukraine; departments of thoracic surgical procedure have been opened in all of regional facilities.

Along with thoracic surgical procedure, surgical procedure of the guts and vessels has received vast growth final years. In Ukraine, the vast majority of surgical interventions on the guts have been carried out by M. M. Amosov. Coronary heart surgical procedure was efficiently developed: in Kiev by O. O. Shalimov, who was a outstanding surgeon, proficient scientist, innovator and organizer of the Institute of Medical and Experimental Surgical procedure, in Lvov — by M. V. Danylenko, in Donetsk — by V. Okay. Gusak, and so on.

M. I. Sytenko is without doubt one of the founders of the Ukrainian faculty of orthopedists-traumatologists, a proficient organizer of trauma service in our nation. His works on the questions of orthopaedic assist and purely theoretic questions have been all the time precise. He made a giant contribution to the analysis of bone callous, the method of bone tissue regeneration, developed the strategy of early therapy of diaphysar and epiphysar fractures in newborns with the appliance of spokes of his personal design, the strategy of therapy of radial bone fracture, developed the analysis of supracondilar fractures of the shoulder and strategies of therapy, decided the indications to surgical therapy of bone fractures. M. I. Sytenko created a giant faculty of followers.

M. P. Novachenko, the follower of M. I. Sytenko, revealed over 100 works, a number of monographs, elaborated the strategy of unique operations on the massive joints, with osteomyelitis and bone tuberculosis, free bone plasty. In his exercise the concept of M. I. Sytenko in regards to the group of orthopaedic-traumatologic care and preventive actions of traumatism received additional growth in Ukraine. M. I. Kolomiychenko revealed over 90 works dedicated to surgical procedure of the guts, pericardium, oesophagus, cardiospasmus, plasty, historical past of surgical procedure, and group of surgical assist within the republic.

A. I. Arutyunov promoted the event of neurosurgery and the group of neurosurgical care within the nation. He introduced up a whole lot of followers — A. P. Romodanov, Yu. A. Zozulya. Within the creation of the Ukrainian faculty of neurosurgeons, a major function was performed by Z. Y. Geymanovich, O. Y. Geymanovich.

O. O. Fedorovsky made an essential contribution to the experimental surgical procedure, therapy of burn traumas, and growth of the haemotransfusion approach.

M. M. Milostanov put a lot work within the growth of pressing medical service, battlefield surgical procedure, therapy of wounds and the introduction of haemotransfusion to the follow. He wrote 80 works, amongst which numerous textbooks and manuals.

An essential function belongs to I. T. Shevchenko, I. Ya. Deyneka and different surgeons in basis of the oncologists faculty in Ukraine. I. Ya. Deyneka, the follower of O.V. Melnikov, revealed over 140 works and 4 monographs, and created a giant faculty of specialists. His followers are on the head of chairs in lots of institutes.

A sure contribution within the historical past of surgical procedure in Ukraine, within the historical past of home medication was made by S. A. Verkhratsky. His works on the historical past of surgical procedure in Ukraine have huge scientific worth.

Okay. T. Ovnatanyan, I. I. Kalchenko, G. G. Karavanov, A. Z. Tseytlin, A. A. Chayka and different surgeons of Ukraine have created faculties of followers.

MODERN IDEAS OF SURGERY, SURGICAL DISEASES AND SURGICAL PROFESSION

A contemporary thought of surgical procedure, definitely, significantly differs from the outdated notion about this career. Surgical procedure developed as a further medical specialty earlier than. Throughout final 100 years it has undergone vital and profound modifications, owing to which it may be thought-about one of many youngest department of medical science, which is growing reasonably rapidly.

If earlier than solely individuals who had totally different pathological processes, exterior options of ailments got here to surgeons, immediately the idea of “normal surgical procedure” received narrower.

After the mastering anatomy and physiology, introduction of anaesthesia and strategies of surgical an infection prevention, surgical procedure undergoes such a stormy interval of growth that a whole lot of specialties which have been below the competence of surgical procedure earlier than turned separated and impartial. So, on the final decade, traumatology and orthopaedics, obstetrics and gynaecology, oncology, urology, eye ailments, anesthesiology, reanimatology, otorhinolaringology, and so on. turned impartial scientific-practical disciplines.

Within the huge industrial facilities of our nation, in addition to in different developed international locations of the world, the method of additional specialization of surgical assist continues to be occurring. Taking into consideration the options of the group of those providers, the requirement for particular gear, surgical procedure of the lungs and mediastinum, surgical procedure of the guts and huge vessels, surgical procedure of the oesophagus and rectum and others have gotten extra separated as impartial disciplines. Specialization of surgical assist is the progressive phenomenon of recent medication.

The idea of “surgical ailments” is constantly altering. After the established traditions, all sicknesses or pathological situations which for his or her normalization, definitely, demand correction with the assistance of a knife belong to “surgical” ailments. They’re trauma and wounds, hernias and tumours of various localization, lifeless tissues and maldevelopment, acute-purulent inflammatory processes, and so on.

