Доцент Соломаха А.А.

1. The role of N.I. Pirogov in development of surgery Доцент Соломаха А.А.

2. The founder of Russian surgery is deservedly considered a great physician of the 19th century Nikolay Pirogov. He was born in 1810 in Moscow

3. Proceedings and achievements of Nikolai Ivanovich Pirogov have historical significance, he made a huge contribution in areas such as surgery, military field surgery, general surgery, founded the medical discipline - topographic anatomy, and also dealt with problems of pedagogy and social life. NI Pirogov was a well-educated man, a brilliant clinician, diagnostician delicate and skillful physician. Nikolay Pirogov (1810 - 1881 gg.)

4. Services to the people Great love of Pirogov enjoyed among the common people and the broadest Miss students. His love for the simplicity, good relationship and unselfishness. The poor and the students he treated for free, and often helped them materially. Throughout his life, without residue gave this remarkable physician and scientist, educator and social activist selfless service to Russian science and its people.

5. The arrival of Nikolai Pirogov in Moscow on the anniversary of the 50th anniversary of his scientific activity Sketch artist Ilya Repin

6. "Surgery without accurate and complete knowledge of anatomy is impossible." Using the method of freezing and sawing bodies, he studied the relationship between bodies in three dimensions. Pirogov himself called it "ice anatomy". topographic anatomy - So a new medical discipline was born. Topographic anatomy illustrated sectional view taken through the frozen human body in three dimensions. Cover to the first edition.

7. Topographic anatomy illustrated sectional view taken through the frozen human body in three dimensions. Cover to the 2nd edition.

8. Illustrations of atlases "Ice anatomy"

9. Illustrations of atlases "Ice anatomy"

10. "Surgical anatomy of arterial trunks and fascia" Fascia until Pirogov did not engage: to know that there are fibrous plates, membranes surrounding muscle groups, ran across on them during operations, incised with a knife, not giving them a meaning. Pirogov studied the direction of fascial sheaths, their position, discovered certain anatomical patterns. Figure Pirogov

11. Figures for work Pirogov Surgical anatomy of arterial trunks and fascia

12. In the audience, where NI Pirogov he taught a course of surgery, 300 people jammed crowd the benches are not only doctors, came to listen to the Pirogov students of other educational institutions, writers, officials, soldiers, artists, engineers.

13. Pirogov Gold Medal for providing essay: "What if there is a major artery banding?». Research Pirogov, called "Is the ligation of the abdominal aorta aneurysm inguinal area easily manageable and safe intervention?", Was intended to answer the question implied in this title. Pirogov studied the effects of abdominal aortic ligation on numerou animals of different species and came to the conclusion that, in spite of continuing with the simultaneous ligation of the abdominal aorta in animals circulation in the the hind limbs, after this operation, there are so heavy rush of blood to the lungs and heart that the animals usually die as a result of severe violations of the these bodies.

14. A brilliant thesis NI Pirogov After studying the detailed topography of the abdominal aorta in humans and animals, Pirogov proved more advantageous, though not always easy access to the aorta is extraperitoneal in which the vessel is exposed by the detachment of the peritoneal sacin an antiseptic during such access has undoubted advantages over transperitoneal access, in which the exposure of the aortic dissection is achieved by the double of the peritoneum, which is a part and the front and back of the abdominal wall. This last way, and was elected, among other thingsBy E. Cooper, performing the ligation of the abdominal aorta in patients with iliac artery aneurysm. After printing of the thesis Pirogov Cooper said that if he had more time to tie up the abdominal aorta in humans, it would be elected extraperitoneal way.

15. NI Pirogov said: "The case is still stalking us, still enough mistakes in the diagnosis, depending on the imperfection of knowledge or from accidental causes weakened the attention - and the fatal outcome is obvious." Juseppe Garibald(the hero of the Italian liberation movement), which advised the known English, French, Italian and German (including Billroth) surgeons were unable to establish the diagnosis. Pirogov identified the presence of bullets in the calcaneus. Of course, in the present conditions in the presence of X-ray machine, it would not be difficult, but Pirogov set accurate clinical diagnosis in clinical manifestations of the disease. Juseppe Garibaldi (1807-1882)

