Ministry of Education and Science of the Kyrgyz Republic Ministry of Health of the Kyrgyz Republic International Medical University Institute _International Medicine University___ Department of Surgical and Special-Clinical Disciplines Study and methodology complex by discipline Proped Surgery Course_________3________ Semester____5__________ Form of control____exams______ Total curriculum hours__272____ Of them: - Lectures_____144_______ - Practical_____128_______ - Independent work___120___ Work program developed: Head of department: PhD, Maikanaev B.B. Teacher of department: Mamyrbaev A.T. Reviewed and approved at a meeting of the department__________________________ Protocol № ________________ from «____»________________20ye._____________ Бишкек 2021 The work program was drawn up on the basis of the State Educational Standard of Higher Professional Education (2000), the curriculum (2000), a typical program in general surgery for students of higher medical educational institutions of medical, preventive medicine. Guidelines of the Ministry of Health of the Kyrgyz Republic "Methodological guide for teachers on the preparation of a work program" and the standard of the academy of the quality management system "Educationalmethodical complexes of disciplines" The program takes into account the recommendations of the “Priority national project in the field of health care”. 2 1. CONTENT - Notation and reductions Explanatory note Structure and content disciplines List and thematic plan of lectures and practical lessons Educational and methodological support of the educational programs Literature 2. SYMBOLS AND ABBREVIATIONS LDdo - General Medicine, day department LDVO - General Medicine, evening department PED - Pediatrics MPD - Medical and Preventive Business 3. EXPLANATORY NOTE 3.1. Subject of the academic discipline Surgery is one of the main branches of clinical medicine that studies diseases and injuries, in the diagnosis and treatment of which methods and techniques are used, to one degree or another accompanied by a violation of the integrity of the integumentary tissues of the body. In the system of medical education, "general surgery" is one of the stages of acquaintance with surgical disciplines, corresponding to the course of propaedeutics of internal diseases in the study of therapeutic specialties. It is one of the basic disciplines that lays the foundations for the study of surgical activity required by the clinician, regardless of his further specialization. Teaching general surgery is based on a syndromic approach to the study of the main pathological conditions in surgery with the study of individual elements of surgical activity by students. After an analytical study of general issues of surgery, it becomes possible to synthesize the study of the foundations of clinical surgery - the basis of private surgery. The acquisition of the skills of clinical, laboratory and instrumental examination of the patient, knowledge of the main syndromes greatly facilitates the subsequent development of both private surgery and other sections of clinical medicine. Particular attention is paid to the use of the latest technologies in surgery, such as minimally invasive surgery, endovascular interventions, modern X-ray and radioisotope research methods, the use of ultrasound, extracorporeal detoxification methods, etc. During the course of general surgery, they master a list of practical skills that underlie the provision of emergency medical care in peacetime and with massive admissions of victims. 3.2. Goals and objectives of studying the subject The main goal of the general surgery course is to master the fundamentals of clinical examination of surgical patients, acquaintance with the principles of surgical methods of treatment and the semiotics of some types of surgical diseases. Discipline objectives The main tasks are to introduce future doctors into the atmosphere of the clinic, foster correct behavior in the departments of the surgical profile, operating rooms, dressing rooms, study the clinical hygiene of employees and patients of the clinic and their environment, and teach the skills of clinical examination of patients. 1. Purposefully find out the patient's complaints and the history of the development of the disease; 3 2. Conduct a physical examination of a surgical patient (examination, palpation, percussion, auscultation); 3. Outline a plan for the examination of a surgical patient; 4. To organize surgical activity in compliance with the rules of asepsis in the premises of the surgical hospital and polyclinic, in the intensive care and intensive care units; 5. Provide first aid on the spot with the determination of the method of transporting the patient to the destination; 6. Perform routine medical diagnostic and treatment procedures; 7. Work as nurses in surgical hospitals; 8. Determine the main surgical syndromes and diagnose the main types of purulent-septic diseases. Psychological and pedagogical goal To foster in students a respectful attitude towards the patient, a sense of responsibility when performing patient care activities and various instrumental manipulations. To study and be able to apply in practice the principles of deontology when communicating with patients and medical personnel. 3.3. Requirements for the level of mastering the content of the discipline 1. The student should know: elements of surgical activity; basic principles of examination of a surgical patient, diagnosis of surgical diseases, general principles of treatment of the most common types of surgical pathology, provided for by the program of the course of general surgery; fundamentals of activity at all stages of treatment of a surgical patient; principles and methods of rendering first medical aid in case of emergency pathology. 2. The student should be able to: organize at a modern level and implement the provision of care for surgical patients in compliance with the rules of asepsis, surgical activity in the hospital and in the clinic (outpatient clinic), in operating rooms and dressing rooms, wards and other premises of the surgical service, the intensive care unit and intensive care unit; personally carry out all the necessary measures for the care of surgical patients, work as a nurse under the guidance of a doctor in a surgical hospital; to diagnose the main types of surgical pathology provided for by the program of the course of general surgery, to provide first aid on the spot with the provision (according to indications) of the direction and transportation of the patient to the destination. 3.4. The place of discipline in the professional training of a graduate The proposed approach makes it possible to coordinate the teaching of "General Surgery" with the work of subsequent clinical departments on the formation of future specialists, to significantly strengthen the practical side of training with a simultaneous increase in its theoretical level, and thereby fulfill the main task facing medical universities. 4 The initial level of knowledge of students The list of disciplines, the assimilation of which by students is necessary for the study of general surgery Discipline Topic name name Normal All topics anatomy Normal Coagulation and anti-coagulation blood systems and their regulation. physiology Blood groups and Rh factor Pathological Necrosis. Morphological signs. Classification. Causes, outcomes. anatomy Inflammation. Morphology of the main forms of inflammation. Changes in the morphology of inflammation depending on the reactivity of the organism. Regeneration, its types and patterns. Regeneration of individual tissues. Tumors Histogenesis Morphological characteristic. Classification. Regularities of metastasis. Tuberculosis. Morphology of primary and secondary tuberculosis. Generalized forms of tuberculosis. Pathological physiology Microbiology Pharmacology Radiology Biochemistry Biology Histology Inflammation. General mechanisms of development, local and general reactions in inflammation, the outcomes of inflammation. Tumors. Pathophysiology of tumor growth, theory occurrence, peculiarities of metabolism and energy in tumors. Compensatory (sanogenetic) mechanisms of blood loss. Shock. Definition, the role of domestic scientists. General mechanisms of development of shock states. The concept of active and passive immunity. Microbiological characteristics of causative agents of purulent infection and specific surgical infection. Groups and characteristics of antibiotics and chemical anesthetics. R-logic fault diagnosis. R- logical methods of research of surgical patients. Technique for conducting biochemical tests. Fundamentals of parasitology Fundamentals of Embryology 5 3.5. The scope of the discipline and the type of educational work Type of educational work Number of hours (credits) by specialty Medicine Medicine Pediatrics Total about hour in Total about hour (credit in) in (credit in) Discipline semester numbers The total complexity of the discipline Auditory lessons: Lectures Practical (clinical) lessons Independent work Views the final control (offset, five 6 244 / 7.5 143 101 163 95 55 Total about hour in (credit in) 7 eight 213 / 6.5 86 127 192 / 5.5 107 85 68 142 57 85 129 72 38 17 36 ni ne tee n 17 37 108 57 51 106 38 68 92 54 81 48 33 71 29 42 63 35 27 copy 36 copy Medical and preventive work Total hours (credits) four fiv e four five 166 / four 81 85 57 111 54 57 eig nin htee etee n n 37 eig htee n ni ne tee n 38 74 36 38 28 55 27 28 27 cop y cre dit exam) 4. STRUCTURE AND CONTENT OF THE DISCIPLINE 4.1. Curriculum Content Introduction to the Subject: Concept of Surgery Surgery as a branch of medicine in which the main treatment method is surgery. The main types of surgical pathology: injuries, acquired and congenital diseases. Diversity and ongoing differentiation of surgical specialties. A brief history of surgery Surgery of the Ancient World and the Middle Ages. The discoveries of surgical anesthesia, antiseptics and asepsis as a fundamentally new stage in the development of surgery. The history of Russian surgery, its place and relationship with the leading surgical schools in the world. Current state of surgery 6 Modern surgery is a dynamically developing, scientifically grounded field of medicine. Modern medical specialties of a surgical profile. The role and place of surgery in modern medicine. Ethics and deontology in surgery The concept of deontology. Deontology as a necessary and indispensable element of surgical activity. The moral character and general culture of the doctor. Medical ethics, medical thinking and new medical technologies. Medical errors in surgery. Iatrogenic pathology in surgery. The structure of the surgical hospital. The concept of medical and protective regime. Placement, layout, functioning of subdivisions. The importance of these factors in the rational organization of work and the prevention of hospital infection. Reception and diagnostic department. Structure, equipment, functions, principles of labor organization. Sanitary treatment of premises, furniture, medical equipment and instruments. Reception, examination, registration, sanitization of the patient with a change of linen and clothes. Preparing for emergency surgery. Transportation from the emergency room to the surgical department and to the operating room. Surgery department. Subdivisions, equipment, labor organization. Sanitary treatment of the premises of the surgical departments. Types, sequence, technique of cleaning individual rooms with the use of disinfectants. Sanitary treatment of furniture and equipment. Ventilation, cleaning, ultraviolet irradiation and other air handling methods. Hygienic control of the environment of the surgical department. Features of the sanitary and hygienic regime in the purulent surgical department. Organization and conduct of general patient care after planned operations. Compliance with medical and protective and motor regime. Organization of patient's body care. Hygiene of secretions, care of the surgical area, drains, probes, catheters, infusion systems, etc. Organization and features of general patient care after emergency operations. The dependence of specific care measures on the nature of the pathology, the presence of complications, age, concomitant diseases, etc. Operating unit. Structure, equipment and equipment, principles of labor organization. Aseptic system in the operating unit and measures to maintain it. Sanitary and hygienic regime in the operating unit. Operating room cleaning, its types, methods and features. Maintenance of devices and equipment in the operating room. Transportation of the patient to the operating room from the surgical department and back. Department of intensive care and intensive care. Structure, equipment and equipment, general principles of work organization. Sanitary treatment of premises, medical equipment and environmental items. Features of clinical hygiene of personnel. Clinical hygiene and care of patients on mechanical ventilation, in an unconscious and agonal state. Asepsis Types and prevalence of surgical infection. Sources and routes of spread of surgical infection. Endogenous pathways of microbial contamination. Exogenous pathways of microbial contamination: contact (direct and indirect), air, implantation. Nosocomial (hospital) infection in a surgical hospital. The concept of asepsis. Organizational forms of asepsis provision. Planning and operating principles of a surgical hospital. Fighting microflora along the path of airborne contamination. Prevention of contact and implantation microbial contamination. Organization of the work of the surgical department and the operating unit Sterilization of operating clothes, linen, surgical gloves, dressings and sutures, surgical instruments, drains. Use of disposable materials and instruments. Sterilization by ionizing, ultraviolet, ultrasonic radiation. Modern means and methods of chemical sterilization and disinfection. Packaging and storage of sterile material. Sterility control. Special functional areas of the operating unit. Operating room cleaning. 7 Preparing the surgeon's hands for surgery. Preparation of the operating field. Asepsis of the participants in the operation and the surgical field. General rules, techniques and modern methods of handling hands before surgery. Preparation and processing of the surgical field. Putting on sterile clothing, dressing, wearing and changing rubber gloves. Rules of work in conditions of strict asepsis. Antiseptic Types of antiseptics. Mechanical antiseptic The concept of primary and secondary surgical treatment of wounds, principles and stages of implementation. Physical antiseptic Drying, tamponing, drainage of wounds and cavities, vacuum treatment, vacuum aspiration, treatment with a pulsating stream of liquid, aspiration-washing method, ultraviolet irradiation, laser irradiation, ultrasonic cavitation, hyperbaric oxygenation, ozone therapy. Chemical antiseptic Methods for using various chemicals. Various types of local and general use of antiseptics. The main groups of antiseptic agents. Fundamentals of Rational Antiseptic Chemotherapy. Biological antiseptic Types of biological antiseptics. Biological antiseptics. Indications for antibiotic therapy. The choice of an antibacterial drug. Evaluation of the effectiveness of antibiotic therapy. Change of antibacterial drug during treatment. Duration of antibiotic therapy. Methods of influencing the body's immune forces. Passive and active immunization in surgery. Immunocorrection and immunostimulation. Pain and pain relief Mechanisms and causes of pain. Characteristics of pain. Narcotic pain relief. Indications, contraindications, documentary registration. Means and principles of drug treatment of pain syndrome. Local anesthesia Types of local anesthesia: pharmacochemical (terminal, infiltration, conduction) and physical. Preparations for local anesthesia, their mechanism of action, main characteristics. Technique of certain types of local anesthesia: indications, contraindications, method of implementation, possible complications and ways to prevent them. Indications for use, types and techniques of novocaine blockades. General anesthesia Anesthetic risk assessment. Preparation of patients for anesthesia, premedication and its implementation. General anesthesia components. Methodology and clinical picture of modern general anesthesia, stages of anesthesia. Standardized monitoring with assessment of oxygenation, ventilation, circulation and temperature. Complications of anesthesia and the next post-anesthetic period, their prevention and treatment. Types of anesthesia. Equipment and methods of inhalation anesthesia. Modern inhalation anesthetics, muscle relaxants. Their combined use to obtain an optimal synergistic effect. Transfusion of blood and its components Immunological bases of transfusiology. Group systems of erythrocytes. Group ABO system and group Rhesus system. Methods for determining blood groups according to the ABO system and rhesus. Modern rules of blood transfusion by groups of the ABO system and rhesus. Responsibilities of the Blood Transfusion Physician. Tests for the compatibility of donor and recipient blood before transfusion. Blood transfusion documentation. Principles of modern component therapy. Blood transfusion reactions. Blood transfusion complications, their prevention, diagnosis, treatment principles. Massive transfusions, the concept of individual blood selection, autologous blood transfusion. Organization of blood and donation services in Russia. Rules for the examination of donors of blood and its components. Organization of diagnostic tests for HIV, syphilis, hepatitis and other vector-borne infections. Modern methods of preparation, preservation of blood and its components. 