On the identical time there are a whole lot of ailments which may be handled both by the overall doctor or by the surgeon. They’re abdomen and duodenal ulcers, cholelithiasis, illness of the thyroid gland, bronchoectatic ailments, power purulent illness of the lungs, hereditary and purchased coronary heart ailments, and so on. The physician ought to estimate the severity of the illness, prognosis in utilization of this or that methodology of therapy, the presence of issues and risk to life or well being of the affected person. Such ailments are referred to as “conditionally surgical” as a result of below unfavourable situations (bleeding, perforation of the ulcer, and so on.) conservative therapy turns into unreasonable and the sufferers are additional handled by the surgeon.

We will additionally specify that with the event of surgical procedure, medical information, medical strategies many ailments beforehand thought to be therapeutic and have been exterior the competence of a surgeon, immediately are handled by surgical strategies in specialised laboratories and institutes, ever extra belong to the class of “surgical” pathology. Particularly, this issues such new components of surgical procedure as coronary heart surgical procedure, surgical procedure of the massive and small arterial vessels, tracheobronchial surgical procedure, transplantation of the kidneys, and so on.

The career of a doctor-surgeon is tough and labor-intensive, calls for selflessness, bodily, mental, and nervous effort The work of surgeon is extraordinarily attention-grabbing and offers many joyful and comfortable moments to the physician who operates on a severely sick affected person, however it additionally brings a lot sorrow. Sadly, surgical intervention which is directed to the affected person’s restoration doesn’t all the time come to a profitable finish. Some sufferers have critical issues and typically with a deadly final result which, definitely, upsets the surgeon who carried out the operation. Every physician takes severely the failures of therapy, as he understands that some issues are doable to clarify by the severity of the pathology or imperfection of science, whereas different unsuccessful circumstances, undoubtedly, are linked with inadequate information of the surgeon, in all probability, with defects of affected person preparation to the operation and errors in strategy of its performing, that’s inadequate skilled qualification of the physician.

The work of a surgeon is difficult, intense, and typically even exhausting. And every pupil who’s going to dedicate himself to this career can perceive this. It’s mandatory to review very lengthy, persistently and steadily to attain the true artwork of a surgeon. With none exaggeration it’s doable to say {that a} surgeon research all his life lengthy. Protecting in thoughts the P. O. Gertsen’s expression that “one of the best device of a surgeon is his fingers”, it’s mandatory to recollect all the time {that a} knife is a two-edged weapon, which may don’t solely good however a lot hurt to a affected person. The doctor-surgeon ought to continuously enhance his information, love his career and sufferers, develop dexterity of fingers and arms, and research diligence, persistence and persistence. What is going to the coaching of surgical procedure be like on the medical college?

The instructing of surgical procedure is carried out persistently within the departments of normal surgical procedure, school and hospital surgical procedure, and internship. After receiving the career of a health care provider, additional specialization and enchancment are carried out within the departments of superior medical research (AMS) as soon as each 5 years. Because of the vast growth of surgical strategies of therapy of numerous ailments, departments of the ІІ, ІІІ, ІV, V programs don’t duplicate each other, however complement and increase the information of scholars.

After finding out the idea of surgical procedure on the division of normal surgical procedure, college students of the ІІІ and ІV programs research classical symptomatology, therapy strategies of some pathological situations, and on the V course are acquainted with diveations from the classical course of ailments, with therapy strategies of their sophisticated types. Apart from, on the V course, college students are acquainted with the work of some specialised providers — surgical procedure of coronary heart and huge vessels, surgical procedure of the lungs and mediastinum.

Regardless of the additional ever explicit surgical training, the continuous seek for new trendy means of coaching, there are some questions which make the bottom for the entire course of of coaching in class. The division of normal surgical procedure, the place college students study the next sections of drugs, is engaged in these questions. What duties deliver the division’s consideration?

Introduction to the speciality: to acquaint college students with workof the surgical division and surgical service, parts of deontology and medical ethics.

To show the scholars some skilled information, whichform the idea of drugs and surgical procedure. These are such questions and sections of surgical procedure, as aseptics and antiseptics, the idea of anaesthesia, bleeding and blood loss, haemotransfusion and blood substitutes, the idea of traumatology, analysis, prevention and therapy of surgical an infection, the group of an operation and caring for the affected person within the pre- and postoperative durations, and numerous different issues.

To aspire that parts of medical considering, which acquire overthe years and develop solely attributable to long-term operational expertise, kind in college students within the division of normal surgical procedure. It’s essential to all the time do not forget that it isn’t essential to deal with the illness which, at first sight, appears easy however the affected person together with his psychological options, sophisticated concomitant ailments and particular person qualities. Regardless of the truth that many questions regarding separate pathology isn’t a topic of the division of normal surgical procedure, college students already now ought to suppose above the questions of operational danger, trauma and hazard of an operation, get theoretical information and sensible habits that are directed on the correction of disturbances which come up in a affected person. Let’s discover that every one further information which college students will obtain, studying not solely textbooks, but in addition monographs, periodic literature, solely increase their outlook, give confidence in work, help within the formation of a future physician.

