Vol 12, No 3 (2019)

Original articles

Electrical function of the abdominal muscles after combined plastic of extensive median hernias in the context of connective tissue dysplasia

Railianu R.


Relevance. Improving the electrical function of abdominal muscles in patients with extensive median hernias of the anterior abdominal wall can be facilitated by optimizing the choice of methods for combined hernioplasty, taking into account the clinical severity of connective tissue dysplasia among the hernia carriers.

Objective. Study the electrical function of abdominal muscles after the methods of combined hernioplasty of extensive median hernias, taking into account the severity of connective tissue dysplasia among the hernia carriers.

Results.  The average numbers of electromyogram frequencies of the abdominal muscles of patients with extensive median hernias from the group without clinical signs of connective tissue dysplasia were almost the same after all the applied methods of combined hernioplasty. The predominance of the rectus muscles electric function over the lateral abdominal muscles among the patients of this group was 33,5 %.

Electrofunctional rehabilitation of the abdominal muscles of patients in the second group of examinations depended on the method of combined hernioplasty and changed in the event of an increase or decrease in the severity of connective tissue dysplasia.  The recovery of electroactivity of abdominal muscles in the postoperative period in patients from the second group was more significant with an increase in the number of abdominal muscles applied to aponeuroses and vagina of relaxing sections, which contributed to an increase in mobility and contractility of the musculoaponeurotic layers of the anterior abdominal wall.

Conclusions. Thus, with an increase in the severity of connective tissue dysplasia in patients with extensive median abdominal hernias, the method of combined hernioplasty with the most pronounced relaxing effect in relation to the anterior abdominal wall promoted optimal rehabilitation of abdominal muscles.

Journal of Experimental and Clinical Surgery. 2019;12(3):152-157
pages 152-157 views

Ultrasound evaluation of the variants position of the femoral artery and vein in surgical practice

Moshkin A.S.


Aim. Clarify common variant of the relationship of the initial parts of the femoral artery and vein among outpatients Orel.

Methods. In the observation, 138 patients were examined on an outpatient basis using a Samsung Medison R7 ultrasound scanner using a 7-12 MHz linear transducer when examining the arteries and veins of the lower limbs [4]. 81 women and 57 men, aged 21 to 91 years (mean age 57.3 ± 9.9 years) were examined.

Results. As a result of the observation, 6 main types of mutual relations of the initial sections of the femoral vein were distinguished on the basis of a possible cover of the anterior wall of the vein of the femoral artery among the 138 outpatients. The results are grouped by type of vascular arrangement, patients' sex, and visualization of structures. The most common option was the close non-intersecting location of the vascular trunks, and the rarest - a partial cover of the surface of the femoral vein by 1/3 and 3/4 of the femoral artery trunk.

Conclusion. Knowledge of the characteristics of the relationship of large arterial and venous highways at “key points” allows us to develop the most optimal techniques for minimally invasive surgical interventions, reducing the likelihood of complications.        

Journal of Experimental and Clinical Surgery. 2019;12(3):158-161
pages 158-161 views

Surgical Tactics in Damages of the Scenosis of the Duodenumi of the Fince

Kubachev K.G., Hachimov K.A., Mukhiddinov N.D., Zarkua N.E.


Rationale. To date, the issues of early diagnosis and surgical treatment of patients with injuries to the retroperitoneal duodenum have not been resolved. Due to late diagnosis, the development of retroperitonitis in a short time after injury, the frequency of postoperative complications reaches 20% - 32%, and mortality - up to 18% - 27%.
Purpose of the study. Improving the results of treatment of patients with damages to the retroperitoneal part of the duodenum.
Methods. The results of treatment of 54 patients with a rupture of the retroperitoneal part of the duodenum are presented. In the study of patients with suspected damage to the retroperitoneal part of the intestine used ultrasound, EUS, FGDS and MSCT with intraluminal contrast
Results. 28 victims were sutured by a duodenal defect and cholecystostomy. In these patients, the patient was disconnected by a flashing apparatus, and a gastroenteroanastomosis was formed. The failure of the duodenal sutures developed in 10 (35.7%), 8 (28.6%) victims died
26 victims, after mobilization of the intestine by Kocher, were performed excision of the edges of the rupture of the intestinal wall and the formation of the side-to-side duodenojejunostomy with the Ruian loop of the jejunum off. The postoperative period was smooth in 20 victims. 2 patients with concomitant injuries of the liver, spleen, skeleton bones died 2 and 4 days after the operation due to severe blood loss and shock. In the postoperative period, 4 patients on the 5th and 6th day developed micrononextensity of the seams of duodenojejunostomy. Both patients were treated conservatively and were discharged.

Journal of Experimental and Clinical Surgery. 2019;12(3):162-167
pages 162-167 views

Plastics of sequestral cavities with fine grained titanium nickelide for chronic osteomyelitis

Trushin P.V., Shtofin S.G.


