Medical tourism

The State Healthcare Institution No. 13 of the Moscow Health Department has been founded in 1940 and was initially called the First Taganskaya Clinical Hospital. Starting with a single building, today it has become a multidisciplinary hospital counting up to 911 beds in the following departments: therapeutic, neurological, traumatological, orthopedic, cardiological, cardiological for patients with myocardial infarction, surgical (pure and purulent), neurosurgical, neurological, traumatological, orthopedic, gynecological, and also pediatric (specificity – nursing of premature babies). In addition to that, there are 113 resuscitation beds and 33 day-stay beds at two out-patient departments.

Traumatology department

The traumatology department forms part of the orthopedic and trauma complex. The traumatology and orthopedic service has its own modern operating unit of 6 operating theaters (2 for carrying out endoprosthesis replacement operations, 2 for traumatological planned operations, a separate emergency operating room and a separate operating room for performing arthroscopic operations).

Department of Minimally Invasive Orthopedics (Arthroscopy)

Successful arthroscopic operations are performed on the knee and shoulder joints. One of the most important social indicators is the provision of medical care to older people with fractures of the proximal femur. Group of orthopedic traumatologists (vertebrologists) Experts working in the field of reconstructive and minimally invasive spine surgery.

Orthopedic department

The main branch of the department is endoprosthetics of the joints of the lower extremities, reconstructive surgery of the forefoot.

Surgery department

Highly qualified specialists provide high-tech, planned and emergency surgical assistance to the population. In addition to this, the whole range of surgical interventions for diseases of the abdominal cavity can be performed at the highest level.

Urology Department

Surgeries of different levels of difficulties are performed to treat benign and malignant diseases of the kidneys, ureters, bladder and prostate gland.

Department of purulent surgery

The State Healthcare Institution No. 13 is an organized cluster for treatment of wounds and wound infections, which includes: on the basis of the polyclinic – an outpatient service of an advisory-diagnostic department and day hospital, and on the basis of the in-patient hospital – a separate hospital room with a dressing room in the emergency department and a department of purulent surgery (50 beds) with specialized intensive care unit (9 beds).

Department of Neurosurgery

Since the beginning of 2018, the Department of Emergency Neurosurgery, with 30 beds, was opened in the State Healthcare Institution No. 13. A group of qualified neurosurgeons receive and consult patients with emergency neurosurgical pathology around the clock.

Extrabudgetary innovative surgical department

Extrabudgetary innovative surgical department provides high-tech planned and emergency surgical assistance to citizens of the Russian Federation and foreign citizens in the following fields: surgery, coloproctology, bariatric surgery, urology, gynecology, neurosurgery.

Gynecological department

The vast majority of the surgical operations are performed by endoscopic access using the latest organ-preserving technologies aimed at the shortest stay of the patient in the hospital and the preservation of menstrual function with the possibility of further childbearing.

Neurological department

The department specializes in the treatment and early rehabilitation of patients with acute disorders of cerebral circulation. The department is one of the leading neurological departments in Moscow in terms of the number of patients treated, the effectiveness of treatment and the use of modern methods of treatment.

Cardiology departments

Department No. 1 for patients with myocardial infarction, the X-ray surgical diagnostic and treatment methods and the ICU are the structural units of the Primary Vascular Department established in 2011.

Department No. 2 specializes in modern complex diagnostics and treatment of a wide range of cardiological diseases.

Therapeutic department

The department provides medical assistance to patients with the following diseases:

  • Diseases of the cardiovascular system (ischemic heart disease, arterial hypertension, heart failure, cardiac arrhythmias);
  • Pathology of the respiratory tract and lungs (chronic bronchitis, bronchial asthma, pneumonia);
  • Pathology of the gastrointestinal tract (gastritis, peptic ulcer, hepatitis and cirrhosis, intestinal diseases).

Neonatology department

Pediatric neonatal units were founded in 1963, the main focus of the department’s activities was to care for premature babies.

Septic Surgery Unit
Profile Cabinet and dressing in the emergency Department

Profile Cabinet and dressing in the emergency Department

The increasing world population, the increasing number of road accidents, the development of technology and the increase in the number of technological disasters, the increasing mass of weapons and the rise of terrorism and local conflicts – all this leads to the increase in the number of traumatic injuries and septic complications. On the other hand, deterioration of the environment, the growing incidence of background diseases (diabetes, cardiovascular disease, immunosuppressive conditions), the development and increasing accessibility of medical technology leads to an increase in the number of invasive procedures and their complications, which potentiated an increase in the resistance of pathogenic microflora to antiseptic and used antibacterial drugs in response to the achievements of pharmacology.