8 Blood clotting disorders in surgical patients and their methods corrections Hemostasis system. Research methods. Diseases that cause changes in the blood coagulation system. Influence of surgical operations on hemostasis. Medicines affecting the hemostatic system. Prevention and treatment of thromboembolic complications. Prevention and treatment of hemorrhagic syndrome. DIC syndrome. Bleeding Classification of bleeding. Protective and adaptive reaction of the body to acute blood loss. Clinical manifestations of external and internal bleeding. Clinical and instrumental diagnostics of bleeding. Assessment of the severity of blood loss and determination of its magnitude. Methods for temporary and permanent stopping of bleeding. Modern principles of blood loss treatment. Safe boundaries of hemodilution. Blood-saving technologies in surgery. Autohemotransfusion. Reinfusion of blood. Blood substitutes are oxygen carriers. Transportation of patients with bleeding. Endogenous intoxication in surgery and the principles of its correction Endogenous intoxication concepts. The main types of endotoxicosis in surgical patients. Endotoxicosis, endotoxemia. General clinical and laboratory signs of endotoxicosis. Criteria for the severity of endogenous intoxication. Principles of complex treatment of endogenous intoxication syndrome in a surgical clinic. Stimulation of natural detoxification, artificial detoxification, syndrome therapy. Surgical elimination of the source of intoxication. Desmurgy The concept of bandaging and bandaging. The medicinal value of the dressings. Basic modern dressing materials. Types of dressings by appointment, by methods of fixing the dressing, by localization. Soft bandages, general dressing rules. Types of bandaging. The technique of applying soft bandages to various parts of the body. Elastic compression of the lower extremities. Requirements for the finished dressing. Special dressings used in modern medicine. Transport immobilization Goals, objectives, principles of implementation. Type of transport immobilization. Modern means of transport immobilization. Plaster of paris and plaster casts. Plaster bandages, splints. The main types and rules for applying plaster casts. Drainage and packing of wounds and body cavities Indications for use. Types of drains and tampons. Types of tubular drainages. Passive and active drainage. Equipment and instruments for active aspiration. Principles and techniques of wound drainage. Methods of flow-aspiration drainage of wounds. Vacuum wound drainage. Principles and techniques of chest cavity drainage. Principles and techniques for abdominal drainage. Drainage of joints. Drainage-microirrigators for the administration of medicines. Drainage of hollow organs Indications. Gastrointestinal and rectal probes. Probing of the esophagus, stomach, duodenum, small and large intestine. Bladder catheterization: indications, contraindications, equipment, technique. Prolonged bladder catheterization, catheter care, prevention of complications. Drainage of hollow organs using endoscopic equipment. Drainage through operatively superimposed external fistulas (gastrostomy, jejunostomy, colostomy, epicystostomy, etc.), caring for them. Errors, complications and their prevention. Enemas: indications, contraindications, equipment. Patient preparation and enema technique. Types of enemas: emptying, laxative, washing (siphon), medicinal. Features of their 9 implementation. Colon gas removal. Examination of surgical patients Purposeful clarification of the patient's complaints and the history of the development of the disease. Concomitant diseases and surgeries. Tolerance to drugs. General clinical examination of the patient using examination, thermometry, palpation, percussion and auscultation. Local status assessment. Drawing up a plan for the examination of the patient. The role of laboratory and instrumental methods in the examination of a surgical patient. Determination of the scope of mandatory and additional studies. The need for specialist advice. The sequence of application of clarifying research methods. The peculiarity of the examination of patients with severe injuries and acute surgical diseases. Determination of the need for urgent diagnostic and therapeutic measures. Preparing the patient for the behavior of instrumental examination methods. Critical disabilities in surgical patients Clinical assessment of the general condition of patients. Objective methods for assessing the severity of the condition of patients and victims. Types of disorders of the body in surgical patients: acute respiratory failure, acute heart failure, acute renal and hepatic failure. Syndrome of multiple organ failure. Types, symptoms and diagnosis of terminal conditions: preagony, agony, clinical death. Signs of biological death. First aid for cessation of breathing and blood circulation. Criteria for the effectiveness of revitalization. Monitoring the control system. Indications for discontinuing cardiopulmonary resuscitation. Shock - types, pathogenesis, clinical picture, diagnosis, phases and stages of shock. First aid. Complex therapy. Treatment success criteria. FUNDAMENTALS OF PURULENT SEPTIC SURGERY Common questions of acute surgical infection Clinical manifestations, laboratory diagnostics. Pathogens and conditions for the development of purulent infection in the body. Acute aerobic surgical infection. Sharp anaerobic surgical infection. The concept of clostridial and non-clostridial anaerobic infection. The concept of a mixed infection. Features of asepsis in purulent-septic surgery. Modern principles of prevention and treatment of purulent diseases. General principles of treatment of purulent diseases, rational antibiotic therapy, immunotherapy, enzyme therapy, detoxification, stimulating and restorative therapy. General principles of surgical techniques. Modern methods of treatment of a purulent focus. Purulent diseases of the skin and subcutaneous tissue Types of purulent skin diseases: acne, ostiofolliculitis, folliculitis, furuncle and furunculosis, carbuncle, hydradenitis, erysipelas, erisepiloid, near-wound pyoderma. Clinic, features of the course and treatment. Types of inflammatory diseases: abscess, phlegmon. Clinic, diagnostics, local and general treatment. Possible complications. Purulent diseases of cellular spaces Phlegmon of the neck. Axillary and subpectoral phlegmon. Subfascial and intermuscular phlegmon of the extremities. Purulent mediastinitis. Purulent paranephritis. Acute paraproctitis, rectal fistulas. Causes, symptoms, diagnosis, principles of local and general treatment. Purulent diseases of glandular organs Acute purulent mastitis. Symptoms, prevention, treatment of acute lactational postpartum mastitis. Purulent parotitis. Predisposing factors, clinical signs, methods of prevention and treatment. Purulent diseases of other glandular organs. Purulent diseases of serous cavities Peritonitis. Classification. Etiology, pathogenesis. Symptomatology and diagnostics. Treatment principles. First aid for acute surgical diseases of the abdominal organs. Acute purulent pleurisy and pleural empyema. Pericarditis. General understanding of the 10 causes, symptoms, diagnosis and treatment. Purulent diseases of the hand and foot Classification. Types of felon. Purulent tenosynovitis. Features purulent inflammation of the hand. The principles of diagnosis and treatment. Diabetic foot. Clinical forms. Clinical and instrumental diagnostics. Comprehensive treatment principles. Purulent diseases of bones and joints Osteomyelitis. Classification. Etiology and pathogenesis. The clinical picture. Features of instrumental and laboratory diagnostics. Symptoms of acute osteomyelitis. Chronic recurrent osteomyelitis. Diagnostics of various forms of osteomyelitis. Principles of general and local treatment of osteomyelitis. Purulent bursitis. Purulent arthritis. Causes, clinical picture, principles of treatment. Surgical sepsis The concept of sepsis. Types of sepsis. Classification. Etiology and pathogenesis. An idea of the entrance gate, the role of macro- and microorganisms in the development of sepsis. Clinical manifestations of sepsis. Laboratory diagnosis of sepsis. Sepsis stages: bacteremia, systemic inflammatory response syndrome, sepsis, severe sepsis, septic shock, multiple organ failure syndrome. Assessment of the severity of the condition of patients with sepsis using scoring systems. Comprehensive treatment principles. Specific surgical infection The concept of surgical specific infection. Classification. Major diseases: tetanus, tuberculosis, anthrax, rabies, diphtheria wounds, actinomycosis, candidiasis. The clinical picture. Laboratory and instrumental diagnostics. Principles of prevention and treatment. Diagnostics and complex treatment of various forms of tuberculosis. Local treatment of sinus abscesses and fistulas. Surgical forms of pulmonary tuberculosis. Tuberculous lymphadenitis. Clinical picture, diagnostics, complex therapy. FUNDAMENTALS OF DAMAGE SURGERY General Injury Surgery Issues Types of injuries and classification of injuries. The concept of isolated, multiple, combined and combined injuries. Medical and social prevention of injuries. Complications and dangers of injuries: immediate, immediate and late. General principles of diagnostics of traumatic injuries. Assessment of the function of the central nervous system, respiration and blood circulation in severe injuries. Scales that measure the severity of the injury. General principles of organization of prehospital and inpatient trauma care. Wounds Classification of wounds. Pathogenesis and phases of the wound process. Clinical features of various types of wounds. Types of wound healing. Principles of first aid for injuries. Primary surgical treatment of wounds, its types. Secondary surgical treatment. Closing the wound. Infectious complications of wounds. Purulent wounds, primary and secondary. General and local signs of wound suppuration. Treatment of a purulent wound, depending on the phase of the course of the wound process. Modern principles of surgical treatment of purulent wounds. Radical surgical treatment of a purulent wound. Complementary physical wound care. Flow-aspiration system. Enzyme therapy, antibacterial