Overweight and imbalance of the intestinal microbiota are risk factors for disruption of reparative processes during the healing of postoperative wounds. Given the scale of the obesity epidemic in the modern world, the number of overweight patients undergoing surgery for various reasons is also increasing. Potentiation of the risk of a delayed and complicated course of the wound process with a combination of obesity and disturbances in the composition of the intestinal microbiota determines the relevance of this study.

Purpose of the study: to study the composition of the intestinal microbiota in patients with overweight and obesity, who have a slowdown in the course of the wound process and the development of complications in the postoperative period.

Material and methods. The composition of the intestinal parietal microbiota was studied by microbial markers in the blood using gas chromatography in 49 overweight women who underwent planned surgical interventions for aesthetic indications aimed at correcting body contours from 2019 to 2020. After surgery, women were followed up for 6 months, assessing the timing of wound healing. A comparative analysis of the composition of the intestinal microbiota was carried out in different courses of the wound process, the prognostic significance of individual indicators of the intestinal microbiota was studied in relation to the risk of delayed and complicated wound healing.

Results. In the postoperative period, three groups were formed: 1st − complicated wound process (n = 21), 2nd − slow wound process 16 (n = 16), 3rd − standard wound process (n = 12). There were statistically significant differences between the 1st and 2nd groups in terms of “Peptostreptococcus anaerobius (Gr 1) ≥ 562.0 · 105 cells/g”, p = 0.025) and “Propionibacterium ≥3.2 · 105 cells/g”, p = 0.0136). Differences were found between the 1st and 3rd groups in terms of “Endotoxin ≥0.7 nmol/ml”, p = 0.051). The highest risk of complicated and delayed postoperative wound healing is observed when the value of the indicators «Propionibacterium ≥32.0 · 105 cells/g”, “Peptostreptococcus anaerobius (Gr 1) ≥7.0 · 105 cells/g” and “Endotoxin ≥0.7 nmol/ml”. On the basis of the decision tree method, 4 risk classes of a delayed and complicated course of the wound process were identified. The highest risk is in patients with a combination of factors “Propionibacterium ≥ 3.2 · 105 cells/g” and “Endotoxin ≥ 0.7 nmol/ml”.

Conclusion. A number of indicators of intestinal microbiota have a high prognostic value in relation to the risk of developing a complicated and delayed course of the wound process in overweight individuals. The data obtained can be used to predict unfavorable healing of surgical wounds. 

А review of domestic and foreign literature on compression methods for the formation of colonic anastomoses is presented in the paper.

Despite advances in the improvement of the manual suture of the colon, the frequency of postoperative complications remains high – 68.7%, while mortality ranges from 1% to 26%. Thus, it was not possible to achieve the absolute reliability of the traditional manual suture in the formation of colonic anastomoses.

Compression anastomosis has an advantage over manual. When forming an anastomosis using a compression method, a decrease in time was noted, ease of creating an anastomosis, a significant decrease in postoperative complications and a high quality of the formed anastomoses, confirmed by morphological studies. 

Purpose of the study: to improving the effectiveness of rehabilitation of patients with mandibular defects of various etiologies based on the development and application of new medical technologies using shape memory materials.

Material and methods. Using medical materials developed at the Research Institute of Medical Materials and Shape Memory Implants at the Siberian Institute of Physics and Technology named after Academician V.D. Kuznetsov, National Research Tomsk State University (Tomsk, Russia) of mandibular endoprostheses made taking into account the individual characteristics of defects, on the basis of porous, nonporous and textile titanium nickelide, surgical treatment of 72 patients aged 7 to 76 years, with pathology of the temporomandibular joint, inflammatory changes, traumatic injuries, tumor and tumor-like conditions, anomalies of the mandibular bone from intraoral or extraoral accesses without immobilization of the lower jaw with the use of fixing structures in the form of titanium nickelide staples with shape memory effect.

Results. The use of titanium nickelide-based endoprostheses in the surgical removal of mandibular defects of various sizes, configurations and etiology to obtain satisfactory results in all operated patients. 64 (88.9%) patients received primary wound healing, in 6 cases the wounds healed a second time, 3 patients are required repeated arthroplasty.

