The paper contains the results of an experimental study of the effect of ferroelectric composite polymer membranes on the healing process of purulent wounds. The membranes were formed by electrospinning based on vinylidene fluoride-terafluoroethylene copolymer, polyvinylpyrrolidone K17 (PVP) polymer, zinc oxide nanoparticles (ZnO). Five spinning solutions with different contents of PVP were prepared: 0, 5, 10, 20 and 40 mass %.

The effect of the membranes was evaluated depending on the content of PVP. The conductivity and viscosity ofthe spinning solutions were determined. The structure of the formed membranes was studied. The diameter of the fibers forming the membranes was determined by scanning electron microscopy. The antibacterial activity of the membranes was evaluated. The ability of the developed membranes to heal a purulent wound was studied in experiments on laboratory animals.

Titanium nickelide is a promising material for use in surgical practice, starting from hernia gate plasty with the use of mesh implant, including the use of this material in surgical interventions of internal organs. Considering that the wound healing by primary tension occurs when using this material, this material is suitable for the formation of a bronchial stump. The results of the study are presented in this paper. 18 operated rats underwent lobectomy and formation of the bronchial stump using the titanium nickelide implant in 9 rats and formation of the bronchial stump using the lavsan thread. The results of macroscopic, radiological, barometric, histological studies and the results of electron microscopy are described and demonstrated.

The aim of this study was to explore the in vivo applicability of intracorporeal constructions with hepatocytes cultured in the fiber TiNi-based scaffold (FTNS). We also sought to determine whether application of hepatocytes cultured in the FTNS was superior to simple hepatocyte injection in terms of restoration of liver functions and survival time in a CCl4-induced hepatitis rat model. In investigation 200 animals were assigned to explore the experimental groups as follows: Group I – control; Group II – animals with CCl4-induced hepatitis; Group III – animals with toxic hepatitis followed by implantation of cell-free FTNS (sham-surgery); Group IV – animals with toxic hepatitis followed by infusion of hepatocytes only (20 × 106 cells/ml); Group V – animals with toxic hepatitis followed by implantation of hepatocytes cultured in the FTNS. In terms of restoration of liver function, Group V showed a significant reduction of serum alanine aminotransferase level compared to Group II. Group IV also showed a significant decrease in ALT level at 15 days. However, the level of ALT increased at 30 days, and the level was similar with results of the Group II. This probably was caused by a short-term effect of hepatocyte injection only. The change patterns of serum protein, lactate, albumin, fibrinogen, and total bilirubin levels were similar to the results of ALT. The survival time of animals was significantly longer in Group V. These findings showed possible abilities of the FTNS as a scaffold to support the hepatocellular metabolism. Using 12 animals, image analysis of SEM data of in vivo hepatocyte evolution in the FTNS was carried out. In the SEM analysis, hepatocytes demonstrated good adhesion and proliferation in the pore space of the FTNS. Moreover, mature tissue comprising both colloidal and fibrous components filled the pore body by 95% in 28 days. Overall, this study sheds a light on how the implantable «auxiliary liver» by engrafting the cultured FTNS substitutes the missing hepatic function without the need to replace the whole liver.

The purpose of the study was to study in an experiment the advantages of creating interintestinal anastomoses using a construction with thermomechanical memory made of titanium nickelide in comparison with the classical method of imposing interintestinal anastomoses. The work was carried out on mongrel dogs by the method of performing compression and ligature interintestinal anastomoses. The tissue response in the area of interintestinal anastomosis was studied by the authors and confirmed by histological studies. In the studied tissues of the compression interintestinal anastomosis, microscopically, the indicators of the reactive inflammatory process were less pronounced and, ultimately, no dystrophic changes and tissue nutritional disorders were found in the test material. The healing of the intestinal mucosa was significantly better than in the classical ligature anastomosis. On the basis of the experimental data obtained by us, it was concluded that the use of compression interintestinal anastomoses for the purpose of creating anastomoses occurs with the best conditions for wound healing at the site of imposition of the performed anastomosis, in contrast to the classical ligature anastomosis.

The paper presents fundamental and applied research in a new direction in science and technology, which has a world priority – medical materials and implants with shape memory. The main directions of the development of a new generation of more advanced biocompatible superelastic implantable materials and long-term shape memory implants based on titanium nickelide are formulated. The physical, biological principles of creating a new class of biocompatible superelastic materials based on titanium nickelide with a certain set of properties for various fields of medicine using technologies of induction melting, self-propagating high-temperature synthesis, and sintering are presented.