therapy. Features of treatment in the phase of reparative regeneration. Physiotherapy treatment. Ultrasound, laboratory and other methods of monitoring the course of the wound process. Prevention of postoperative wounds suppuration. Head injury Classification. Assessment of the severity of the victim. The main dangers of head injuries are life-threatening. First aid for head trauma. Features of transportation of patients. Chest trauma Classification. The concept of pneumothorax. Types of pneumothorax. Clinical picture and 11 diagnosis of pneumothorax. Peculiarities of rendering first aid in case of tension, valvular and open pneumothorax. Treatment principles. Hemothorax. Clinical manifestations of hemothorax. First aid for hemothorax. Features of transportation of patients with breast injury. Injury to the abdomen Classification. Clinical, laboratory and instrumental diagnostics of injuries of the abdominal and retroperitoneal organs. Foreign bodies of the gastrointestinal tract. First aid tasks. Treatment principles. Damage to soft tissues, tendons and joints Closed soft tissue injuries. Bruises, sprains and tears, concussions and compression, prolonged compression syndrome. First aid and treatment of soft tissue injuries. Fractures and dislocations Classification. The clinical picture. Basics of X-ray diagnostics. First aid. The basic principles of treatment: pain relief, reposition, immobilization, rehabilitation. Complications of traumatic fractures: pain shock, fat embolism, acute blood loss, development of infection and their prevention. Thermal damage Classification Determination of the depth and area of burns Prediction of the course First aid for burns Burn disease - phases of the course Principles of general and local treatment Radiation and chemical burns Local manifestations First aid Features of first aid for chemical burns of the skin, mouth, esophagus, stomach Injuries from cooling Types of general and local cold injury Classification Clinical picture, first aid First aid and further treatment for frostbites in the pre-reactive period General and local treatment of frostbites in the reactive period, depending on the degree of damage General complex therapy for victims of cold injury Electrical injury Local and general action of electric current First aid for electrical injury Features of further examination and treatment Fundamentals of surgery for regional circulatory disorders Arterial blood flow disorders Acute and chronic. The main causes of impaired arterial blood flow. General principles of clinical and instrumental diagnostics. The degree of acute ischemia and the stage of chronic arterial insufficiency. Operative and conservative treatment. First aid for acute disorders of arterial circulation. Comprehensive treatment principles. Venous circulation disorders Acute venous thrombosis and chronic venous insufficiency. General principles of clinical and instrumental diagnostics. Prevention of complications. Comprehensive treatment principles. Lymph circulation disorders Lymphostasis. Main reasons. The principles of diagnosis and treatment. Necrosis Clinical forms. Causes of occurrence. Gangrene, bedsores, trophic ulcers. The dynamics of bedsore development. Prevention and treatment principles. Fundamentals of Surgical Oncology General characteristics of tumors. Benign and malignant formations. Metastatic pathways. Clinical classification of tumors. Clinical diagnostics. Immunomarkers of tumors. Special diagnostic methods. Morphological verification of the diagnosis. Determining the stage of cancer. Principles of surgical treatment of tumors. Fundamentals of complex therapy of malignant tumors. The principles of organization of the oncological service Fundamentals of Plastic Surgery and Transplantology The concept of plastic surgery. Autoplasty, alloplasty and xenoplasty. Plastics of tissues and organs by various methods. The place of plastic methods in surgery. The use of synthetic materials. Replantation of extremities and understanding of microsurgical techniques. The concept of organ and tissue transplantation. Principles of Clinical Transplantation. Prostheses and artificial organs. 12 STAGES OF TREATMENT OF A SURGICAL PATIENT Outpatient surgery The structure of the surgical service of the polyclinic, trauma center. The scope of conservative and surgical surgical treatment. The main contingent of surgical outpatients. Organization and equipment of the surgical room. Outpatient operating room - features of asepsis. The procedure for outpatient admission to surgical patients. One day hospital. Surgical documentation in polyclinic. Clinical examination of surgical patients. The procedure for hospitalization of planned and emergency patients. Surgical aspects of clinical examination of the population. Inpatient surgery. Preoperative period Absolute, relative indications for surgery in elective and emergency surgery. The concept of contraindications to surgery. Operational risk criteria, ways to reduce it. Preparing the patient for surgery. Training goals. Deontological training. Medical and physical preparation of the patient. The role of physical fitness in the prevention of postoperative infectious complications. Preparation of the oral cavity, preparation of the gastrointestinal tract, skin. The choice of pain relief and preparation for it. Preparing for emergency operations. Legal and legal basis for examinations and surgical interventions. Operation period The concept of a surgical operation. Types of surgical operations: planned, urgent, emergency, radical and palliative. Types of operations: with removal of the pathological focus, restorative (reconstructive) and plastic surgery. The position of the patient on the operating table. Principles of choosing an operational access. Minimally invasive surgery. Stages of a surgical operation. Distribution of responsibilities between all participants in the operation during the period of anesthesia and surgery. Monitoring the patient's condition during the operation. Postoperative period The body's response to operational aggression. Disorders of respiration, cardiac activity, function of the gastrointestinal tract and urinary organs, thromboembolic complications. Their prevention, diagnosis and treatment. Observation of the patient. 5.1 LIST AND THEMATIC PLAN OF DISCIPLINE LECTURES "GENERAL SURGERY" List of lectures P/ p No. 1 2 3 4 5 6 7 LDdo Topic / Faculty Ldvo Ped Total hours 2 2 2 2 Mpd Introduction in surgery Asepsis. Sources of surgical infections. Methods for their prevention Antiseptic. Types of antiseptics. Anesthesia in surgery. Anesthesia. History of the issue. 2 2 2 2 2 2 2 2 2 2 Inhalation and non-inhalation anesthesia. Anesthesia clinic. Local anesthesia. Spinal anesthesia. Types and methods of carrying out. Critically disruptive at surgical patients. 2 2 2 2 2 2 2 2 2 2 2 2 13 2 2 8 Bleeding Classification clinic, diagnostics. Temporary and permanent stop of bleeding. 2 2 2 2 9 Transfusion of blood and its components. Donation. Indications and contraindications for blood transfusion. Errors and complications of blood transfusion. Basic injury surgery. Traumatic shock. Classification, clinic, treatment, prevention. 4 2 0 0 2 0 0 0 Bone fractures. Clinic, treatment, prevention. Dislocations. Thermal damage. Classification, clinic, treatment, prevention. Fundamentals of Surgical Oncology The doctrine of wounds. Modern principles of wound treatment Basic purulent-septic surgery. surgical infection issues. Infection of the skin subcutaneous etiology and 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 3 2 0 0 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 0 2 2 2 0 2 2 2 0 0 0 2 2 2 2 55 0 0 0 0 36 0 one 0 0 37 0 one 0 0 37 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 pathogenesis. Clinic and treatment. Infection of the hand and fingers. Etiopathogenesis. Clinic, treatment, prevention. Bone and joint infection. Etiology, pathogenesis, clinic, treatment. Hematogenous osteomyelitis. General purulent infection. Sepsis. Classification, clinic, treatment. Acute specific infection. Tetanus. Clinic and treatment. Anaerobic infection. Chronic specific infection. Tuberculosis bones. Clinic and treatment. Fundamentals of regional circulatory disorders. Necrosis, gangrene Fundamentals of Plastic Surgery and Transplantology. Fundamentals of Malformation Surgery Fundamentals of surgery for parasitic diseases. Vascular diseases. Total 14 Thematic plan of lectures on the discipline "General Surgery" № Subject Total hours 1 Introduction to the subject. The concept of surgery: surgery as a branch of medicine, in which the main treatment method is surgery; the main types of surgical pathology; variety of surgical specialties. A brief history of surgery: surgery of the ancient world and the Middle Ages - surgery of injuries and "external" diseases; the discovery of surgical anesthesia, asepsis and antiseptics as a fundamentally new stage in the development of surgery; history of Russian surgery; main surgical schools of ISMU. The current state of surgery: modern medical specialties of the surgical profile, the role and place of surgery in modern medicine, the globalization of information exchange in modern surgery, the use of surgical methods in other medical specialties, the system of training in surgery. Ethics and deontology in surgery. 