The purpose of the study: to study the morphometric parameters of lower third of the face and neck in men and women to identify the points of application of surgical correction of lower third of the face and neck.

Material and methods. A study of 100 computed tomograms of the head of Europeans (50 men and women) was conducted using the Vitrea Core program (Netherlands). During the study of the material, the main morphometric parameters of the lower third of the face and neck were determined and analyzed. Statistical data processing was carried out using the StatTech v. 3.0.9 program (Stattech LLC, Kazan, Russia).

Results. When studying 100 computed tomograms of the head of Europeans, the main morphometric indicators of the lower third of the face and neck were determined. Characteristic differences in the anatomical structure of the studied computed tomography of the heads of men and women were revealed. It was revealed that the significant difference in the length of the face (from the border of hair growth on the forehead to the lower point of the chin) in men is on average 12.4 mm greater than in women. The significant difference in the height of the lower part of the face (from the border of the nasal septum and the skin of the upper lip to the lower point of the chin) of men and women is on average 10.60 mm. The significant difference in height from the deepest point of the nose root to the lowest point of the chin of men and women is on average (12.23 ± 9.48) mm. The significant difference in width between the projections of the bases of the coronal processes in men is on average 5.10 mm greater than in women. The significant difference in the distance between the gonial angles of men and women is on average 9.85 mm. The significant difference in chin height between the central incisors in men is on average 5.00 mm greater than in women. The significant difference in the length of half of the body of the lower jaw (from the angle of the lower jaw to the lower point of the chin) of men and women is on average 6.00 mm. The significant difference in the chin-neck angle formed by the intersection of the chin and neck lines of women and men on average is (18.17 ± 2.98) degrees.

Conclusion. The presented data can help practitioners to determine the target points of application of surgical correction more accurately of the lower third of the face and neck to improve the social adaptation of patients.

Purpose of the study: to experimentally study the morphological features of the reaction of diaphragm tissue to porous titanium nickelide in comparison with medical felt.

Materials and methods. A series of experiments was carried out on 20 rats. The animals were divided into two comparison groups: in the main group (n = 10), the reaction of diaphragm tissue to an implant made of titanium nickelide was studied; in the control group (n = 10), an implant made of medical felt (fluoroplastic-4) was used. Animals were removed from the experiment 14, 30, 60 and 90 days after surgery. A histological study of the reaction of the diaphragm tissue to the implant was carried out, as well as the structural behavior of the material under study.

Results. Macroscopically, after 14 days in the main group, a local adhesive process was noted. In the long term, the implant was covered with a thin connective tissue film without signs of inflammation. In the control group, after 14 days, phenomena of inflammatory infiltration with organ involvement were observed. After 30 days, the inflammatory infiltrate persisted with the formation of a connective tissue capsule. The implant increased in size with deformation, swelling, and in the long term, disintegration of the structure. Histologically, on the 14^th day in both groups, granulation tissue formed between the implant and the diaphragm. By the 30th day in the main group, the number and thickness of collagen fibers increased, they filled the porous structure of the material. In the control group, the appearance of giant multinucleated cells was noted between the felt fibers, which are indicators of the body's tissue reaction to foreign material. On the 60th day in the main group, a regenerate of mature connective tissue formed around the implant, filling the pores of the material and spreading to the muscle fibers of the diaphragm. In the control group, a picture of productive granulomatous inflammation with phenomena of biodegradation of the material was observed.

Conclusion. The results of the experiment demonstrated the absolute advantage of titanium nickelide in reconstructive surgery of the diaphragm. At the same time, the disadvantages of using medical felt associated with the body’s reaction to the material as a foreign body and the tendency to resorption are noted.

Compression of nerves in anatomical canals in the upper extremities is quite common. The cause of secondary compression is a change in the contents of the canal or its geometry, for example, in rheumatoid arthritis, intracanal tumors or trauma accompanied by damage to the canal walls. The etiology of primary compressions is still unclear. It is believed that the cause may be impaired blood circulation in the nerve and disruption of the blood-neural barrier. In this regard, understanding the anatomical aspects of the blood supply to the nerves of the extremities becomes incredibly relevant. The paper provides an overview of the available data on the options for blood supply to the nerves of the extremities. A theory has been put forward about the origin of the venoarterial reflex in the pathogenesis of compression neuropathy.

The effectiveness of ozone therapy in the treatment of cancer pathology lies in the proven process of destruction of atypical cells due to the inhibition of vicious anaerobic metabolism. Ozone selectively causes the death of cancer cells, since healthy cells have their own antioxidant defense system, while atypical cells do not. Ozone therapy for cancer pathology is an auxiliary treatment method that involves the effect of the oxygen-ozone layer on cancerous cellular structures. Numerous clinical studies confirm that ozone therapy is well tolerated and is extremely rarely accompanied by side effects and does not cause negative reactions in the human body. The advantages of ozone therapy include: safety for human health, minimal side effects, proven effectiveness, low cost of equipment and the possibility of use as cancer prevention. In addition, this treatment method is indicated for people suffering from chronic diseases and disorders that increase the risk of cancer, such as atherosclerosis, hypertension, type 2 diabetes, obesity, immunosuppression, menstrual disorders, etc. The use of ozone in medicine is very promising due to its anti-inflammatory, immunomodulatory and antitumor effects, and its hepatoprotective effect makes it possible to reduce the patient’s time in the hospital due to the rapid restoration of liver function in the postoperative period.

