Objective. Damage to peripheral nerves has a strong impact on the life of patients, as the absence during the care provided can lead to disability. It is important to determine the prognostic factors that affect the outcome of the disease.

Material and methods. During the initial selection, 1902 publications (PubMed) and 675 results were found using the Google Scholar database. From the initially identified search results, an analysis of 5 papers was carried out.

Results. The total number of patients with peripheral nerve injuries of the upper extremities was 120. The average age of patients is (9.1 ± 1.5) years old. The conducted meta-analysis of the difference in the average values of recovery of motor function of peripheral nerves after surgery showed: the final increase in the recovery rate of motor function, depending on age, was 0.47 (0.08–0.87) %, p < 0.02; the final increase in the recovery rate of motor function, depending on the level of damage, was 0.71 (0.27–1.13) %, p < 0.02.

Conclusion. The obtained results showed the prognostic value of such indicators as age at the time of surgery and the level of damage. Thus, we can confidently say that the smaller the age of the child and the more distal the level of damage, the better results can be expected after surgery. 

Purpose of the study: a comparison of various vaginoplasty techniques and results in patients with transsexualism based on the analysis of data from the world scientific literature.

Material and methods. The seeking of published research results placed in open databases by keywords. A total of 391 articles were initially analyzed of which 33 have met our acceptability criteria. A total of 3716 cases were analyzed where patients have undergone penile inversion, flap surgery (scrotal flap, free flap, rotational flap), endoscopic method and other modifications of vaginoplasty. The method includes comparing of the presented surgery techniques, their functional and aesthetic results, and complications rate.

Results. Due to the involvement of different criteria for the results of surgical treatment evaluation by different scientific teams, as well as the insufficient number of objective studies on some methods, it is difficult to match the methods, their outcome, and complications. However, based on the described experience of practitioners and researchers, it can be concluded that the penile inversion technique is the most examined one and has a stable and appropriate results. Laparoscopic methods are equally effective but have a few specificities. The scrotal flap seems to be the most promising method that meets all the criteria for vaginoplasty in transsexuals. Free flaps or the rotational flaps usage has historical importance and could be used in certain circumstances.

Conclusion. Various surgical techniques have demonstrated the safety and reliability of vaginoplasty in MtoF patients providing the low number of complications and a significant improvement in the patient's quality of life. Studies using different methods in a similar population and standardized results obtained from patients are required to further analyze the results of various methods to highlight the main principles for use in practice.

Purpose of the study: to evaluate the effectiveness of early laser treatment of various types of local complications after surgical blepharoplasty based on the dynamics of the clinical picture and outcome, as well as patient satisfaction indicators according to FACE-Q.

Material and methods. The study involved 24 patients with various types of local postoperative complications: scars with a tendency to hypertrophic growth (5 cases), inversion of the lower eyelid (4), seroma with undetected ligature fragments (2), aseptic inflammation of soft tissues of unknown genesis (2), neoangiogenesis in the eyelid area (3), extensive hemorrhages in the surgical intervention area (8 cases). Treatment was started on the day of the patient's treatment when the fact of the complication was established. The treatment was performed using the MultilineTM laser multiplatform using the Nd:YAP/KTP vascular laser with a combination of two wavelengths of 540 and 1079 nm and/or the Er:YAG, 2940 nm laser with SMA technology. The choice of the type of laser radiation and the interval between sessions were determined by the nature of the complication. Patients' satisfaction with the results of treatment was determined by the FACE-Q questionnaire.

Results. The results of treatment by evaluators were determined as excellent in 19 patients (79.2%) and good in 5 patients (20.8%). The outcome of the resolution of complications in all patients was a thin, flat, inconspicuous scar, persistent defects requiring additional correction were not observed. During 6 months of follow-up, the dynamics of FACE-Q indicators after laser treatment of complications showed a statistically significant improvement on all assessed scales: the general appearance of the eye, the outcome of the operation performed, the severity of side effects, psychological stress, social adaptation.

Conclusion. Laser treatment of postoperative complications of blepharoplasty allows improving the aesthetic result of the operation and restoring the psychoemotional state of the patient.

