The article presents information about Research Institute of Microsurgery (Tomsk, Russia) and the 3rd Microsurgical Summit in Siberia, which was held in Tomsk on September 27–28, 2024.

The article presents information about the 12th Annual Symposium of the Robotic Microsurgery and Endoscopy Society (RAMSES) held in Singapore in Autumn 2024.

Analysis of clinical manifestations of involutional eyelid deformities in patients with indications for blepharoplasty revealed that almost one in four (24.7%) had clinical signs of hyperextensible eyelids (HES): flaccid, thin, well-dislocated eyelid tissues that easily stretch in vertical and horizontal directions, may evert at night with floppy eyelid syndrome (FES), multiple skin folds - festooned eyelids, positive ‘pinch test’ in hypotony, etc. Despite the great variability of clinical manifestations, common pathogenetic mechanisms of HES have been established: damage to elastic and collagen fibres, chronic aseptic inflammation, impaired haemomicrocirculation in tissues of varying degrees of severity. The danger of HES lies in the reduction of the supporting properties of tissues and a high risk of postoperative complications associated with eyelid retraction. Therefore, the problem of identification of such patients, development of diagnostic tests for planning and predicting the results of blepharoplasty remains relevant.

Purpose of a study: to improve the efficiency of diagnostics of patients with HES when planning blepharoplasty operations.

Material and methods. A total of 352 patients with involutional eyelid deformities were analysed. The age of the study participants ranged from 31 to 68 years, the mean age was (47.0 ± 9.6) years. Out of the total number of examined patients, 87 (24.7%) cases of combination of eyelid involutional deformities with signs of eyelid hyperextensibility were revealed: blepharochalasis was diagnosed in 40 (11.4%) patients, hyperelastosis in 28 (7.9%), and blepharochalasis was combined with hyperelastosis in 19 (5.4%) patients. The control group included 53 patients with involutional eyelid deformities without signs of HES. The examination was performed using four tests: 1) vertical distraction of the upper eyelids (McNab A.A., 1997); 2) vertical distraction of the lower eyelids (McNab A.A., 1997); 3) horizontal distraction of the upper eyelids (Iyengar S.S., Khan J.A., 2007); 4) dystopia of the outer corner of the eye (Grishchenko S.V., 2013).

Results. Analysis of quantitative indicators of diagnostic tests irrespective of the age of the study participants made it possible to reveal reliable values of the norm and in case of HES in millimetres. Thus, in involutional eyelid deformation without HES, the maximum linear values were: 1) vertical upper eyelid distraction test – (6.31 ± 0.47) mm; 2) vertical lower eyelid distraction (5.21 ± 0.58) mm; 3) horizontal upper eyelid distraction – (4.62 ± 0.55) mm; 4) external eye angle dystopia – (5.23 ± 0.50) mm, while in patients with involutional eyelid deformities combined with HES, the minimum values in similar tests were: (7.90 ± 0.79); (7.72 ± 0.73); (6.27 ± 0.55) and (5.41 ± 0.50) mm, respectively.

Conclusions. Eyelid hyperextensibility occurs in almost every fourth patient with involutional eyelid deformities and is an indication for blepharoplasty. Due to impaired tissue support function, these individuals have a high risk of postoperative eyelid retraction. Eyelid hyperextensibility is a characteristic sign of blepharochalasis and hyperelasticity of tissues and can be diagnosed using objective tests: 1) vertical distraction of the upper eyelid (McNab test) more than 6.8 mm; 2) vertical distraction of the lower eyelid (McNab test) more than 5.8 mm; 3) horizontal distraction of the upper eyelid more than 5.1 mm; 4) dystopia of the external eye corner more than 5.7 mm.

Purpose of the study: to conduct a comparative characterization of the risks of developing complications of mastopexy compared with combined mastopexy/augmentation surgery: based on the literature data.

Scientific articles in PubMed, eLibrary, Scopus, Medscape databases are analyzed. The following terms were used in search queries: “mastopexy”, “breast augmentation”, “mastopexy complications”, “breast augmentation outcomes”, “mastopexy-augmentation”, “mastopexy-augmentation complications”, “wound healing after mastopexy”, “hemorrhagic complications after breast surgery”, “double bubble deformity after mastopexy”, “implant malposition after mastopexy”, “breast lift with and without implant”. The data of 73 foreign articles on a given topic were selected. According to the eLibrary database, there are no major review studies in the Russian literature devoted to a comparative analysis of the risks of postoperative complications of mastopexy in combination with and without augmentation mammoplasty.

The analysis showed that the frequency of complications after breast plastic surgery for ptosis correction varies in modern scientific literature. The largest studies indicate the development of complications in 1.15% after mastopexy, 1.40% after augmentation and 1.86% after augmentation/mastopexy.