Objective. Tracheostomy is one of the most frequently performed surgical procedures in seriously ill patients in the intensive care unit and in intensive care units who require long-term mechanical ventilation. Protecting the larynx and upper airway from the complications of prolonged intubation is an important reason for tracheostomy and airway management. Early tracheostomy can reduce the dosage of sedatives used, contributes to a gradual decrease in artificial ventilation support. However, with the development of minimally invasive techniques for performing tracheostomy, the medical community raises the question of the need to choose the optimal surgical method. First, it depends on the timing of its application, the tracheostomy, the duration of the transition to independent breathing, and the behavior of patients after the procedure. The use of dilation tracheostomy can improve the aesthetic outcome of patients.

Purpose of a study: Comparative evaluation of the effectiveness of performing tracheostomy using traditional and modified technology at different times of mechanical ventilation in seriously ill surgical and therapeutic patients in the intensive care unit.

Material and methods. The study was based on an analysis of the results of treatment of 331 patients (212 men (64 %) and 119 women (36 %)) aged from 18 to 92 years old (average age (55,7 ± 5,2) years), who were in the intensive care unit of the Regional Clinical Hospital No. 1 named after Professor S.V. Ochapovsky (Krasnodar) for 2020–2022, in which a tracheostomy was performed to prevent cicatricial complications. The patients were divided into 2 groups. The first group included 219 patients from the intensive care unit who underwent tracheostomy using traditional technology, and the second group (112 patients) included patients who underwent tracheostomy using a modified technology.

Results. A new modified technology for performing tracheostomy in seriously ill surgical and therapeutic patients in the intensive care unit has been improved and developed. Objectively substantiated and noted the advantages and disadvantages of the modified tracheostomy technology from the hemodynamic, gas transport positions, possible complications and long-term results.

Conclusion. The use of a new modified technology of tracheostomy imposition allows preventively protecting patients from the development of complications in the form of profuse bleeding in comorbid coagulopathy and against the background of the use of therapeutic dosages of anticoagulation therapy, reducing the risk of decanulation, improving functional and cosmetic results of treatment due to less skin trauma.

The World Obesity Federation published an atlas in 2023, which reports that if the current trend continues, in 2035 every second person in the World will be overweight or obese. Often, overweight or obese patients turn to a plastic surgeon for help, as the “easiest way” to solve this problem. Nevertheless, the initial state of the patient's health is fundamental to obtain a satisfying result for both the surgeon and the patient of the aesthetic intervention. Therefore, a thorough understanding of the pathomorphological processes occurring in the body of patients with overweight or obesity is necessary, which determines the relevance of this study.

Purpose of the study: to study the morphological picture of the subcutaneous tissue in patients with overweight or obesity.

Material and methods. A morphological and immunohistochemical assessment of the state of the subcutaneous tissue was carried out in 49 overweight women who, in the period from 2019 to 2020, underwent planned surgical interventions for aesthetic indications aimed at correcting body contours. After the operation, women were observed for 6 months, assessing the timing of wound healing, as well as the presence or absence of seromas, ligature fistulas, and wound infection. We carried out a comparative analysis of the morphological picture of the subcutaneous tissue in different course of the wound process, studied the prognostic significance of the identified subcutaneous tissue morphotypes in relation to the risk of delayed and complicated wound healing.

Results. Histological examination revealed two morphological types of subcutaneous adipose tissue structure: adipocyte and adipocyte-fibrous. The adipocyte type of structure of the subcutaneous adipose tissue is represented by the adipose tissue itself from typical mature adipocytes with interadipocyte small capillaries, which has a lobular structure with thin layers of interlobular connective tissue. This morphological type of structure was observed mainly in the group with a standard postoperative period. The mixed adipocyte-fibrous type of subcutaneous adipose tissue structure was characterized by a different ratio of two tissue components - fatty and fibrous. This morphological type of structure is typical for a group of patients with a delayed and complicated wound process in the postoperative period. The established changes in the histological structure, cell infiltration with an increase in the number of CD68+ positive macrophages and HLA-DR+ positive immune cells, perivascular CD20+ B-lymphocytes in the subcutaneous fat indicates that patients with a complicated healing process have already been admitted to the clinic in a state of local chronic inflammation of the subcutaneous tissue.

Conclusion. The morphological changes in the subcutaneous tissue revealed during our study can partially explain the prolongation of the wound process and the development of complications in the postoperative period in overweight and obese patients. However, in order to create a routine algorithm for the preoperative identification of patients at risk, it is necessary to identify correlations between biochemical changes in the blood and the development of changes in the subcutaneous tissue.

Extraneural ganglia are the most common lesions in the wrist and hand. In contrast, intraneural ganglia on the upper extremity, particularly the wrist and hand, are extremely rare. The paper presents a clinical case of successful treatment of a patient with intraneural ganglion of a rare anatomical location – the median nerve at the level of the wrist.

There is no information in the modern Russian literature concerning the history of the formation of plastic surgery in Russia and in particular in Tomsk. The aim of the research was to analyze the contribution of Tomsk surgeons to plastic surgery, from the time of the opening of the Medical Faculty of the Imperial Tomsk University (1888) to the present days. The authors analyzed the current trends in the development of plastic surgery in Tomsk, its achievements and impact on the development of plastic surgery in Russia.