The paper describes the indications for the use of buccinator flaps, the surgical technique, the postoperative period of patient management, the effectiveness of the secondary surgical procedure in cleft palate patients.

The objective of our study is to introduce practical doctor to compression neuropathy of the peroneal nerve in the peroneal tunnel and prove the need for timely detection and referral of patients with fibular neuropathy, if there are indications, for surgical treatment. We have considered examples of modern diagnostics and treatment of entrapment neuropathy of the peroneal nerve in the peroneal tunnel, moreover, we presented clinical cases. In the period of 2011–2022 29 patients (19 women and 10 men) with entarpment neuropathy of the peroneal nerve were examined on the base of the Clinical and Diagnostic Center of the I. Kant Baltic Federal University (Kaliningrad, Russia) and the Department of Traumatology and Orthopedics, Kaliningrad Regional Clinical Hospital (Kaliningrad, Russia). Ultrasonography was performed on a APLIO 500 company Tochiba (Japan) sensor Canon PLT 1204 BT 38 mm (5–18 MHz) and convex sensor CANONPVT-375 SC (1.5–6.0 MHz), as well as on the device ACUSON S 2000 Siemens (USA) with sensor 18L6 HD (5.5–18.0 MHz). Electromyography (EMG) was performed on the VIASYS Healthcare Neurocare (USA). The age of the patients ranged from 18 to 78 years old. All patients have been decompression, revision, neurolysis (5 endoneurolysis) of the peroneal nerve in the peroneal tunnel. 26 patients has excellent results, 2 patient has good, 1 patient has poor results of treatment.

Objective: the purpose of the study was to evaluate the effects of three forms of allogeneic platelet concentrates on segmental tubular bone defect osseous regeneration.

Material and Methods. In 145 laboratory rats tibial shaft segment was resected and stable osteosynthesis of the bone ends was performed. In group 1 animals the bone defect was left graftless, in group 2 animals biomaterial Collapan and shattered orthotopic autologous bone mixture into the bone defect site was placed. In group 3 animals as part of Collapan-autobone mixture defect filling fresh allogeneic platelet rich plasma was added, in group 4 animals allogeneic cryodestructed platelet rich plasma to the Collapan-bone mixture was added and group 5 animals received Collapan-bone mixture with allogeneic platelet rich fibrin added.

Results. According to gross dissection data in 23 of the 32 group 3 rats, in 25 of the 37 group 4 rats and in 19 of the 27 group 5 rats complete visual tibial shaft defect healing occurred. In group 2 on visual inspection of tibial bone in 5 of the 10 rats defect healing was noted and in group 1 rats the defect healed in 15 of the 39 animals only. Bone defect healing rates in groups 3, 4 and 5 differed from group 1 healing rate significantly with χ² = 7,889, χ² = 6,452 and χ² = 6,504 respectively, group 2 bone defect healing rate did not differ from that of group 1 (χ² = 0,439). Histological analysis of specimens from groups 3, 5 and especially from group 4, at 3 weeks after plasty demonstrated active intermediary callus formation at bonesaw-line and neoformed osteoid bone on Collapan-bone chips aggregations surfaces; no intermediary callus formation in specimens from group 2 was found. At 6 to 12 weeks after plasty the most mature osseous tissue in specimens from group 4 was observed, the least mature neoformed osseous tissue amount was common to specimens from group 2.

Conclusion. All three allogeneic Collapan-immobilized platelet concentrates studied promoted bone formation and healing of considerable segmental tibial shaft bone defect in rat model. The most evident osteogenesis activating effect was histologically confirmed in cases where cryodestructed platelet rich plasma to Collapan-bone chips mixture was added.

Objective. Arthritis of the wrist joint can cause significant pain and decreased motion, resulting in a significant impact on quality of life. Total wrist Arthroplasty can provide pain relief and motion in these patients. Ceramic implants can be used in arthroplasty, but their longer-term performance in the wrist remains unknown. The purpose of the study was to review outcomes utilizing a ceramic total wrist arthroplasty.