All this leads to an increase in the number of purulent-septic complications, which makes this problem even more relevant today than 100 years ago and requires new solutions to scientific, practical, tactical and strategic and organizational.

In Moscow City Hospital №13 organized by the cluster for treatment of wounds and wound infection, which included: the polyclinic – ambulatory service outpatient, and hospital – separate box with dressing in the emergency Department and the Septic Surgery Unit with 59 beds with the profile the intensive care unit on 9 beds. It should be noted that surgical clinic of city hospital №13 is the clinical base for Departments of General surgery and radio-diagnostics of the medical faculty Pirogov Russian National Research Medical University Russian Federation Ministry of Health.

The Septic Surgery Unit operates year round with a full workload due to high demand for this type of specialized care in the city of Moscow.

Septic Surgery Unit

Septic Surgery Unit

Elective surgery and dressings are made 6 days a week.

Equipment in the Department:

  • Total cleaning and disinfection in all areas
  • Self planned/emergency operating, operating 24 hours a day and equipped with all necessary equipment – argon-plasma coagulation, electro-optical Converter (C-arm) equipped with arthroscopic stand, power tool “Synthes”, dermatomes, etc.
  • Two dressings
  • Cabinet of hyperbaric oxygenation (HBO)
  • The office of innovative therapies (ozone therapy, quantum therapy, cell technologies, transcutaneous measurement of oxygen tension in tissues, plantscape)
The Department of purulent surgery and operating room

The Department of purulent surgery and operating room

On the same floor with the Department of purulent surgery is a specialized branch of Septic intensive care unit, which includes a separate box with the gateway for patients with anaerobic infections and is fully equipped with medical and diagnostic equipment.

In the diagnosis of diseases opportunities for hospital, laboratory, morphological, ultrasound, x-ray and endoscopic examinations, MRI, CT (including 3D CT-angiography – definition of pathology in the arterial blood flow), transcutaneous determination of oxygen tension in tissues. Since 2017 we use mobile ultrasound devices.

Examples of 3D MSCT angiography

Examples of 3D MSCT angiography

In the diagnosis of infection periimplant implemented method of sonication, allowing a more reliable estimate qualitative and quantitative characteristics of peri-implant infection, to determine the algorithm and the duration of antibiotic therapy and improve patient outcomes.

To ensure phasing and continuity of medical care from November 2012 in the City Hospital №13 organized Outpatient Unit of wounds and wound infections, the number of visits – over 500 visits a month:

  • Work 6 days a week, providing a multidisciplinary approach
  • Consultations, pre – and post-hospital monitoring of patients
  • Outpatient management of patients with chronic wound defects
  • Stationariness technology treatment of wounds, small surgical intervention
  • For outpatient services developed and implemented a software “the Registry of patients with purulent-septic profile”
Comparison of results of growth of S. aureus on the left, and biopsy of the peri-implant tissue, to the right of sonicate implant.

Comparison of results of growth of S. aureus on the left, and biopsy of the peri-implant tissue, to the right of sonicate implant.

In the purulent surgery Department of the hospital and in ambulatory practice used modern methods of treatment of wounds and wound infections, introduces the latest domestic and foreign technologies, develop and implement innovative and import-substituting technologies. The main areas of work – the treatment of patients with purulent diseases of soft tissues, syndrome of diabetic foot, osteomyelitis periprosthetic infection, chronic wounds and trophic ulcers of different etiology, complications abdominal and thoracic surgery.

 

Modern and innovative methods of treatment of wounds and wound infections:

  • Interactive dressings, polymeric dressings
  • Compression stockings, multi layered compression bandages
  • Indirect electric pulse muscle toning
  • Air-plasma / argon-plasma / helium-plasma flows, NO-therapy
  • Wound oxygenation, hyperbaric oxygenation, ozone therapy
  • Quantum therapy
  • Vacuum-assisted bandages
  • Сellular technology
  • Revision spacer endoprosthetics
  • Osteosynthesis and MIPO technology
  • Antibacterial biocomposite materials
  • Reconstructive plastic surgery
  • Non-surgical magnetic overlay inter-intestinal anastomosis

Here was developed in 2009, is patented in 2012 and registered in 2015, import-substituting apparatus for treatment of local negative pressure “Vasta”, which is used in hospital and in ambulatory practice and is now represented in various regions of our country.

Multidisciplinary team of surgeon – pediatric surgeon – endoscopist in 2013, obtained a patent on a method for the treatment of short bowel syndrome, comprising a magnetic anastomosis and quantum therapy.

