Bioabsorbable screws and rods were used for treatment of different types and locations limb fractures in the CCH of RAS orthopedic trauma department between 2014 and 2016 for 120 patients. Interfragmentary fixation with bioabsorbable implants was applied as a single fixation method for 53 patients (44%), and in 67 (56%) cases it was combined with metallic plates and screws. Bioabsorbable implants were recognized as effective devices for interfragmentary fixation. Generally, bioabsorbable screws and rods did not require particulary scills for the surgeons brigade and accorded with AO principles of fracture management. However there were find out some features of that implant type application like implant destruction possibility when incorrect instrumentation was used, X-ray and visual transparency while implanted, that lead to some difficulties in length measurement and implant position assessment, a possibility of implant length adaptation, drilling through implanted device that eliminates risks of implants conflict, and gives an opportunity for augmentation of bone defects by screws. Also it is desirable to fix implants in two cortexes, and to use fully threaded and lag-screws together in a pair.

The authors have analyzed the results of treatment of 310 patients with inguinal hernias using different methods (TAPP, Lichtenstein and applying PHS system) in hospitalization replacement environment and based on the health status survey MOS SF-36 (Medical Outcomes Study Short Form-36) of 220 patients after the surgery. The best results on post-surgery complications (TAPP - 3,3%, Lichtenstein - 12%, PHS - 8,7%), on treatment efficacy - relapse rate (TAPP - 0,67%, Lichtenstein - 2,5%, PHS - 1,257%), on recovery time were obtained when using the TAPP methods with laparoscopic technology. The use of TAPP in hospitalization replacement environment is justified, especially with patients of working age, for faster recovery of labor activity. The data obtained demonstrate the high efficiency of the applied methods of inguinal hernia treatment and allow to reasonably recommend their use in hospitalization replacement environment.

The article is devoted to assessment of cellular and molecular mechanisms of skin stimulation after implantation of polydioxanone threads.The aim of the study: assessment of polydioxanone threads impact on the skin biostimulation.Design: prospective, independent, placebo-controlled study.Materials and methods: the authors performed a prospective, independent, placebo-controlled clinical and morphological study in the period 2015-2017, that enrolled 22 volunteers (35-50 years old) with age associated skin changes. General morphological examination of skin bioptates was performed on slides stained with hematoxylin and eosin, and by van Gieson method. To assess different cell lines after polydioxanone treads implantation the immunohistochemistry was used.The results of study showed that polydioxanone treads stimulates several mechanisms of skin remodeling with activation of repair mechanisms. This process was manifested by angiogenesis through stimulation of VEGF expression and reorganization of the vascular bed of the skin and stimulation of the private reserve of fibroblasts lineage through the activation of the stromal vascular fraction. It should be noted that in addition to activation of neocollagenogenesis leading to the restructuring of the dermis and epidermis, polydioxanone threads implantation had a positive impact on the balance of MMP/TIMR, limiting degradation mechanisms and contributing to the accumulation matrix of the connective tissue of the dermis.Conclusion: Thus, polydioxanone treads have pleiotropic stimulating effect on the dermis remodelling.

The article is devoted to optimization of surgical treatment of chronic pancreatitis with consideration of blood supply variants of the pancreas head. At the morphological stage of the study, extraorganic arteries of the pancreas and duodenum were studied by the preparation of 42 complexes of upper abdominal organs. In the course of the retro- and prospective study, a comparative evaluation of the results of surgical treatment was carried out, taking into account the anatomical features of the pancreatic blood supply. It has been established that the anterior pancreatoduodenal artery arc has several variants of location in relation to the pancreatoduodenal complex. The combination of the preliminary ligation of the elements of the anterior pancreatoduodenal arterial arch with more radical excision of the scar-altered pancreatic parenchyma allows optimizing the surgical treatment of chronic pancreatitis.

The aim of the research was to determine the optimal surgical tactics in patients with various forms of infected pancreatic necrosis. Results of treatment of 48 patients. The patients were divided into 2 groups depending on the period of illness and operation. The first group was formed from the 21 patients who were operated on at the first and second stages of the disease. The second group was formed of the 27 patients who were operated on in the phase of living with complications. Mortality in the first group was 45.4%, 17.8% in the second. Treatment of infected necrotic pancreatitis should be integrated with priority surgical. Success in infected necrotizing pancreatitis management depends on the completeness of inviable tissues removing.

The article in the literature reviewed postoperative complications after mammoplasty. Capsular contracture is the most important, since modern implants are foreign bodies, which the body naturally responds with the formation of capsule. The formation of capsules fiziologicheskii process that develops in the postoperative period, but under certain conditions it is the seal with the formation of a scar capsule, which leads to compaction of the breast, a change in its shape, disruption of contours, the appearance of pain, development of local inflammatory changes, the displacement and deformation of the implants. The review considers the reasons for the formation of capsular contracture, Baker classification scale and the prevention of the development of capsular contracture in the early and late postoperative period. Describes the technical, operational techniques, allowing to prevent the development of capsular contracture in the postoperative period.

The article is devoted to the search for optimal access and the method for resolving acute adhesive intestinal obstruction. The analysis of existing methods for resolving acute adhesive intestinal obstruction, their advantages and disadvantages is carried out. The authors concluded that laparoscopic access in the treatment of acute adhesive intestinal obstruction meets modern requirements, has clear advantages over laparotomy, since it is accompanied by a smaller number of complications. Currently, more clear indications and contraindications to the use of laparoscopic access in acute adhesive intestinal obstruction are formed