Among the materials created, the development of alloys for long-term functioning in a living organism is of great importance: monolithic elastic, porous and ultra-thin porous-permeable materials, fabric and textile materials made of thin filaments based on titanium nickelide. The main medical and technical requirements for a new class of implants of the future have been identified. Criteria for the biomechanical compatibility of metallic materials under deformation conditions in aggressive tissue media have been determined. Conditions are formulated under which monolithic and porous materials exhibit properties that are optimal for implantation. A comprehensive study of the properties of cell incubators made of porous titanium nickelide was carried out, and the morphological characteristics and patterns of cell development in the porous structure of bulk biomaterials made of titanium nickelide were revealed.

The main directions of creation of unique medical technologies based on the developed materials are characterized. The principles of application of biocompatible superelastic materials in various fields of medicine are described. Titanium nickelide-based materials and implants with shape memory implanted into the body are intended for a wide range of medical purposes in dentistry, traumatology, surgery, ophthalmology, vascular surgery, oncology and other fields of medicine as implants for osteosynthesis, endoprosthetics, replacement of tissue defects, creating anastomoses and support frames of organs.

The purpose of the study was to study the possibility of using intracorporeal constructs in vivo with healthy or autologous dead tumor cells on porous extracellular matrix of titanium nickelide (PEMTN).

We aimed to determine the advantage of the effect of this method on the change in the immunological status of cancer patients in comparison with patients receiving traditional treatment.

The study used CBA and AKR JY mice and studied 10 patients with solid stage IV tumors of various localization (pancreas, intestines, lungs, ovary, head and neck) and 3 oncohematological patients (lymphoblastic lymphosarcoma, chronic myeloid leukemia (CML)).

PEMTN was seeded with a suspension with bone marrow cells from CBA mice and cultured for 8 weeks in a long-term Dexter culture. It was shown that after 6 weeks of incubation of bone marrow cells on PEMNT in vitro, the proportion of bone marrow cells produced from the pores of the matrix into the liquid medium varied within 58–82%, which corresponded to the figures of the 1st week of incubation.

After implantation of PEMTN with fetal liver cells in AKR/JY mice with spontaneous lympholeukemia, the implant successfully engrafted and after 30 days, no noticeable fluctuations in the leukocyte count were observed. After 3–4 weeks implantation, a 3-fold increase in the level of erythrocytes with fetal hemoglobin, which is not normally found in adult AKR/JY mice, was observed. There was also an increase (by 274%, p < 0.05) in the number of blood reticulocytes and a 26% decrease in the activity of the tumor process.

In cancer patients with solid tumors, the level of SH-groups erythrocytes of blood increased 1.5–2.3 times 2 months after the implantation of hybrid oncotherapy implants carrying autologous apoptized tumor cells, treated in vitro. This implants, already 3–4 weeks after implantation in oncopatients, restored the blood system parameters.

The most active (2–3 times) increased individual indicators of cellular immunity, in particular the number of NK cells, active (CD25+) and apoptotic lymphocytes (CD95+ marker). From the 3rd month of the study, the level of humoral immunity increased (immunoglobulins, circulating immune complexes). Clinically, the activation of immunity was accompanied by the stabilization of the process or a decrease in the volume and fragmentation of the primary nodes of solid tumors.

In oncohematological patients, an increase in the CD95 marker in the peripheral cells of blood was observed.

Therefore, in a patient with CML, the implantation, which followed therapy with low doses of cytostatics (myelosan, hydroxyurea) and the immune effect of the implantation, led to a 6-month hematological remission with normal values of the total number of leukocytes and leukocyte blood count. It has been shown that healthy cells in this matrix retain their viability and it allows them to multiply both in the in vitro system and in the in vivo system. The possibility of clinical use of PEMNT carrying autologous dead tumor cells treated in vitro with the aim of improving antitumor immunity, accelerating the recovery of blood counts in cancer patients and achieving partial remission has been shown.

Samples of metal knitted mesh made of the 40 μm, 60 μm and 90 μm diameter TiNi wires are studied by uniaxial tension to rupture and uniaxial cyclic tension. It was found that the metal knitted TiNi mesh behaves like a hyperelastic material under uniaxial tension in contrast to the superelastic wire from which it is made. Using the rheological models of Gent, Neo-Hookean, Mooney–Rivlin and Bergstrom-Boyce, the calculation of the cyclic tension of the knitted mesh was carried out. The similarity of the mechanical behavior of knitted mesh and biological tissues is shown. Criteria for quantitative assessment of the biomechanical compatibility of a knitted mesh implant for plasty of hyperelastic biological tissues are proposed.

The main criteria for the rheological similarity of knitted mesh and soft tissues are the ultimate tensile strength, elastic modulus and the range of low-modulus and high-modulus elastic strain under loading and unloading; the residual strain value during cyclic tension.