Apart from {of professional} information and habits, college students in thisdepartment could elevate the overall academic degree, get acquainted with the historical past of world and residential achievements, know the event and prospects of house surgical procedure, really estimate these benefits that are given by the general public well being providers.

HISTORY OF THE GENERAL SURGERY DEPARTMENT

The clinic of normal surgical procedure accommodates 120 common beds. All mandatory situations for qualitative coaching of scholars are created on the division. The division has its personal lecture auditorium, enough variety of academic rooms, acceptance chamber, scheduled and pressing operational rooms, wound-dressing rooms, radiological cupboards and medical laboratory.

Within the sensible lessons college students get acquainted with these rooms in additional particulars. It’s mandatory to emphasise that our division has very outdated and type traditions, which immediately we attempt to help and increase.

The division was based in 1903, first as a theoretical, then medical base, and was located in 4 rooms on the primary flooring of the primary academic constructing of the Odessa Medical College. First it was referred to as the “Division of Surgical Pathology and Remedy with Desmurgy and the Research of Dislocations and Fractures”.

For five years the division didn’t develop, and the heads have been altering nearly yearly. The primary head of the division was prof. Shchogolev Mykola Oleksandrovych; from 1904 until 1907 — private-senior lecturer I. F. Sabaneyev.

In 1907 the division was headed by prof. Konstantin Petrovich Serapin who remodeled it from theoretical to medical, and we rightfully take into account him the founding father of the clinic of normal surgical procedure. With out taking into account the break (in 1914–1918 he was referred to as to army service), prof. Okay. P. Serapin headed the division and clinic until 1920. First the clinic was small with solely 22 beds, situated in a two-storied home of the town ambulance station of the infectious hospital. After the third flooring constructing in 1913 the mattress fund began to extend step by step.

All of the heads of the clinic introduced one thing considerably new to growth of surgical science. Professors I. Ye. Kornman, A. G. Sosnovsky, I. O. Bakkal, which headed the division after prof. Okay. P. Serapin, developed the strategies of anaesthesia, utilized new methods of antiseptics, put into follow haemotransfusion, handled traumatological sufferers, sufferers with purulent pathology, utilized new surgical interventions.

Probably the most lively interval of surgical procedure growth of our division occurred in 1950–1970, when the clinic was headed by the honored employee of science prof. I. Ya. Deyneka. Throughout this era, staff of the clinic began to develop extra intensively the query of abdomen and gut surgical procedure, apply intervention on the organs of the mediastinum, and perform the operations on the lungs and coronary heart. Parasitic ailments, largely human echinococcus, have been intensively studied.

I. Ya. Deyneka’s quite a few disciples ready and efficiently defended theses of candidate and physician diploma, launched new strategies of analysis and therapy of various ailments. A few of them work in different cities of our nation now, many left to work in our medical college; they head the departments, work as senior lecturers and assistants (prof. A. I. Tregubenko, prof. A. O. Babur, prof. A. M. Torbynsky, affiliate professor T. V. Khomitska, V. V. Pirozhenko, and so on.).

In 1960–1978 prof. Okay. D. Dvuzhilna turned the top of the clinic. She paid a lot consideration to the options of the course and therapy of wound infections, to the practical disturbances in ailments of the thyroid gland, to hormonal disturbances in duodenal ulcer, and to new antiseptic means, and so on.

From 1978 until 1989 the division was headed by prof. L. Z. Drobkov. Beneath his supervision the employees of the clinic directed their efforts to review of most critical shows of surgical an infection — peritonitis and surgical sepsis, on the estimation of immunobiological violations in sufferers with this pathology, the seek for technique of correction of intoxication syndrome and the advance of penalties of surgical therapy of those situations.

The departament of the overall surgical procedure was headed by professor B. I. Dmytriyev from 1989 to 2004. He supplied a correct materials help of surgical clinic; the educational-clinical base of college prolonged. The fundamental path of scientific researches was dedicated to issues of analysis, therapy, preventive upkeep of ailments of the liver, pancreas, endotoxicosis drawback, diabetes.

In 2004 the Normal Surgical procedure Departament and the surgical clinic have been headed by professor V. V. Mishchenko. A fundamental path of scientific-practical actions of clinic is analysis, preventive upkeep, therapy of acute surgical ailments of belly organs. 14 academics work within the division immediately.

On the division the scholars can get elucidation of any unclear query and take the primary steps in mastering the physician career. It’s fascinating that every pupil would regard the trainer not solely as a trainer of self-discipline, but in addition as a mentor, senior comrade, buddy.