The article presents information about the III International Forum on Surgery of Modern Armed Conflicts “Gunshot Wound. Surgery of Injuries”, which took place in November 2024 in Moscow, Russia.

The article presents a comparative analysis of existing aesthetic methods for augmenting the chin area. An assessment of the risks of postoperative complications was conducted. It was found that chin augmentation using a subplatysmal autologous fat graft is a minimally invasive, safe, predictable, and long-lasting method that works well in combination with other facial rejuvenation procedures.

The purpose of a study: to evaluate the effectiveness of a three-stage algorithm in performing reconstructive procedures in patients with acquired head defects in the postoperative period.

Material and methods. An analysis of patient management in the postoperative period was conducted in 180 patients. Patients were divided into two groups: the main group (100 patients, including 67 men and 33 women) and the control group (80 patients: 62 men and 18 women). The average age in the main group was 47 ± 13, in the control group –(45 ± 12) years old. The surgery in the main group was carried out using a three-stage algorithm and the Autoplan software (state contract of the Ministry of Industry and Trade of the Russian Federation dated 07.04.2014 No. 14411.2049999.19.013 “4.3- Avtoplan-2014”), in the control group – based on generally accepted principles. A comparison was made of the number of postoperative complications, the degree of congruence of the flaps and the recipient wound, and the severity of lymphatic edema as a consequence of trauma to the donor area.

Results. Complications: total flap necrosis – were noted in 8 cases (8%) in the main group and in 10 (12.5%) in the control group; from the recipient wound – in 22 (22%) and 30 cases (37.5%), respectively. In the main group, 14 scapular flaps were used, the average deviation of the bone structures of the flap and the recipient area was (3.2 ± 2.7) mm. When using 42 fibular flaps, the average deviation of the flap and recipient tissues was (2.5 ± 1.1) mm. In the control group, 12 scapular flaps were used, while the average deviation of the structures (6.10 ± 1.66) mm. Among 31 fibular flaps, the average deviation of bone structures was (4.40 ± 1.14) mm. Radial and ALT flaps were not accompanied by the appearance of persistent lymphatic edema of the limb 12 months after surgery, in contrast to the use of the fibular flap.

Conclusion. The use of a three-stage algorithm for performing surgical treatment allows us to reduce the number of postoperative complications and achieve better results in matching the bone structures of the flap and the recipient area, leading to better patient rehabilitation results.

The purpose of the study: to analyze and systematize the most common complications of rhinoplasty based on the literature data.

Material and methods. Scientific articles in the databases PubMed, eLibrary, Scopus, Medscape, Cyberleninka were analyzed. The following terms were used in search queries: “rhinoplasty”, “septoplasty”, “rhinoplasty complications”, “rhinoplasty outcomes”, “airflow assessment”, “septoplasty complications”, “secondary rhinoplasty”, “rhinoplasty outcomes classification”, “functional rhinoplasty complications”, “nasal surgery outcomes”. The data of 88 foreign and 3 domestic articles on the topic under consideration were selected.

Results. Based on a review of the literature on the topic under study, it was found that the side effects that occur during the correction of deformities of the external nose are classified according to the time of their occurrence: during surgery, in the immediate postoperative period and in the long-term period after surgery. Their occurrence may be due to various factors, including mistakes made during surgery, reaction to anesthesia, exacerbation of chronic diseases during surgery, or inadequate postoperative care.

According to various estimates, the overall complication rate during surgery reaches 25%. Long-term effects of classical rhinoplasty are observed in 2–10% of cases. The most common complications include: persistent difficulty in nasal breathing, bleeding, septal hematoma, perforation of the nasal septum, formation of adhesions in the nasal cavity, infectious complications and aesthetic defects.

There are no major studies in the Russian literature devoted to a systematic description of the most common complications of rhinoplasty.

Conclusion. The steady increase in the number of operations aimed at correcting the external nose requires further study of the structure of possible complications, the surgical methods used and the materials used to reduce the number of revision interventions.

The purpose of this work was to study the use of platelet-rich fibrin in the treatment of patients with inflammatory diseases of the maxillofacial area.