Conclusion. The choice of the volume of surgical intervention is not regulated in the modern scientific literature. Simultaneous combined mastopexy/augmentation surgery increases the volume of surgery and summarizes the possible risks of complications in the postoperative period.

Objective. Androgenic alopecia is the most common form of baldness in both men and women. This pathology is chronically progressive and is present in millions of people around the world. To date, it is considered proven that alopecia is associated with androgen exposure.

Purpose of the study: to compare the existing methods of treatment of androgenic alopecia according to the literature.

Material and methods. The search for research results by keywords was carried out in open databases. A total of 127 scientific sources have been analyzed, which consider the etiology, surgical approaches and methods of treatment of androgenic alopecia.

The results. The etiology, pathogenesis, diagnosis and conservative methods of treatment of androgenic alopecia according to the world literature are considered. Special attention is paid to the study of sources devoted to various methods of surgical treatment of androgenic alopecia.

Conclusion. Despite the fact that complex treatment of androgenic alopecia is currently used, autotransplantation of hair has been and remains the gold standard of treatment. Surgical hair restoration in alopecia ensures high graft survival and satisfaction from its use. The integration of molecular biology, genetics, pharmacology and clinical research can lead to new discoveries in the understanding and treatment of androgenic alopecia and improve treatment outcomes.

Objective. The fascia lata allomaterial (FLA) has been successfully used in ophthalmology, dentistry, thoracic surgery, neurosurgery, and other fields. However, data on its application in breast reconstruction are extremely limited.

Purpose of a study: to conduct a randomized controlled experimental investigation of the histological and biomechanical characteristics of cadaveric fascia lata allomaterial (alloplant®) compared to other allomaterials used in breast reconstruction.

Material and Methods. The study involved 30 white outbred rats, randomly divided into 3 groups (10 animals each): xenograft, synthetic mesh, and FLA. On days 1, 3, 7, 10, and 14 post-surgery, the implants were removed en bloc for histological analysis, focusing on neovascularization, fibrosis, inflammatory response, and collagen fiber organization. Additionally, the thickness of the inflammatory infiltrate and the lysis surface area were assessed.

Results. In the FLA group, inflammatory cells infiltrated the matrix surface more actively at both the beginning and end of the experiment compared to the other groups (p < 0.05). The most active resorption occurred in the synthetic mesh group, while the lowest lysis rate, particularly in the second week, was observed in the xenograft group. The FLA showed superior fibrosis (p < 0.05), inflammatory infiltrate (p < 0.05), and collagen organization (p < 0.05) compared to the synthetic mesh.

Conclusion. The cadaveric fascia lata allograft in a rat model demonstrated slower biodegradation compared to a synthetic mesh, with no statistically significant difference from the xenograft group.

The article describes clinical cases of successful treatment of gunshot wounds (shot) in the Trauma Department of the Scientific Research Institute – Regional Clinical Hospital No. 1 named after Professor S.V. Ochapovsky" (Krasnodar, Russia). In the treatment of gunshot fractures, the recognized method is the use of external transosseous fixation devices, but in modern conditions it is possible to use various surgical techniques of one-stage and staged treatment. To prevent infectious complications, in addition to medications, VAC drainage and subsequently delayed autodermoplasty are recommended for victims with the most severe fractures.

Purpose of a study: to select the most successful effective tactics for the treatment of non-standard clinical cases with ligamentous gunshot wounds of the extremities.

Material and methods. Upon admission, all wounded underwent laboratory tests: general blood and urine tests, biochemical blood tests, immunological cytological studies, radiography and ultrasound examination (ultrasound) of the injured limb. Subsequently, surgical treatment of the wound, its vacuum therapy, plastic surgery with pedicle flaps and free skin autoplasty were performed in stages.

Results. To replace the wound defect with exposure of deep anatomical structures, plastic surgery with skin-fat flaps was performed with an individual approach to the choice of the type of skin plastic surgery.

Conclusion. The key factors for the success of the surgical results are consistency in treatment and active monitoring of the wound surface, aimed at early detection of potential complications in the postoperative period.

The report presents a clinical case of partial erythrocyte aplasia that developed as an autoimmune syndrome of giant thymoma. Manifestation of the disease included persistent and progressive aplasia of the erythrocyte lineage of the bone marrow against the background of long-term growth of the anterior mediastinal thymoma. The reason for surgical treatment was the phenomena of compression syndrome, complicating the patient's eating and breathing. Despite the radical removal of the tumor and improvement of the general condition of the patient, remission of erythrocyte aplasia was not achieved. Literature data demonstrating pathogenetic features of the course of a rare thymus-associated autoimmune syndrome, including the features of postoperative support, are presented.