Material and Methods. А consistent ceramic arthroplasty technique and postoperative regimen was performed. The number of observations subjected to preoperative analysis at Novosibirsk Research Institute for Traumatology and Orthopedics is 63. The results of the study and the nature of the changes determine the indications for wrist arthroplasty. The average observation period was 8 years. Medium-term results were evaluated in 35 patients operated on between 2010 and 2017. The article evaluated three main time points: before the operational intervention, 2017 and 2019. Comparable results of objective and subjective evaluation of the intervention are indicated. X-ray methods and questionnaires were used to analyze the material: the Visual Analogue Pain Syndrome Scale (VAS), the Mayo Clinic Wrist Function Scale (MWS), and the Disability of the Arm, Shoulder and Hand (DASH). All patients underwent total wrist arthroplasty with ceramic endoprosthesis. In one patient, total arthroplasty of both wrists were performed, which corresponds to two clinical cases, in all other cases surgical treatment was carried out on one wrist joint.

Results. At the preoperative stage, according to the DASH scale, the result was from 15.8 to 86.2 points, the median was 69.2 (56.2; 76.5) points. Performance characteristics and subjective sensations in the joint according to the MWS questionnaire ranged from 0 to 70, median 30 (15; 45) points. The assessment of the initial state of patients according to the Mayo clinic scale corresponded to very poor results of adaptation and functional activity. The value of the pain scale had indicators from 0 to 10 points, the median was 7 (5; 8) points.

In 2017 (second time point), the mean VAS pain score decreased by 2.35 times (by 3.9 points, p < 0.0001), the mean DASH score decreased by 2.64 times (by 40.9 points, p < 0.0001), the average score of the MWS questionnaire increased 1.84 times (by 25.4 points, p < 0.0001). In 2019 (third time point), the average pain syndrome score on the VAS scale decreased by 2.19 times (by 3.7 points, p < 0.0001) compared to the first point; the average score on the DASH scale decreased by 2.25 times (by 36.6 points, p < 0.0001) compared to the first point; the mean score of the MWS questionnaire increased by 1.99 times (by 29.8 points, p < 0.0001) compared to the first point.

Conclusions. 1. In the vast majority of cases, there is an increase in the volume of movements in the wrist joint compared to the original condition. 2. According to the results of a midterm study, stability and positive dynamics are noted. 3. Pain syndrome decreases or disappears completely. 4. Preservation of physiological mobility of bones of distal row of wrist contributes to redistribution of force action (damping) and stabilization of components in long period of time. 5. We divide the postoperative period for orthopedic pathology into the nearest (in the hospital), early (up to 2 years), medium-term (2-8 years) and long-term (more than 8 years).

The paper describes the technology of installing breast implants in the subpectoral cellular space while maintaining the attachment of the abdominal part of the pectoralis major muscle and evaluate the results of its application. A retrospective analysis of the results of primary breast augmentation in 762 patients operated by the authors in 2010–2020 was carried out.

The space for the breast implant was formed following a certain sequence of actions. The boundaries of the receptacle were: inside – the place of attachment of the pectoralis major muscle to the sternum, outside – the abdominal part of the pectoralis major muscle and the pectoral fascia, passing to the bundles of the anterior serratus muscle, at the top – thoracoacromial vascular bundle, below – VI rib and fascial node, formed by the transition of the thoracic fascia and the aponeurosis of the abdominal part of the pectoralis major muscle to the anterior wall of the sheath of the rectus abdominis muscle. Conclusions. 1. The technology of installing implants in the subpectoral cellular space, while maintaining the distal attachment of its abdominal part, allows achieving the stability of the position of the implants and avoiding rotation and malposition of the implants. 2. In terms of up to 3–4 months after surgery, a higher location of implants on the chest is often observed. 3. The decision on the need and degree of mobilization of the abdominal part of the pectoralis major muscle should be made individually. 4. The technique cannot be used when the width of the implant base exceeds the width of the pectoralis major muscle at the level of the IV rib, and, therefore, limits the choice of larger implants.

The purpose of this study was to determine the role of cardioesophageal lipoma in the development of hiatal hernia in patients after bariatric surgery.