16. Pirogov worked on a number of new techniques. One of these techniques to date called "operation Pirogov". Operation Pirogov - osteoplastic method of removing the lower leg at the ankles during husking foot, first described by NI Pirogov in 1854. During the operation, the cut is made in the lower leg area of of the calcaneus, which allows you to create a good reference stump. patient with amputation   Pirogov method (1867)

17. The great achievements before the Motherland of Pirogov Pirogov was a participant in four wars: Caucasian (July 8, 1847 Pirogov went to the Caucasian theater of operations)   Crimea (from October 29, 1854 on December 3, 1855, he stayed in the Crimea); in 1870, at the suggestion of the Red Cross, Pirogov went to hospitals to review Theater Franco-Prussian war in 1877, for the same purpose, he made a trip to the theater of Russian-Turkish war.

18. In the Caucasus, it is the first to apply a bandage roller impregnated starch. Starch ligation was more convenient and more durable than ever before applied splints. However, in practice, making its imperfections, he in 1852 replaced the last of his little relief alabaster, t. E. A plaster, bandage

19. Nikolay Pirogov justly considered the "Father of Russian surgery", the founder of field surgery. Pirogov first in the world used ether anesthesia in war

20. Whole great surgeon spent about 10 thousand. Operations under ether anesthesia. He also created his original equipment for its administration is constantly working to improve them. So it creates a device for anesthesia klizopomp, perfect design masks for anesthesia. Klizopomp A mask for anesthesia

21. bag collection of tools belonged to NI Pirogov.

22. In 1855, during the Crimean War, he was the chief surgeon Pirogov precipitated Anglo-French troops Sevastopol. NI Pirogov - a highly surgeon - a clinician with a heavy heart watching a grim picture of the organization of assistance to the wounded in the Russian army.

23. "Sevastopol letter" "Above the camp of martyrs, folded and piled up for nothing, anyhow, in the soldiers' tents, suddenly burst into the shower and soaked through, not only people, but even the mattress underneath. Accidents and lay in puddles . You could imagine what it was like to cut off legs lying on the ground for three and four together: almost mattresses floated in the mud; and all under them, and around them were thoroughly had soaked; It was only dry place where lay without moving; but at the slightest movement they had to get to the puddles, and when someone came into the tent hospital, all screaming for help, and on all sides were heard loud piercing rending groans and cries, and gnashing of teeth, and those special knocking teeth from which trembling. Doctors and nurses could not help except on my knees in the mud. At least 20 amputated were dying every day, and all of them were up to 500 "

24. Medical triage "Proper sorting of the wounded and even distribution of medical practice at all wounded at the dressing station is much more important than all the hurry and bustle made operations that benefit only a few"

25. System of Pirogov was that, first of all, the wounded were divided into five main categories: 1) bad and mortally wounded, 2) heavy and dangerously wounded, requiring immediate assistance; 3) badly wounded, requiring also be put off, but it is moresafety benefits;4) the wounded, for whom immediate surgical guide is only necessary to make it possible to the transportation; Lastly, 5) slightly wounded, or those in which the first benefit is limited to the imposition of a light dressing or removing surface seated bullets.

26. NIPirogov emphasized the obvious benefits of blood transfusion at some wounds in the military field.

27. Also, during the siege of Sevastopol, to care for the injured, Pirogov directed learning and working communities Holy Cross Sisters of Mercy Sisters.

28. Russia's largest community of Sisters of Mercy, the first women's organization in the world help in the war.

30. Great discoveries of the little man

31. In 1864, three years before the publication of the doctrine of Lister antiseptic, NI Pirogov on clinical experience has established the role of infection ("miasma") in the development of wound complications. "Purulent infection spread not only through the air, which is obviously harmful when` clustering wounded in an enclosed space, as the wounded through the surrounding objects: clothes, mattresses, bandages, walls, floor, and even medical personnel. "

32. He described the previously unknown cell inflammatory granuloma A giant multinuclear cell of Pirogov - Langhans.

33. Creatively developing the question of antiseptic solutions, the most benign tissue, Pirogov chose the silver nitrate solution and showed a very favorable effect on the healing of his wounds.

34. Pirogov gave the classical definition of shock, which is still quoted in the manuals and in almost every article devoted to the doctrine of shock.