Conclusion. Due to the biocompatibility of titanium nickelide with body tissues, individual mandibular endoprostheses based on it, after being placed in the defect zone, function for a long time in the body, ensuring full restoration of the functional capabilities of the dental apparatus and minimizing all types of complications inherent in this type of intervention. 

Purpose of the study: to assess the patho-histological changes in the intact pancreas and parietal peritoneum against the background of the directed ozone gas flow.

Material and methods. The prospective study was conducted in 54 adult male Wistar rats. In 1st and 2nd groups (n = 24, each) the left pancreatic lobe and parietal peritoneum, respectively, was treated with a 40 mg/L ozone gas stream at a rate of 2 L/min for 1.5 minutes. 1, 3, 30 and 120 days after the first operation 6 animals of each groups were sacrificed and tissue specimens were collected for histological analysis. In the control group (6 sham operated animals), tissue samples were collected 120 days after laparotomy.

Results. A day after treatment with ozone gas stream, the pancreatic specimens of 1st group differed from the control in moderate and mild perivascular infiltration and edema. In the period from 3 to 120 days after exposure, the pancreatic specimens of 1st group and control did not differ significantly. Specimens of 2nd group differed from the control degree of edema and infiltration in the first 3 days, the level of proliferation of fibroblast-like cells and fibrosis in 120 days after treatment of the parietal peritoneum with a directed ozone gas stream.

Conclusion. Local use of the directed ozone gas flow at a concentration of 40 mg/L at a rate of 2 L/min is accompanied by the same type of patho-histological changes from the intact pancreas and parietal peritoneum in the form of mild to moderate edema, perivascular polymorphic cell infiltration in the early period after exposure. Late parietal peritoneum reaction (moderate events fibroblast-like cell proliferation and fibrosis) requires additional safety studies of intraabdominal use of ozone-oxygen mixture. 

Myositis ossificans occurs extremely rare in the wrist and hand. Its clinical manifestations and prognosis differ significantly in comparison to the classical localizations on the thigh or shoulder. It is difficult to diagnose this kind of disease during the early stages of the pathological process. The article presents a clinical case of successful treatment of a patient with myositis ossificans of the lumbricals of the hand. Myositis ossificans in our case is shown not just through local symptoms, but also by clinical neuropathy in the median nerve. A review of the available literature on this topic over the past 40 years is presented.

Purpose of the study: to develop of method for prediction of development of purulent-necrotic complications in amputation stump of the hip.

Material and methods. 90 disease histories of patients of both sexes were analyzed, aged 40–91 years old (mean age 65 (40; 91)), admitted to the hospital with a diagnosis of obliterating atherosclerosis of the vessels of the lower extremities, critical ischemia or gangrene of the foot. Patients were divided into two clinical groups: 1st group - 69 (76.7%) patients with a favorable course of the postoperative period; and 2nd group – 21 patients (23.3%) with a complicated postoperative period of infection of the thigh stump wound.

Results. The original method developed includes the determination of the following risk factors: the systemic nature of atherosclerotic vascular damage; amputation at the level of the upper third of the hip; emergency surgery; hematoma in the early postoperative period; prothrombin time; INR; a quick prothrombin test: when receiving the sum of points 16 and more, a high risk of development is predicted, with the sum of points from 13 to 15 – moderate risk; and with a score of less than 12 – low risk of developing purulent-necrotic complications in amputation stump of the hip.

Conclusion. Proposed method allows to objectively and quickly determine development of purulent-necrotic complications in amputation stump of hip, which further allows to correct starting therapy and in cases of high risk of development of complications, to prescribe enhanced antibacterial and detoxification therapy. 

A huge contribution to the development of modern lymphology belongs to the great Soviet scientist Professor Dimitry Arkadyevich Zhdanov. He performed an active scientific and educational work, which was frequently review in different journals. In particular, the work of D.A. Zhdanov in Moscow and Leningrad were the subject of several publications. At the same time, the Tomsk period of the life of Dimitry Arkadievich did not receive wide coverage in the literature. In this paper, the authors study the results of D.A. Zhdanov’s work in Tomsk as director of the Tomsk Medical Institute named after V.M. Molotov, scientific progress of his students and their influence on development of lymphology.