2 2 Asepsis and antiseptics: Concept of asepsis, history of development. Paths penetration of infection into the wound. The fight against microflora along the paths of air contamination: the layout and principles of operation of the surgical hospital, special functional areas of the operating unit. Prevention of contact and implantation microbial contamination: modern methods of physical and chemical sterilization, asepsis of the participants in the operation and the operating field, modern methods of treating the surgeon's hands. Prevention of anaerobic and viral infections (hepatitis, AIDS). Asepsis and antiseptics. Types of antiseptics. Mechanical antiseptics: the concept of primary and secondary surgical treatment of wounds. Physical antiseptics: traditional methods of physical antiseptics, modern physical antiseptics. Chemical antiseptics: ways of using various chemicals, the main groups of antiseptics, the basics of rational antiseptic chemotherapy. Biological antiseptics: types and means of biological antiseptics, principles of antibacterial therapy in surgery, methods of influencing the immune forces organism. The principles of a rational combination of various types of antiseptics. 2 Pain relief in surgery. General anesthesia. History of the issue. Pain and pain relief. General anesthesia: types of anesthesia, stages of anesthesia, methods of inhalation anesthesia, components of general anesthesia, combination of methods of anesthesia, complications of anesthesia, their prevention and treatment. Features of pain relief in children. Non-inhalation anesthesia. Pain and pain relief. Local anesthesia: types, drugs for local anesthesia, technique of certain types of local anesthesia, possible complications and their prevention; indications for use. Critical disabilities in surgical patients. Clinical assessment of the general condition of patients. Objective methods for assessing the severity of the condition of patients and victims. Types of disorders of the body in surgical patients: acute respiratory failure, acute heart failure, acute renal and hepatic failure. Terminal states: types, symptoms, diagnostics, signs of biological death. Cardiopulmonary resuscitation: first aid for cessation of breathing and blood circulation, criteria for the effectiveness of revitalization, monitoring control systems, indications for termination of cardiopulmonary resuscitation. Features of resuscitation in children. 2 2 3 4 5 6 7 15 2 2 2 8 9 10 ele ve n 12 Bleeding. Classification of bleeding. Protective and adaptive reaction of the body to acute blood loss. Clinical manifestations of external and internal bleeding. Clinical and instrumental diagnostics. Assessment of the severity of blood loss and determination of its magnitude. Methods for stopping bleeding. Modern principlestreatment of blood loss. Blood-saving technologies in surgery. Blood substitutes - carriers oxygen. Transportation of patients with bleeding. Transfusion of blood and its components. Stages of development. Immunological foundations of transfusiology. Determination of blood group and Rh-affiliation. Modern rules of blood transfusion: responsibilities of the transfusion doctor blood, compatibility tests, blood transfusion documentation, principles of modern component therapy. Transfusion of blood and its components. Blood transfusion reactions and complications:prevention, diagnosis, treatment principles, the concept of individual blood selection. Organization of blood and donation services in Russia: rules for screening donors, organization of diagnostic researches on infections transmitted by a vector-borne way, modern methods of preparation, preservation of blood and its components. Fundamentals of injury surgery. General issues of injury surgery: types of injuries and classification of injuries; the concept of isolated, multiple, combined and combined injuries, medical and social prevention of injuries; general principles of diagnostics of traumatic injuries; determination of the severity of the injury. Soft tissue injuries: bruises, sprains and tears, concussions, prolonged compression syndrome; first aid and treatment of closed soft tissue injuries. Wounds: classification, pathogenesis and phases of the wound process, types of wound healing, clinical features of various types of wounds, principles of first aid for injuries; primary surgical treatment of wounds, its types. Traumatic shock. Classification, clinic, treatment, prevention. 2 Fundamentals of injury surgery. Fractures and dislocations.Classification. The clinical picture. Fundamentals of X-ray diagnostics. First aid: goals, objectives, means of implementation; types and means of transport immobilization. The basic principles of treatment: pain relief, reposition, immobilization, rehabilitation. Complications of traumatic fractures: pain shock, fat embolism, acute blood loss, the development of infection and their prevention. 2 16 2 2 2 13 Fundamentals of injury surgery. Thermal damage... Classification. Burns: determination of the depth and area of burns, prognosis of the course, first aid, burn disease - phases of the course, principles of general and local treatment, radiation and chemical burns - local manifestations, first aid, especially first aid for chemical burns of the skin, oral cavity, esophagus , stomach. Cold injury: types of general and local Cold injury, classification; clinical picture, first aid and further treatment for frostbites in the pre-reactive period, general and local treatment of frostbites in the reactive period. Electrical trauma: local and general effects of electric current, first aid for electrical trauma, features of further examination and treatment. Head trauma: classification, assessment of the severity of the victim, the main hazards of head injuries that pose a threat to the life of patients, first aid, peculiarities of transportation of patients. Chest trauma: classification; the concept of pneumothorax - types, clinical picture, diagnosis, features of first aid for various types of pneumothorax, principles of treatment; hemothorax - clinical manifestations, first aid; peculiarities of transportation of patients with breast injury. Abdominal trauma: classification, clinical, laboratory and instrumental diagnostics of injuries to the abdominal cavity and retroperitoneal organs, tasks first aid, principles of treatment. 2 fo urt ee n Fundamentals of Surgical Oncology. General characteristics of tumors. Benign and malignant neoplasms. Metastatic pathways. Clinical classification of tumors. Clinical diagnostics. Immunomarkers of tumors. Special diagnostic methods. Morphological verification of the diagnosis. Determining the stage of cancer. Principles of surgical treatment of tumors. The basics of complex therapy malignant tumors. The principles of organization of the oncological service 2 fif tee n The doctrine of wounds. Modern principles of wound treatment.Classification of wounds. Pathogenesis and phases of the wound process. Clinical features of various types of wounds. Types of wound healing. Principles of first medical care help with injuries. Primary surgical treatment of wounds, its types. Secondary surgical treatment. Closing the wound. Infectious 2 17 18 19 si xt ee n 17 ei gh tee n ni ne tee n tw en ty 21 22 23 complications of wounds. Fundamentals of septic surgery. Endogenous intoxication in surgery.The concept of endogenous intoxication. The main types of endotoxicosis in surgical patients. Endotoxicosis, endotoxemia. General clinical and laboratory signs of endotoxicosis. Criteria for the severity of endogenous intoxication. Principles of complex treatment of endogenous intoxication syndrome in a surgical clinic. Stimulation of natural detoxification, artificial detoxification, syndrome therapy. Surgical elimination of the source of intoxication. Modern principles of prevention and treatment of purulent diseases. General principles of treatment of purulent diseases. Features of the course of purulent processes in children. 3 Fundamentals of septic surgery... Types of purulent skin diseases: acne, ostiofolliculitis, folliculitis, furuncle and furunculosis, carbuncle, hydradenitis, erysipelas, erysipeloid; clinic, features of the course and treatment, phlegmon of newborns. Basics of purulent-septic surgery Panaritium: classification, types of felon, features of purulent inflammation of the hand, principles of diagnosis and treatment. Modern principles and methods of treatment of purulent wounds depending on from the phase of the course of the wound process. Fundamentals of septic surgery. Osteomyelitis:classification, etiology and pathogenesis, clinical picture, features of instrumental and laboratory diagnostics, symptoms of acute osteomyelitis, principles of general and local treatment of osteomyelitis. Surgical tuberculosis: diagnostics and complex treatment of various forms, local treatment of drip abscesses and fistulas. Tetanus: clinical presentation, principles of diagnosis and treatment, prevention of tetanus in childhood. Gas gangrene: causative agents, features of the clinical picture, principles of prevention and treatment. 