Репозиторий Университета

© IV Karpenko et al. A modern military physician can perform their duties at a high professional level only when they are au fait with a complex of military medical disciplines, such as military field surgery, military hygiene, organisation and tactics of medical service and some others, along with general medical knowledge. Back in his time, our great fellow countryman N.I. Pirogov described war as a “traumatic epidemic”. Hence the importance of knowledge of military field surgery for a military physician, which is difficult to overestimate. This article presents the historical picture of the introduction of issues of military field surgery, first in hospital schools, then at the Saint Petersburg Medical and Surgical Academy (MSA), and then, during Soviet times, at the S.M. Kirov Military Medical Academy (the Military Medical Academy of the Workers’ and Peasants’ of the Red Army). It is shown that particular issues of military surgery were sporadically taught in hospital schools since the 18th century. Usually, it would happen on the brink of or during military conflicts, and the students attending would be graduates of hospital schools going to the front. First, particular issues of military surgery can be found in the programme of the Department of Theoretical Surgery of the Saint Petersburg MSA introduced by Professor P.A. Dubovitsky in 1844. The next stage was the establishment in the academy in 1869 of the first independent course of military field surgery which was addressed to military physicians who were annually seconded to the academy for improvement in military field surgery. Since 1879, this course was also studied by students of the Saint Petersburg MSA. The opening in the Academy in 1936 of the first independent Department of Military Field Surgery in the USSR, headed by the well-known scientist and surgeon V.A. Oppel, can be considered the completion of the development of the teaching of this academic discipline.

© NA Kuznetsov. This article reviews the main approaches to the interpretation of the term “risk”, which has acquired the status of a general scientific and widely interpreted concept. The unresolved issues of surgical risk terminology make it extremely difficult to solve the problem of perioperative prognosis at the narrow professional (medical) level. The author considers the problem of objec-tifying operational risk at an interdisciplinary level. In his opinion, understanding risk as a specific form of the subject’s active relation to the surrounding reality is the most justified at the present time. The essential particular features of such activities are the lack of confidence and the subject’s uncertainty in achieving the stated goal since a doctor’s professional activity takes place under conditions of risk, uncertainty and in contradictory situations. The author of the article suggests using the definition of “risk” proposed by A.P. Algin, according to which risk should be understood “as an activity connected with overcoming uncertainty and the situation of inevitable choice, in the process of which it is possible to quantitatively and qualitatively assess the probability of achieving the expected result, failure and deviation from the goal.” This definition prevents the use of antiscientific and scholastic views of this phenomenon. With reference to medical science (in particular, to surgery), this approach to risk allowed the author to formulate an individual quantitative prognosis and to distinguish five types of perioperative prognosis.