It has been found that knitted mesh made of superelastic TiNi wire exhibits a rubber-like behavior characteristic of hyperelastic materials under soft zero cyclic tension. At the same time, in the most loaded contact areas of the superelastic TiNi wire, the martensitic transition did not affect the tension cycles is due to friction, which counteracts the recovery of elastic strain during unloading. It has been established that the Bergstrom–Boyce model is closest in terms of the stress–strain diagram to the knitted mesh and biological tissues. Knitted mesh implants made of nickeide titanium wire were used for plasty of soft tissues and musculoskeletal complexes. The developed method for quantitative assessment diagram of the hyperelastic knittes mesh. The residual strain during the first two tension of the biocompatibility of the implant and biological tissue make it possible to choosу knitteв mesh with a certain wire diametre, focusing on the forces developed by the knitted mesh and the variable elasticity modulus. The knitted mesh was applied without additional fixation, using elastic self-fixation of knitted mesh loops into soft tissues.

The authors report the case of a patient with peritoneal adhesions, intestinal obstruction, postoperative peritonitis due to entero-enteroanastomosis leak, complicated by abdominal sepsis, intestinal failure, phlegmon of the abdominal wall, bilateral polysegmentary pneumonia. Fistula-bearing part of the small intestine was resected, several debridement relaparotomies were followed by entero-enteroanastomosing. In the postoperative period, a laporostoma was brought out because of phlegmon of the anterior abdominal wall and compartment syndrome. An vacuum pack system was used to sanify the abscess. After stopping peritonitis, the abdominal cavity was sealed with mobilized skin grafts. The patient was discharged on the 41st day after admission to the hospital and on the 53rd day from the onset of the disease. The male was examined 2.5 years later, the level of his health was good, he was engaged in work. The presented case reports the stages of surgical treatment of postoperative unstable intestinal fistulae associated with diffuse peritonitis and intestinal failure in the early terms of their onset. The authors discuss diagnostic, tactical, and technical errors and analyze the reasons.

The problem of treating diseases of the pancreas remains highly relevant. Despite the large arsenal of methods of surgical treatment of this pathology, even the introduction of endoscopic, minimally invasive and organpreserving technologies does not allow us to speak unambiguously about solving the problem. The high incidence of acute and chronic forms of pancreatitis, the frequent occurrence of malignant neoplasms of the pancreas, in which it is not possible to carry out radical operations, determined the need for the use of cryosurgical technologies both for open interventions on the pancreas and for laparoscopic operations. In an experiment on animals, the effectiveness of the use of ultra-low temperatures in the pathology of the pancreas was proved. The developed methods of cryotherapy began to be used in the clinic not only as independent surgical interventions, but also in combined operations with good immediate and long-term results.

Summarizing the experience of research and treatment of 218 patients (134 (61.5%) men and 84 (38.5%) women) with pathological symptoms frolicking after surgery on the stomach and duodenum. The average age of patients was (56.7 ± 13.7) years old. The authors formulated the obligatory scope of examination of patients to select possible options for reconstruction of the gastrointestinal tract. The results of the developed methods are demonstrated, confirming the need to restore the natural passage of food, and, if necessary, the creation of functionally active formations that prevent the occurrence of a retrograde pathological flow of contents from the distal parts of the digestive tract to the proximal.

The possibility of using titanium nickelide (TiNi) cryoapplicator in the surgery of nonparasitic cysts and liver hemangiomas was study.

Material and methods. The analysis of the results of surgical treatment of patients with the use of TiNi cryoapplicator was carried out in 26 patients with nonparasitic liver cysts and in 31 patients with liver hemangiomas of various localization and diameter.

Results. It was proved that the use of a TiNi cryoapplicator is as effective as a stationary cryoinstallation with a constant supply of a cryoagent (liquid nitrogen).

Conclusion. The use of TiNi cryoapplicator increases the effectiveness of the action on cysts and hemangiomas of the liver, causing their cryodestruction and preventing the recurrence of these diseases, reduce blood loss and reduce trauma when using laparoscopic cryoprobes. In addition, when using the open access of Merzlikin– Paramonova, it becomes possible to manipulate with less trauma in the area of the diaphragmatic surface of the organ and the caval gates of the liver, which are difficult to access for surgical intervention from traditional incisions, especially when the pathological process is located in 7–8 segments of the liver.

The paper presents a comparative characteristic of the results of surgical treatment of 27 patients with hiatal hernias using the Rampal–Narbona cardiorespexy technique and 16 patients who underwent laparoscopic Nissen– Rosetti fundoplication with cruroraphy. Cardioterespexy according to the Rampal-Narbona technique consists in the use of lig. Teres hepatis with the aim of forming the angle of His, fixing the cardiac part of the stomach and esophagus in the abdominal cavity. There were no cases of mortality. Complications after surgery were observed in older patients who were associated with concomitant pathology. The patients were examined within 10 to 18 months after surgery; in both groups, several cases of relapses and complications were recorded. In percentage terms, these data are as follows: during cardioterespexia surgery, the recurrence rate was 3.7%, signs of esophagitis were observed in 18%, cardia insufficiency was observed in 11.1%, signs of GER were in 11.1%, while in patients, of those operated on according to the Nissen–Rosetti technique, similar indicators were somewhat different: the percentage of relapse was 6.25%, signs of esophagitis were observed in 18.75%, cardiac insufficiency was observed in 18.75%, signs of GER were also in 18.75%. The results obtained indicate a good efficiency of cardiopexy with the round ligament of the liver, and a lower percentage of recurrence and complications in comparison with the Nissen– Rosetti technique (18.7%). The authors see the expediency of using the cardioterespexia technique in clinical practice both in the classical version and subject to its further improvement, which consists in increasing the mechanical properties of the round ligament of the liver and performing this operation by laparoscopic access.