Due to the lack of a tendency to reduce morbidity and mortality in this group of patients, the problem of their treatment remains one of the most pressing to date. Treatment of wounds resulting from surgical debridement of a purulent-septic focus in the purification and proliferation phase involves the use of various means and techniques aimed at stimulating regeneration. The particular interest is the use of platelet concentrates (autologous platelet rich plasma and platelet-rich fibrin obtained from it). According to most literary sources, platelet-rich fibrin in dentistry and maxillofacial surgery is used primarily in dental implantology. Significantly fewer publications are devoted to the use of platelet-rich fibrin in the treatment of patients with inflammatory diseases of the lower jaw. The use of platelet-rich fibrin in the treatment of patients with inflammatory diseases of the soft tissues of the maxillofacial area and neck has so far remained outside the field of view of researchers and requires further study.

Purpose of the study was to experimentally study the possibility of the effect of lymphotropic antibiotic therapy and regional stimulation of lymphatic drainage on the healing of a gunshot wound of an extremity.

Material and methods. Experimental studies were carried out on 50 rabbits, in which, by using light and electron microscopy, as well as studying the pharmacokinetics of gentamicin, morphological changes in tissues and the lymphatic bed were studied, as well as the pharmacodynamics of the antibiotic in lymphotropic (main group, 25 animals) and traditional (control group, 25 animals,) treatment limbs.

Results. Studies have shown that the lymphatic system undergoes significant changes during gunshot wounds, with the development of insufficiency of lymphatic drainage of the tissues of the affected limb, accumulation of edematous fluid, dysmetabolic products and microbes in the interstitium. With traditional methods of antibiotic therapy, already 6 hours after a single injection, the soft tissues and regional lymph nodes of the affected limb contain only “traces” of the antibiotic. Lymphotropic antibiotic therapy and lymphostimulation contribute to a significant reduction in edema, inflammation and acceleration of tissue regeneration, as well as prolonged (up to 24 hours) accumulation of therapeutic concentrations of the antibiotic in the tissues under study (p < 0.05 when compared with intramuscular administration).

Conclusion. Lymphotropic therapy, when compared with traditional treatment, accelerates the healing, helps reduce edema, enhance the resorption of necrotic masses, foreign particles and microbes, early restoration of muscle fibers in the area of commotion, and more physiological remodeling of the wound defect. The use of lymphotropic therapy in the clinic will allow the successful use of primary surgical treatment with the application of primary sutures and early reconstructive plastic surgery, as well as reduce the likelihood of developing a surgical infection.

The purpose of a study was to compare the blepharoplasty methods of pretarsal (Asian eyelid blepharoplasty) and sub-brow approaches in patients of the Asian ethnic group based on the analysis the surgical correction results of age-related upper eyelids changes.

Material and methods. The prospective clinical study included 133 mongoloid race people aged 45 to 71 years in the period up 2019 to 2024. The study participants were randomly divided into two groups. The 1st group (72 people) underwent age-related Asian blepharoplasty using a pretarsal approach, the 2nd group (61 people) underwent blepharoplasty using a sub-brow approach. The validated FACE-Q Satisfaction with Eyes questionnaire was used to assess the treatment results before, 3 and 6 months after blepharoplasty.

Results. Comparison of preoperative groups with blepharoplasty did not reveal statistically significant differences in satisfaction with eye appearance (p = 0.089). After blepharoplasty, we were unable to find differences between the study groups when assessing the degree of satisfaction with the appearance of the eyes after 3 months (92 (92–100) in patients of the 1st group and 92 (92–100) in patients of the 2nd group, p = 0.192). The score 6 months after blepharoplasty was statistically significantly higher in patients of 2nd group than in study participants from 1st group 100 (92–100), 96 (92–100) points, respectively, p = 0.027).

No complications such as postoperative brow ptosis or recurrence of lateral blepharochalasis were observed performing blepharoplasty using a sub-brow approach (group 2). This fact indicates that the risk of these complications is minimized.

Conclusion. Blepharoplasty using a sub-brow approach is a promising method of surgical correction of agerelated upper eyelids changes in patients of the Asian ethnic group, showing comparable effectiveness in comparison with age-related blepharoplasty of Asian eyelids. Using myo-periosteal fixation, this technique gives fewer complications in the form of postoperative brow ptosis.

Modern thymus surgery cannot be imagined without videoendoscopic technologies. Thymus surgeries are performed using multiport, single-port, subxiphoidal approaches, as well as with the participation of robotic systems. This report presents an original method of videothoracoscopic thymectomy, the peculiarity of which lies in the sequence of stages of the operation. According to the technique, before the isolation of the thymus gland in combination with mediastinal tissue, mobilization and ligation of the thymic veins are performed. The described technique is aimed at preventing a massive release of autoantibodies to nicotinic acetylcholine receptors into the bloodstream and preventing the development of postoperative myasthenic crisis.