Material and methods. The research involved three groups of patients: patients with obesity without a hiatal hernia, who subsequently underwent a sleeve gastrectomy (1st group, 54 people); patients with normal body mass index (BMI) and diagnosed hiatal hernia (2nd group, 56 people); patients with normal BMI without hiatal hernia (3nd group, 60 people). The assessment of the area of visceral fat and cardioesophageal lipoma was determined according to the MSCT data of the abdomen. Patients completed a questionnaire using the GERD-HRQL, patients of 1st group (after bariatric surgery) completed a questionnaire using the BAROS.

Results and discussion. We noted a higher incidence of cardioesophageal lipoma in obese patients (70.4%). In obese patients after a bariatric procedure, along with a decrease in BMI, not only the area of internal visceral fat, but also the area of cardioesophageal lipoma significantly decreases, which led to the formation of hiatal hernia in 68.75% of patients.

Conclusion. The data obtained indicate a high incidence of cardioesophageal lipoma in obese patients. Cardioesophageal lipoma is an important pathogenetic link in the development of hiatal hernia, and, as a result of gastroesophageal reflux, in bariatric patients in the late postoperative period.

Based on the analysis of domestic and foreign literature in the context of comparative effectiveness, the characteristics of the methods for creating an artificial sphincter during colostomy are presented. Various methods of colostomy formation are highlighted. Currently more than 200 methods and modifications of colostomy are known each of which has advantages and disadvantages and therefore cannot be considered ideal. In addition, there is the problem of maintenance of the colostomy associated with the constant functioning of the intestine and accordingly the release of contents. Therefore the search for a solution to the issue of preventing complications of terminal colostomy and improving the technique of forming an artificial anus is a very urgent and far from solved problem of operative coloproctology.

Purpose of the study: to conduct a comparative analysis of endoscopic retrograde transpapillary interventions in patients with chronic opisthorchiasis and obstructive jaundice of various etiologies.

Material and Methods. The results of treatment of 129 patients with chronic opisthorchiasis and obstructive jaundice of various etiologies who underwent transpapillary interventions to correct bile duct, were analyzed. In order to assess the condition of patients, general clinical methods and a set of laboratory and instrumental methods were used. The study was carried out in two groups, in the first endoscopic drainage of the bile ducts was carried out, in the second – either endoscopic papillosphincterotomy with choledocholitholite extraction, or endoscopic papillosphincterotomy with bougienage of the ducts. Each group of patients was divided into subgroups according to nosology: 1 – diseases of the biliary tract; 2 – oncological diseases of the hepatopancreatic zone; 3 – pancreatitis. Laboratory indicators before and after the application of minimally invasive interventions were compared.

Results. The use of various methods of transpapillary interventions normalizes indicators of bilirubin, and aminotransferases in patients by 5–10 days. Endoscopic stenting of the ducts was the method of choice with cancers of the parasitic organs. With concomitant choledocholithiasis, the endoscopic papillosphincterotomy technique with subsequent lithotripsy and lithoextraction were used. Draining operations showed a good efficacy in the treatment of jaundice in the case of impossibility of removing the calculus. Endoscopic papillosphincterotomy with ductal bougienage was the operation of choice for streak tours of the common bile duct. With purulent cholangitis, endoscopic papillotomy with the installation of nasobiliary drainage and subsequent sanitation of the bile ducts was used.

Conclusion. The use of endoscopic drainage has proven itself well in patients with obstructive jaundice of tumor etiology, as well as in patients with choledocholithiasis when it is impossible to remove the calculus. This surgery allows for quick normalization of the bilirubin level.

Purpose of the study: to study the efficacy and safety of the intravenous form of ibuprofen “Intrafen” 800 mg in patients after mammoplasty.

Material and methods. The use of intravenous ibuprofen “Intrafen” 800 mg on the day of surgery for 200.0 0.9% sodium chloride solution and the next day in 27 patients of the main group after mammoplasty at the Clinic of Plastic Surgery DR. SABAZBEKOV" (Almaty, the Republic of Kazakhstan). The inclusion criterion was informed consent to mammoplasty and the absence of contraindications to the administration of Intrafen according to the instructions. The control group also consisted of 27 patients who underwent mammoplasty; as non-steroidal antiinflammatory drugs, they were prescribed a solution of ketoprofen 100 mg/day intramuscularly once.