35. The study of the anatomy of the prostate. Pirogov lithotomy produced in various ways on numerous corpses, then frozen and produced cuts in different directions. In his «Anatome topographica» we find 30 images related to this kind sawed. These figures clearly reveal the nature of the injury, deposition tools used at lithotomy. Pies on the basis of a detailed study of the anatomy of the prostate surgical lithotomy offered his method and his instrument - litotes - for this operation.

36. Ring of Pirogov-Waldeyer Nikolay Pirogov regardless of Waldeyer studied and described accumulation of lymphoid tissue in the throat, surgical techniques for the treatment of inflammation.

37. Intestinal suture of Pirogov The suture of Pirogov (boundary serous-muscular-submucosal) into the suture capture serous and muscle membranes and submucosal layer, which has the highest strength. The needle is injected from the serous membrane and gouged out between the submucosal layer and the mucosa. At the other end of the needle is carried out between the wound mucosa and submucous layer and gouged out on the serosal surface. Suture provides a reliable hemostasis. Intestinal suture without the capture of the mucous membrane, the node which bind outside.

38. Amputation of the thigh three moment Konus circular manner of Pirogov: • 1 - 1st moment: dissection of the skin; II - 2nd moment: cut the fascia and muscles along the edge to cut the skin; III - the third moment: the dissection of a deep layer of muscles along the edge drawn soft tissues; IV - the position of the dissected tissue: 1 - bone, • 2 - periosteum, 3 - muscles, 4 - skin, 5 - fascia; V - retractor

39. Osteoplastic amputation of the lower leg by Pirogov: I - operation scheme (shaded in distant sites the bones); II - a line of soft tissue incisions; III - sawing of the calcaneus; IV - section of the calcaneal tuber, prepared to shelter sawdust leg bones; dashed line shows the bone sawdust leg

40. White robe For the first time wearing robes was proposed by Russian surgeon Nikolai Pirogov, who was known for his passion for purity. As it is written in his biography, he even material for bandaging examined with a microscope.

41. It was invented in order to protect patients from infections carried by and distributed by doctors. Before the advent of robe doctors usually were receiving patients in everyday clothes, at best, putting sleeves and apron operations. White robe was designed in order to become a real hygienic buffer between the patient and the doctor. A white robe was a reminder of the need to wash it, and need to change it as often as possible.

42. NI Pirogov described a number of features of the anatomy and topography of the upper respiratory tract. • NI Pirogov is very detailed and meticulously analyzed the options for the anatomical structure of the frontal and maxillary sinuses; • Described in detail the anatomy of the ear; • For the first time I made a rhinoplasty.

43. Nose barber In 30-ies of the XIX century in the life of a barber from one of the Baltic town, a public person, loved by all, it was a monstrous event. He left without a nose. Clientele of fled: who will trust his head to this barber - somehow inadvertently doubt that he knows how to deal with a sharp object. Friends try to stay away, faithful wife is gone ... Christ unfortunate young professor Pirogov, who recently returned from abroad. He cut him out of the skin of the forehead a new nose - by the method of the famous German surgeon Dieffenbach

44. The basic meaning of the entire activity of of Pirogov is that their selfless and often selfless work he turned surgery into science, by arming physicians evidence-based method of surgery.

45. The basic meaning of the entire activity of of Pirogov is that their selfless and often selfless work he turned surgery into science, by arming physicians evidence-based method of surgery.

46. from. Cherry, now part of Vinnitsa.

47. Pirogova's body was embalmed his doctor DI Vyvodtsevym using newly developed his method, and was buried in a mausoleum in the village of Cherry near Vinnitsa. At the end of 1920 in a crypt visited by robbers, who damaged the lid of the sarcophagus Stole his sword Pirogova (a gift from Franz Josef) and the crucifix. During the Second World War, during the retreat of Soviet troops, the sarcophagus with the body of Pirogova was concealed in the ground, while damaged, which led to the deterioration of the body, then subjected to the restoration and re-embalming.

48. Officially tomb of Pirogova called "church-necropolis' body is below ground level in the crypt - the ground floor of an Orthodox church in the glass sarcophagus, which can be accessed by those wishing to pay tribute to the memory of the great scientist.

49. Nikolay Pirogov   (1810-1881)

50. N.I.Pirogov organically combines the features of the great thinker and citizen, embodying the ideal image of a doctor. So he stayed in the story, so he lives in our presentation today, showing an example for the new generations of doctors. Pirogov Monument in Ukraine