2 Fundamentals of septic surgery. Surgical sepsis: stages of sepsis, bacteremia, systemic inflammatory reaction syndrome, sepsis, severe sepsis, septic shock, multiple organ failure syndrome. Purulent-resorptive fever Acute specific infection. Tetanus. Clinic and treatment. Anaerobic infection. Chronic specific infection. Tuberculosis Clinic 2 treatment. Fundamentals of surgery for regional circulatory disorders Acute and chronic disorders of arterial blood flow. Main reasons, general principles of clinical and instrumental diagnostics. The degree of acute ischemia and chronic arterial insufficiency. Operative and conservative treatment. First aid for acute disorders of arterial circulation. Comprehensive treatment principles. Acute thrombosis and chronic venous insufficiency: general principles of clinical and instrumental diagnostics, prevention of complications, principles of complex treatment. Lymphostasis: main causes, principles of diagnosis and treatment. Necrosis: clinical forms of necrosis, causes of occurrence; gangrene, bedsores, trophic ulcers, fistulas; prevention and principles treatment. 20 2 2 2 2 2 24 Fundamentals of Plastic Surgery and Transplantology... The concept of plastic surgery. Autoplasty, alloplasty and xenoplasty. Plastics of tissues and organs by various methods. Place of plastic techniques in surgery. The use of synthetic materials. Replacement of limbs and 21 2 25 26 27 idea of microsurgical technique. The concept of organ and tissue transplantation. Principlesclinical transplantation. Dentures and artificial organs. Fundamentals of surgery for parasitic diseases. The concept of surgical parasitic diseases. Echinococcosis, alveococcosis, ascariasis, opisthorchiasis. Reasons, diagnosis, surgical treatment. View of the tropical surgical parasitic diseases Fundamentals of Malformation Surgery. The concept of congenital pathology. Congenital malformations of organs and tissues. Diagnostics. Principles surgical treatment. Vascular diseases. Arterial blood flow disorders. Acute and chronic. The main causes of impaired arterial blood flow. General principles of clinical and instrumental diagnostics. The degree of acute ischemia and the stage of chronic arterial insufficiency. Operative and conservative treatment. First aid for acute disorders of arterial circulation. Comprehensive treatment principles. Venous circulation disorders. Acute venous thrombosis and chronic venous insufficiency. General principles of clinical and instrumental diagnostics. Prevention of complications. Comprehensive treatment principles. Lymph circulation disorders. Lymphostasis. Main reasons. Principles diagnosis and treatment. Total 2 2 2 55 5.2 LIST AND THEMATIC PLAN OF PRACTICAL EXERCISES ON THE DISCIPLINE "GENERAL SURGERY" List of practical lessons P/ p No. LDdo Ldvo Ped Mpd Subje ct one Introductory lesson. Desmurgy 2 Desmurgy. Bandages on the limbs. Head and torso bandages. Types of adhesive dressings, work in the dressing room 3 The concept of modern asepsis and antiseptics. Ways of infection of the surgical wound. Types of antiseptics 3 3 Total hours 2 3 four 3 2 2 3 four 3 2 four Prevention of contact and implantation infections five Prevention of airborne infection. Preparation of the surgeon's hands and the operating field for surgery 3 2 3 2 3 2 3 2 3 four 3 2 3 2 3 2 3 2 3 2 6 General questions of anesthesiology. Local anesthesia 7 General anesthesia. Types of anesthesia. Modern combined anesthesia. Complications of anesthesia. Non-inhalation methods of anesthesia eight Critically disruptive at surgical patients 22 P/ Subje p ct No. nine Bleeding. Methods for stopping bleeding 10 Serological characterization of groups blood. Determination of blood groups and Rh factor. Drugs blood. Blood transfusion rules ele Blood substitutes. Complications of ve transfusion blood and blood n substitutes. Prevention paths HIV infection of patients and medical staff 12 Fundamentals of Traumatology, Traumatic Shock 13 Operating room visit fo Soft tissue injury urt ee n fif Bone fractures tee n si Thermal damage: burns, frostbite. xt Burn disease ee n 17 Injury to the head, chest, abdomen ei Preoperative period. Preparing the patient for gh operations tee n ni Surgical operation, its effect on the body ne tee n tw Postoperative period, its phases. en patients in the postoperative period ty 21 Surgical patient examination technique 22 Modern diagnostic methods in surgery 23 Patient supervision. Medical history protection 24 General questions surgical infections Endotoxicosis. Purulentresorptive fever 25 Sepsis. Multiple organ failure syndrome 26 Modern methods for the treatment of purulent wounds 27 28 29 thi (clinic) Purulent diseases of the skin and subcutaneous tissue Purulent diseases of the hand and foot Purulent diseases of serous cavities Acute and chronic osteomyelitis 23 LDdo Ldvo Ped Mpd 3 3 2 2 3 3 2 2 3 four 3 2 3 3 3 2 2 2 3 3 3 2 2 2 3 2 3 2 3 2 3 2 3 3 2 2 2 2 2 2 3 2 2 2 3 four 2 2 3 3 nine 3 four four eight 2 2 2 6 2 2 2 6 2 3 3 2 6 2 2 2 2 3 3 3 3 four four 2 four 2 2 2 2 2 2 2 2 rty 31 32 33 34 35 36 Acute specific surgical infection Chronic specific surgical infection Regional circulatory disorders. Necrosis gangrene, ulcers, fistulas Tumors Fundamentals of Plastic Surgery and Transplantology Fundamentals of Parasitic Disease Surgery Total one 3 3 2 2 four 2 2 2 2 2 2 3 one one 108 four 2 2 106 2 2 2 92 2 0 2 74 Thematic plan of practical lessons P/ p No. one Total hours Subje ct Introductory lesson: acquaintance with the clinic, the history of the department. Desmurgy. Types of dressings 24 3 No. p/p 2 3 Subje ct Desmurgy. Bandages on the limbs bandages on the head and torso. Views adhesive dressings, work in the dressing room The concept of modern asepsis and antiseptics. Ways of infection of the surgical wound. Types of antiseptics. The concept of primary surgical treatment. Drainage types. Modern methods physical antiseptics. Modern antiseptics. Antibiotics in surgery Total hours 3 3 four Prevention of contact and implantation infection. Sterilization methods. Autoclave device and principles of its operation. Sterilization of surgical linen, dressings, surgical instruments. Pre-sterilization treatment surgical instruments. Prevention of viral hepatitis, anaerobic infection, AIDS. Suture sterilization 3 five Organization of work of the operating unit and the surgical department. Training of a surgeon and an operating pole operations. Prevention of airborne infection General questions of anesthesiology. Local anesthesia: types, 3 6 drugs for local anesthesia, techniques for various types of local anesthesia. Novocaine blockade 7 General anesthesia. Types of anesthesia. Modern inhalation anesthetics, muscle relaxants. Stages of anesthesia. Modern combined anesthesia. Complications of anesthesia. Non-inhalation methods of anesthesia eight Critical disabilities in surgical patients. Types, diagnosis, first aid. Cardiopulmonary technique intensive care principles postresuscitation illness nine Bleeding: types, clinic of different types bleeding diagnosis, cause of death from blood loss. Stop method bleeding 10 Serological characteristics of blood groups. Determination of blood groups and Rh factor. Blood preparations. Indications for blood transfusion. Ways and methods of blood transfusion. Donor blood compatibility and recipient. Donor testing for HIV and hepatitis ele Blood substitutes. Classification, indications for use. Complications of blood ve transfusion and blood substitutes: prevention, clinical presentation, diagnosis, n treatment. Ways to prevent infection HIV patients and medical staff 12 Fundamentals of traumatology, traumatic shock. Classification, etiology, clinic, principles of treatment and prevention. 13 Visit to the operating room. Operation block layout. Compliance with the rules asepsis during surgery. Types of cleaning in the operating room. fou Soft tissue injuries: bruises, concussions, sprains. Dislocations. rte HAPPY BIRTHDAY. Clinic, diagnostics, first aid, treatment en. 25 3 3 3 3 3 3 3 3 3 fift een . Bone fractures: classification, mechanisms of fractures and displacement, general issues of diagnosis and treatment. First aid. Principles X-ray diagnostics. immobilization. Complications of fractures 26 3 No. p/p six tee n. 17. eig hte en nin ete en tw ent y 21 22 23 24 25 26 27 28 29 thir ty 31 32 33 Subje ct Thermal injuries: burns, frostbite. Diagnosis, firsthelp, principle of treatment. Determination of area and depth burn damage. Burn disease Injury to the head, chest, abdomen. Classification, clinic, first aid. The concept of pneumo- and hemothorax, types, principles of treatment Preoperative period. Indications for surgery. Preparing the patient for surgery. Preparation of the skin, oral mucosa, gastrointestinal intestinal tract. Deontological preparation of the patient Surgical operation, its effect on the body. Types of operations. Stages of the operation. Minimally invasive surgery Postoperative period, its phases. Complications, their prevention and treatment. Management of patients in the postoperative period. Nutrition for surgical patients: organization of enteral, tube, parenteral nutrition Examination technique for a surgical patient. Planningexamination of a surgical patient. volume compulsory and additional studies Modern diagnostic methods in surgery. X-ray and endoscopic research methods (supervision) Patient supervision. Medical history protection General issues of acute purulent surgical infection. Endotoxicosis. Principles of treatment of purulent surgical diseases