Result and discussion. The following types of plastic surgery on the mammary glands were performed: augmentation mammoplasty – 8 (29.6%), reduction mammoplasty – 10 (37.0%) and isolated mastopexy – 9 (33.4%). The intensity of pain on the VAS scale on the day of surgery was (4.5 ± 0.5) points, on the 1st day the relief was up to (1.4 ± 0.5) points. Hemodynamic parameters within 1 day were within normal limits: systolic blood pressure (113.9 ± 7.0) mm Hg, diastolic blood pressure (73.2 ± 6.47) mm Hg, heart rate (79.1 ± 4,9) beats per minute, saturation (99.6 ± 0.68) %. No gastrointestinal disturbances were found in the control group. The intensity of pain syndrome after surgery was (8.4 ± 1.3) points according to the VAS, which required the administration of an opioid solution of tramadol hydrochloride 100 mg/day and on the day of discharge the VAS was (4.1 ± 0.75) points, followed by the appointment of a solution of ketoprofen 100 mg/day once.

Conclusion. The intravenous form of ibuprofen “Intrafen” 800 mg once a day of surgery and then 1600 mg/day during the day is effective for relieving pain in patients after mammoplasty and is safe due to the absence of adverse events from the gastrointestinal tract and stable hemodynamics.

The paper was prepared according to archival and published documents, the study and systematization of which made it possible to find out how the monument was installed and then lost on the grave of the outstanding professor E.G. Salishchev at the cemetery of the Ioanno-Predtechensky (John the Baptist) Tomsk Convent in Tomsk. According to the materials of the newspaper “Sibirskaya zhizn'” (“Siberian Life”) it was revealed that Professor E.G. Salishchev, who died in June 1901, was buried in the professorial section of the monastery cemetery. Two years after the funeral, a monument made in St. Petersburg was erected on his grave. The newspaper “Sibirskaya zhizn'” published a photograph of the monument, taken on the day of its consecration on November 10, 1903. The newspaper report and the inscription on the monument, copied in 1910 by the abbess of the convent Zinaida (Kotelnikova), provide reliable information about the tombstone. Subsequently, this information was distorted, and the monument was destroyed. After the revolutions of 1917, anti-church sentiments were whipped up in society, liturgical churches were closed, and clergy and parishioners were persecuted. In 1920 the nunnery in Tomsk was closed, in 1927 burials at the monastery cemetery were prohibited. In the same year, the buildings of the monastery were transferred to the Siberian Technological Institute (modern Tomsk Polytechnic University) for student hostels. And in 1930, under the pretext that the campus, located in a former convent, needed “places for walking”, the Tomsk City Council decided to liquidate the cemetery and use gravestones as building material. Attempts by the head of the Tomsk Regional Museum M.B. Shatilov to save the professorial section of the monastery cemetery from destruction were unsuccessful. In the mid 1950s on the cemetery site, construction began on a 4-storey residential building (modern Uchebnaya st., 42). In the course of work on the paper, it turned out that along with reliable information about the monastery cemetery and the monument on the grave of E.G. Salishchev, there are quite a lot of distortions. The most important of them is the decision of the executive committee of the Tomsk Regional Council of Working People's Deputies dated July 25, 1961 No. 242 “On the further improvement of the protection of cultural monuments in the region”. In the appendix to this document, in addition to all other information, “the grave of the famous Russian scientist surgeon Prof. E.G. Salishchev. Location – campus of the Tomsk Polytechnic Institute. Unverified and unconfirmed data on the burial of Salishchev at the long-destroyed monastery cemetery were included in 2017 in the unified state register of objects of cultural heritage of the peoples of the Russian Federation, and even the address of the nonexistent monument was indicated: 39/2, Vershinin st., Tomsk. It was found out that the chapel in the name of St. Domna Tomskaya is located at this address. Completing the search for a grave monument, the authors of the paper express confidence that the memory of the surgeon E.G. Salishchev will survive all the losses and distortions and will be eternal.