The results of a study of titanium nickelide devices used for the formation of compression anastomoses in patients with digestive system diseases and describes the techniques of compression fistula formation using these devices has been presented. Besides, the paper presents clinical experience in the formation of anastomoses between the organs of gastrointestinal tract for the treatment of 96 patients with various pathologies of digestive organs. 116 compression anastomoses were applied in our clinic. Anastomotic dehiscence was found in three cases (2,6%) which are described in details in the article. In all patients, the devices evacuated from the digestive tract in a natural way for 14 days. Fibrotic scope examination performed after an operation showed that created anastomoses corresponded to the dimensions of used structures. A soft scar by primary healing type was formed on the parts with compression anastomosis. Using titanium nickelide devices for the formation of compression anastomoses between the gastrointestinal organs will improve the quality of fistula formation, reduce mortality and postoperative complications.

Purpose of the study was to assess the impact of the COVID-19 pandemic on the direct work of the surgical service providing specialized care for patients with lung cancer.

Material and methods. The study is based on the results of work for the period 2020–2021 of two departments providing basic surgical care for patients with lung cancer in the Tomsk Region. The impact of the spread of the virus in the region on the number of operations performed for lung cancer were assessed. In the postoperative period, the number and nature of common and associated with infection with COVID-19 complications were analyzed, both in a hospital setting and after discharge.

Results. A decrease in the number of patients with lung cancer treated during a pandemic was noted, and a tendency for a decrease in the number of operations up to a complete cessation of work during periods of an increase in the spread of the virus was indicated. Infectious complications associated with infection with COVID-19 after surgical treatment of lung cancer were confirmed in 11 patients, of whom bilateral pneumonia developed in 9 cases (81.8%), mortality in 3 (27.3%) cases.

Conclusion. The outbreak of the COVID-19 pandemic has led to a decrease in the volume of surgical care for all localizations of neoplasms, including lung cancer. Infection of a patient at different times after surgical treatment is accompanied by an extremely high risk of developing viral pneumonia and death.

Methods of surgical intervention in acute intestinal obstruction with necrosis of the strangulated area of the intestine are the subject of ongoing discussions. There is no doubt that every patient with this disease should undergo emergency surgery. However, diagnosing necrosis of the strangulated area is not easy. For this reason, a number of authors recommend refraining from emergency surgery for all patients with intestinal obstruction during dynamic follow-up, which can last up to 14 days. Over the past century, the etiology of intestinal obstruction has shifted from strangulated hernia to postoperative adhesive disease, which has led to a paradigm shift in methodological approaches. In order to successfully manage acute intestinal obstruction with suspected strangulation, the clinician today must be able to distinguish between patients requiring urgent surgery and those who should receive conservative therapy.

In this paper, we consider the surgical approach of delayed anastomosis formation on significant clinical material, including tactical approaches, timing and necessary conditions for anastomosis formation in patients with intestinal obstruction complicated by necrosis of the strangulated area.

The complex of therapeutic measures in the treatment of patients with acute intestinal obstruction complicated by necrosis of the strangulated area of the intestine, intraoperative perforation of the intestine during separation of adhesions, both in conditions of peritonitis and without it, should include obstructive resection of the intestine in combination with the formation of an anastomosis in a delayed order, as well as or planned sanitation of the abdominal cavity. All this makes it possible to reduce the incidence of interintestinal anastomosis failure from 86.7 to 0.96% of cases, and postoperative mortality from 41.8 to 14.4%.

Peripheral pulmonary nodules are one of the most common forms of lung lesions that are detected on screening computed tomography. Verification of these lesions is a key task for the early diagnosis of lung cancer. The review paper discusses modern endobronchial methods used to verify lung nudules. The PubMed system of the US National Library of Medicine was used as a search for available literature.

A combination of the words: bronchoscopy and pulmonary nodule was used as keywords to search for the necessary information and sources. Despite all the technologies being developed, designed to increase the information content of bronchoscopic techniques in the diagnosis of peripheral pulmonary nodules, their diagnostic significance extends within 70–80%. However, standard bronchoscopic technologies, which have been used since the second half of the 20th century, allow a sensitivity of 63% to be achieved.