Sepsis. Types, classification, clinical manifestations, stages. Polyorgan failure syndrome Principles an integrated treatment Wounds: classification, phases of the course of the wound process, types of sutures and wound healing, types of primary surgical processing. Modern methods of treatment of purulent wounds (polyclinic) Purulent diseases of the skin and subcutaneous tissue. Views, clinic, diagnostics (clinic) Purulent diseases of the hand and foot. Classification. Types of felon. Purulent tenosynovitis. Clinic, diagnostics, treatment (polyclinic) Purulent diseases of the serous cavities. Peritonitis, pleurisy, and empyema pleura. Classification, diagnosis, treatment principles Osteomyelitis. Classification, diagnostic features and principlesTreatment Symptoms of acute osteomyelitis. Chronic osteomyelitis. Purulent bursitis and arthritis Acute specific surgical infection. Tetanus. Anaerobicputrefactive infection. Classification, clinic, diagnostics, principles of treatment, prevention Chronic surgical infection. Tuberculosis, actinomycosis Regional circulatory disorders. Necrosis, gangrene, ulcers, fistulas 27 Total hours 3 3 3 3 3 3 3 nine 3 3 3 3 3 3 3 one 3 3 34 Tumors. General characteristics of tumors. Benign and malignant neoplasms. Clinical classification of tumors. Clinical diagnostics. Morphological verification diagnosis. Determining the stage of cancer. Principles of Surgical Treatment and Fundamentals of Complex Therapy of Malignant Tumors 28 3 No. p/p 35 36 Subje ct Fundamentals of Plastic Surgery and Transplantology The concept of plastic surgery. Autoplasty, alloplasty and xenoplasty. Plastics of tissues and organs by various methods. The place of plastic methods in surgery. The use of synthetic materials. Replantation of extremities and understanding of microsurgical techniques. The concept of organ and tissue transplantation. Principles of Clinical Transplantation. Prostheses and artificial organs. Total hours one Fundamentals of Parasitic Disease Surgery The concept of surgical parasitic diseases. Echinococcosis, alveococcosis, ascariasis, opisthorchiasis. Reasons, diagnosis, surgical treatment. Understanding Tropical Surgical Parasitic Diseases one Total 108 5.3. Thematic plan of independent work of students in the discipline "General Surgery" P/ p No. one 2 3 four five Total hours Subject Introductory lesson. Desmurgy mastering the technique of bandaging each other filling out albums for the section "Desmurgy" (classification of dressings, different types of dressings) Desmurgy. Bandages on the limbs. Head and torso bandages. Types of adhesive dressings, work in the dressing room mastering the technique of bandaging each other the imposition of various dressings in the dressing room filling out albums for the section "Desmurgy" (classification of dressings, different types of dressings) The concept of modern asepsis and antiseptics. Ways of infection of the surgical wound. Types of antiseptics determining the type of antiseptic used at the patient's bedside work in the dressing room (dressing wounds, removing stitches) mastering the skills of wound drainage Prevention of contact and implantation infection preparation of dressing material and surgical linen for sterilization and placing it in bixes implementation of pre-sterilization processing of surgical instruments control over the quality of pre-sterilization processing of instruments and sterilization operating room self-deployment 2 Prevention of airborne infection. Preparation of the surgeon's hands and the operating field for surgery hand treatment treatment of the operating field 2 29 2 2 2 6 General questions of anesthesiology. Local anesthesia performance of infiltration anesthesia with novocaine 30 2 No. p/p 7 eigh t nine 10 elev en 12 13 Total hours Subject solving situational tasks album design General anesthesia, types of anesthesia, modern combined anesthesia. Complications of anesthesia. Non-inhalation methods of anesthesia determination of clinical signs of drugs general pain relief central venous pressure measurement solving situational tasks Critical disabilities in surgical patients diagnostics of terminal conditions practicing first aid techniques for stopping breathing and blood circulation writing abstracts album design Bleeding. Methods for stopping bleeding clinical diagnosis in a patient with bleeding determination of the degree of blood loss mastering the methods of temporarily stopping bleeding solving situational tasks Serological characteristics of blood groups. Determination of blood groups and Rh factor. Blood preparations. Blood transfusion rules filling out the blood transfusion protocol writing abstracts solving situational tasks Blood substitutes. Complications of blood transfusion and blood substitutes. Ways to prevent HIV infection in patients and medical staff determination of indications for blood transfusion and blood substitutes in specific patients determination of the suitability of blood for transfusion writing abstracts solving situational tasks album design Fundamentals of traumatology, traumatic shock. writing abstracts solving situational tasks album design Visit to the operating room. Operation block layout. Compliance with the rules of asepsis during the operation. Types of cleaning in the operating room. writing abstracts solving situational tasks album design 31 2 2 2 2 2 2 2 fourt een Soft tissue injury select instruments for primary surgical treatment of a wound diagnostics of soft tissue injuries solving situational tasks album design 32 2 No. Subject p/p fif Bone fractures tee examination of patients with fractures n determination of the type of fracture displacement by radiograph drawing up a treatment plan for a patient with a fracture plaster cast immobilization of transport immobilization on top of each other solving situational tasks album design si Thermal injuries: burns, frostbite. Burn disease xt writing abstracts ee solving situational tasks n album design 17 Injury to the head, chest, abdomen writing abstracts solving situational tasks album design ei Preoperative period. Preparing the patient for surgery gh taking anamnesis tee drawing up a plan for preparing for the operation, determining its type n in specific patients solving situational tasks ni Surgical operation, its effect on the body ne writing abstracts tee solving situational tasks n album design tw Postoperative period, its phases. en in postoperative period ty determine the way of nutrition of the postoperative patient solving situational tasks 21 Surgical patient examination technique determination of the examination plan for a surgical patient analysis of roentgenograms surgical pathology 22 Modern diagnostic methods in surgery determination of the examination plan for a surgical patient analysis of roentgenograms surgical pathology supervision writing a medical history 23 Patient supervision. Medical history protection determination of the examination plan for a surgical patient analysis of roentgenograms surgical pathology supervision writing a medical history 24 General questions of acute purulent surgical infections. Endotoxicosis. Purulent-resorptive fever work in the dressing room of the surgical room of the polyclinic 33 Total hours 2 2 2 2 2 2 2 2 2 2 No. p/p 25 26 27 28 29 thi rty 31 32 33 Total hours Subject (dressings, dressings, participation in purulent operations, filling out an outpatient card) writing abstracts solving situational tasks Sepsis. Multiple organ failure syndrome to draw up a plan of examination and treatment of a patient with sepsis writing abstracts solving situational tasks Modern methods of treatment of purulent wounds (polyclinic) work in the dressing room of the surgery room of the polyclinic (dressing, dressing, participation in purulent operations, filling out an outpatient card) writing abstracts solving situational tasks Purulent diseases of the skin and subcutaneous tissue work in the dressing room of the surgical department (dressing, dressing, participation in purulent operations) determination of a method of treating a purulent wound, depending on the phase of the wound process writing abstracts solving situational tasks Purulent diseases of the hand and foot work in the dressing room of the surgical department (dressing, dressing, participation in purulent operations) determination of a method of treating a purulent wound, depending on the phase of the wound process writing abstracts solving situational tasks Purulent diseases of serous cavities work in the dressing room of the surgical department (dressing, dressing, participation in purulent operations) writing abstracts solving situational tasks Acute and chronic osteomyelitis examination of patients with osteomyelitis analysis of radiographs of patients with osteomyelitis and osteoarticular tuberculosis writing abstracts solving situational tasks Acute specific surgical infection writing abstracts solving situational tasks Chronic surgical infection analysis of radiographs of patients with osteomyelitis and osteoarticular tuberculosis writing abstracts solving situational tasks Regional circulatory disorders. Necrosis, gangrene, ulcers, 34 2 2 2 2 2 2 2 2 3 No. p/p 34 35 36 37 Total hours Subject fistulas writing abstracts solving situational tasks Tumors determination of the type of tumor growth according to examination