Implemented a method of indirect electric pulse myostimulation of patients with different pathologies, including patients with diabetic foot syndrome in the conditions of limited physical activity or immobilization of the limb and for the first time in patients of trauma profile with immobilized limb (skeletal traction or external fixation apparatus), which reduced the risk of thromboembolic complications, reduce the duration of the hospital treatment and the rehabilitation of such patients.

For the first time in world practice in this Department developed and implemented methods of stimulation of regenerative processes in chronic wounds using autologous platelet growth factors – PRP, platelet rich plasma (previously the technique has been used in dentistry, traumatology and sports medicine), providing a complete biological safety of the patient.

In surgical practice with different pathologies are widely used bioresorbable antibacterial biocomposite materials to replace the tissue defect and provide prolonged local antibiotic therapy (PLAT).

The Department developed the methodology of using various types of minimally invasive organ preserving and reconstructive osteoplastic operations with the use of antibacterial biocomposite materials with submersible and external osteosynthesis on the infected diabetic foot and the Charcot foot. A multi-disciplinary team “the surgeon – endocrinologist” from three different medical institutions of the proposed new combined classification of diabetic foot syndrome with algorithm choice of treatment strategy, the operational benefits, additional medical procedures and means of unloading of the foot in accordance with the recommendations of the IWGDF-2015.

In the five years of program implementation for the treatment of complications of diabetes, the proportion of amputations at any level has decreased almost in 3 times and at the same time, the share of plastic and bone-plastic operations in this category of patients has increased more than 6 times. This led to snijeniyu of percentage of disability of patients with diabetic foot syndrome by almost 5 times.

The Department performs various types of plastic operations for the closure of extensive and chronic wound defects.

Great attention is paid to the treatment of patients with periprosthetic infection after endoprosthetic replacement of large joints, osteosynthesis of fractures of endocorrection scoliosis, tension-free hernioplasty; use different types of antibiotic spacers, and antibiotic osteogenesis biocomposite materials, platelet growth factors, the method of local negative pressure, etc.

From 2017 the Department implemented method of remediation of arthroscopy for patients with purulent-inflammatory lesions of large joints, reducing the length of hospital stay and improve the quality of life and prognosis for these patients.

In 2016, tested a method of treatment of chronic and infected wounds argon plasma flow using a unique domestic installation “Plasmaran”; the rationale and effects of the method published in the Russian scientific press; also in 2016, tested the application of the method of shock wave therapy in the treatment of chronic wounds; clinical material analyzed at the present time. In 2017, is clinical testing of domestic apparatus “Helios” – the treatment of wounds and the stimulation of regenerative processes of the helium plasma flows.

Since 2018, an original method of treating chronic wounds and ischemic lesions using injection carboxytherapy has been implemented.

In the last 2 years, the department together with neurosurgeons introduced a new surgical concept for the treatment of patients with purulent spondylodiscitis and paravertebral purulent-inflammatory processes using vacuum therapy and antibacterial spacers.

Before surgery After surgery

Before surgery After surgery

The team of the cluster for treatment of wounds and wound infections represented by qualified nurses and doctors, half of them were PhD. Doctors of the department have different specializations besides wound surgery – proctology, thoracic surgery, traumatology, orthopedics, endoscopy – which provides an informed approach to the treatment of patients with any infectious complications.

The staff of the Department provide Advisory and operational assistance in many city, Federal and commercial health institutions on a regular basis.

For example, in 2016, on the basis of FGAU “national scientific-practical center of neurosurgery named after academician N. N. Burdenko” treated the patient with postoperative purulent wound of soft tissues of the head, osteomyelitis and bone defect of the skull using the method of local negative pressure (such examples are not described in world literature) – case published in 2017.

The Department carried out the principle of multidisciplinary management of patients due to daily availability of consultants: the therapist, neurologist, cardiologist, endocrinologist, rheumatologist, urologist, nephrologist, vascular surgeon, transfuziolog, traumatologist, orthopedist, psychologist, clinical pharmacologist; if necessary 1-2 times a week available consultation of a hematologist, dermatologist, infectious diseases specialist, psychiatrist; in difficult clinical situations help full-time and online consultations leading pathologists ‘ Russia and Europe.

The development plans of the cluster for treatment of wounds and wound infections – further development and implementation of medical devices and methods of treatment of wounds, introduction in practice of work of the Department of the method of thoracoscopy and minimally invasive technologies as well as new methods of diagnosis of wound infections.

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