data determination of the stage of cancer based on complaints, anamnesis, data from special examination methods writing abstracts Fundamentals of Plastic Surgery and Transplantology writing abstracts solving situational tasks Fundamentals of Parasitic Disease Surgery writing abstracts solving situational tasks Fundamentals of Malformation Surgery writing abstracts solving situational tasks In addition, when mastering the material on all topics of the discipline, students can additionally prepare albums, abstracts, tables, reports Total 3.5 3.5 3.5 3.5 81 6. EDUCATIONAL AND METHODOLOGICAL SUPPORT OF THE EDUCATIONAL PROGRAM ON THE DISCIPLINE "GENERAL SURGERY" (METHODS AND TOOLS OF LEARNING) The teaching of 2nd and 3rd year students of the Faculty of General Medicine (day department), 4th year of the Faculty of General Medicine (evening department), 2-3 courses of the pediatric and preventive medicine faculties takes place at lectures, in the process of conducting practical classes and as a result of independent study of certain topics. The lectures guide students in matters of general surgery, determine the connection with other topics and sections of the course, introduce them to the most relevant at the present stage, particular issues of surgical infection. Much attention is paid to the issues of etiology, pathogenesis, mechanisms of development of certain syndromes and symptoms, modern methods of treatment of purulent surgical pathology. The lectures are used: Explanatory and illustrative method, which is based on the receipt of new information by students from the teacher, comprehension, generalization and systematization of new knowledge A problematic method, the essence of which is to create a problem situation, analyze it, realize the essence of the difficulty and formulate an educational problem, find a way to solve the problem by putting forward a hypothesis and justifying it. Practical classes are held at the bases of surgical departments of hospitals. In practical classes, when working with patients, the questions of desmurgy, asepsis and antiseptics, bleeding and transfusiology, traumatology, methods of examining a surgical patient and the rules for writing a medical history are studied. As a result of practical and independent studies, the material obtained at the lectures is consolidated, and also the topics unaffected by the lectures, provided by the program, are studied. 35 In practical lessons and in independent work, methods are used to improve knowledge and develop skills: Informational-receptive (message or oral information using visual aids (diagrams, drawings, dummies, tables, patient, radiographs, etc.). Reproductive or creative-reproductive using algorithms for studying a specific topic. Solving problems (including using information technology, design and graphic, information retrieval), analysis of the clinical situation, business games, clinical conferences, etc. A problematic method, the essence of which is to create a problem situation, analyze it, realize the essence of the difficulty and formulate an educational problem, find a way to solve the problem by putting forward a hypothesis and its justification. The method can be used when discussing the differential diagnosis of various diseases. Small group method An advanced learning method that allows students to gain knowledge of the latest and most promising technologies in the examination and treatment of patients with various diseases. A method of contextual learning, which provides students not only with academic knowledge, but also bringing them as close as possible to their professional activities, by conducting roleplaying games, student conferences, analyzing the production situation, etc. For this, the department uses: 1. Business and role-playing games, there are game scenarios on the topics: A / asepsis and antiseptics, B / basic cardiopulmonary resuscitation. 2. Solving situational tasks with missing and redundant data, tasks with conflicting conditions, tasks requiring limited time to solve, tasks with probable solutions, tasks for the ability to find someone else's mistake, etc. 3. Small group work 4. Clinical conferences with 2-3 groups on the topic of emergency care, according to a previously prepared abstract or in the form of a presentation 5. Modern teaching technologies: computer and written testing to determine the initial, midterm and final level of students' knowledge. 6. UIRS in the 3rd year of the Faculty of General Medicine in the form of a competition for "Experts in General Surgery" with homework on a fixed topic from the course of General Surgery. Means of education: 1. Stationary stands, portable tables 2. A set of instruments for applying skeletal traction, metal structures for various types of osteosynthesis, splints for transport immobilization 3. Phantoms of wounds and fractures 4. Hemostatic tourniquet, hemostatic clamp 5. Kits of reagents and laboratory equipment for determining blood groups and Rh factor 6. Samples of blood products and blood substitutes, infusion and transfusion systems 7. Laryngoscope, endotracheal tube, mask, airway tube, Ambu bag 8. Intracardiac injection kit 9. Demonstration model for resuscitation "Vitim" 10. A set of instruments for surgical treatment of wounds, various drains 11. Samples of medicines for the treatment of surgical infection (antibiotics, antiseptics, ointments, enzymes) 36 12. Sets for role-playing game "Preparing for surgery" (basins, disinfectants for treating hands, biks with gowns, gloves, sterility control devices) 13. Monitor, PC, instructional videos 14. Multimedia Projector, Teaching Slide Sets 15. Screens 16. Digital camera 17. Personal computers 18. Printers, scanner, copier 19. Laboratory equipment BIBLIOGRAPHY Main literature 1. V.K. Gostishchev General surgery: textbook for medical schools with CD. - 4th ed., Revised, add. and rev. - M.: GEOTAR-Media, 2006 .-- 832 p. : ill. 2. Petrov, Sergey Viktorovich. General Surgery: Textbook with CD. - 3rd ed., Rev. and add. M.: GEOTAR-Media, 2007 .-- 768 p. additional literature 1. Ageenko V.A., Kelchevskaya E.A. Transfusion of blood and its components: a textbook for students. - Irkutsk, 2007 .-- 66 p. 2. Bregel A.I., Kelchevskaya E.A. Endoscopic Diagnosis of Surgical Diseases of the Abdominal Cavity: A Textbook for Students. - Irkutsk. - 2007 .-- 27 p. 3. Beloborodov V.A., Genich E.V., Kelchevskaya E.A. and others. Anesthesia. Terminal states, resuscitation. Bleeding: A Study Guide for Student General Surgery Classroom Work. Irkutsk: type. Irkutsk state honey. University, 2011 .-- 48 p. 4. Beloborodov V.A., Genich E.V., Kelchevskaya E.A. and other Blood transfusion. Operation. Fundamentals of traumatology: a textbook for classroom work of students in general surgery. - Irkutsk: type. Irkutsk state honey. University, 2011 .-- 60 p. 5. Beloborodov V.A., Genich E.V., Kelchevskaya E.A. and others. Wounds. Fundamentals of Oncology. Necrosis. Polyclinic. Purulent surgical infection: a textbook for classroom work of students in general surgery. - Irkutsk: type. Irkutsk state honey. University, 2011 .-- 76 p. 6. Beloborodov V.A., Kelchevskaya E.A., Pavlov L.Yu., Frolov A.P. Acquaintance with the clinic. Desmurgy. Asepsis and antiseptics. Local anesthesia: a study guide for classroom work of students in general surgery. - Irkutsk: type. Irkutsk state honey. University, 2011. - 52 p. 7. Beloborodov V.A., Kelchevskaya E.A., Pavlov L.Yu. A study guide for students for extracurricular work in general surgery. - Irkutsk: type. Irkutsk state honey. University, 2010 .-- 100 p. 8. Mironov, V.I. Wounds and wound process: textbook / Mironov V.I., Frolov A.P., Gileva I.I .; - GOU VPO ISMU Roszdrav. - Irkutsk: ISMU, 2010 .-- 136 p. 9. General surgery: textbook / ed. N.A. Kuznetsov. - M.: MEDpress-inform, 2009 .-- 896 p. 10. Frolov A.P. Basics of desmurgy. - Irkutsk, 2008 .-- 98 p. 37 Additions and changes in the work program of the academic discipline "General surgery" by 20 -20 academic year The following changes (additions) are made to the work program: 1.. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 2.. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... 3.. ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... ... Changes (additions) in the work program were approved at a meeting of the department "General Surgery with Urology Course". twenty g. protocol no. Head department prof., d.m.s. V. A. Beloborodov Approval sheet of the work program "General Surgery" of the Department of General Surgery with the course of urology with related departments Department human anatomy Specialty human anatomy Agreed Surname I.O. head of the department date Professor Shalina T.I. Department of Pathology with Pathological physiology, the Course of Clinical pathological anatomy Professor I am Seminsky I. Zh. Immunology and Allergology Microbiology Department of Microbiology Therapeutic Patient Care Professor Zlobin V.I. Professor Propedeutics of Kalyagin Internal Diseases A.N. Chemistry Biochemistry Professor L.S.Kolesnichenko ... Signature Normal physiology Normal physiology Professor L.A. Korytov Medbiology Medbiology Professor Maiboroda A.A. Histology Histology Professor Vasilyeva L.S. Pharmacology Radiation diagnostics and radiation Pharmacology Dr. med. Leventa A.I. Radiation diagnostics Associate Professor Sidorov A.I. therapy 31