The goal of research. To assess the efficiency of surgical treatment of patients with chronic osteomyelitis by the use of grafting post - osteomyelitis cavity with fine-grain porous titanium nickelide.
Methods. The research covered patients with chronic osteomyelitis, 60 patients were made an original operation of single stage sequestrectomy and grafting the residual bone cavity with fine-grain titanium nickelide.
Results. There was demonstrated clinico-roentgenologic efficiency of this treatment method in early rehabilitation period and in further monitoring.
Conclusions. Clinical practice confirms that the use of the treatment method of chronic osteomyelitis by sequestrectomy with the following grafting with the granules of titanium nickelide gives more positive results than the traditional method. It is less traumatic, simpler in realization. The use of this technology allows to reduce the number of post-operational complications and negative results in distant periods.

Journal of Experimental and Clinical Surgery. 2019;12(3):168-171
pages 168-171 views

The use of polypropylene mesh in thoracoplasty: an experimental and clinical study

Belov S.А., Grigoryuk A.А., Krasnov D.V.


Relevance. Thoracoplasty is an effective way to close the cavity of destruction of the lung tissue and achieve clinical recovery in case of fibro-cavernous pulmonary tuberculosis. A promising direction of creating selective collapse in thoracoplasty is the use of synthetic mesh implants.

The purpose of the study was to assess the effect of synthetic implants from the “Surgipro" polypropylene mesh on the inflammatory and reparative reaction in thoracoplasty.

Materials and methods. The work was performed on male Wistar rats weighing 250±50 grams (n=12). The “Surgipro” polypropylene mesh was implanted on the right posterolateral surface of the chest (n=9). As control, the material was taken from intact rats (n=3), which were kept in the same conditions as experimental animals. The study material was biopsy specimens of the muscular aponeurotic scar of the posterolateral surface of the chest of rats. The cellular composition and total number of mast cells were determined. A clinical study was conducted on 26 cases of thoracoplastic with the use of polypropylene mesh in the pulmonary-surgical department of the Seaside regional antituberculous dispensary in Vladivostok.

Results. During the experimental study, it was recorded that the implant used in the reconstruction of the chest has a pronounced reactogenicity from the first day, which manifests itself as a local inflammatory reaction with the concentration of mast cells. The population of mast cells progressively declined by the 30th day, while an increase in the number of macrophages and fibroblasts was observed with the advent of giant multinuclear cells of foreign bodies. On the 30th day after the operation, a widespread post-inflammatory reactive fibrosis and angiomatosis with chronic productive inflammation was observed in the experiment. In clinical observation, the resulting inflammatory reaction around the endoprosthesis spreads to the surrounding tissues and lung, which contributes to the formation of pronounced pulmonary fibrosis and restriction of a specific process.

Journal of Experimental and Clinical Surgery. 2019;12(3):172-175
pages 172-175 views

Comparative experimental analysis of usage of different meshy implants

Sigua B.V., Zemlyanoy V.P., Mikhaylov G.A., Mavidi I.P., Zakharov E.A., Sakhno D.S., Vinnichuk S.A., Cherepanov D.F., Melnikov V.A., Kulagin D.V., Beria G.Z.


Importance of the topic. Using a net explant in Hernioplasty is one of the most common operations performed in surgical hospitals around the world. Despite of the achievement in chemical industry and the abundance of various endoprosthesis, there are always some drawbacks. Also, there is a problem in finding a plastic material that meets all the requirements of an ideal endoprosthesis and it is still relevant.
Purpose. Study the timing of connective tissue germination of mesh implants made by different manufacturers in intact and compromised conditions (aseptic inflammation).
Materials and methods. For the experiment we took 4 rabbits «Chinchilla» breed. We made 4 cuts on the back side of all animals (on both sides of the spine) which we used for the implantation of mesh implants. On the left side of the spine, the conditions were intact, on the right, aseptic inflammation was modeled by applying 0.3 ml of turpentine on liquid paraffin. On the 11th, 14th, 17th, 21st day an excision biopsy was performed. A complex of tissues was sent to histological examination, which would help us to rate the maturity of formed connective tissue that was evaluated by the severity of the inflammatory response.
Results. In the end of our experiment we found out that the formation of the mature connective tissue around all endoprosthesis under conditions of aseptic inflammation occurred faster than in intact conditions. On the other hand, the time of germination in the explants was different, which should be considered in the postoperative period.
Conclusion. None of the presented grids can be considered an ideal endoprosthesis.

Journal of Experimental and Clinical Surgery. 2019;12(3):176-186
pages 176-186 views

The antibiotic prophylaxis algorithm for open hand injuries in children. Experimental study.

Gordienko I.I., Borisov S.A., Tsap N.A.


Relevance. The rapid development of new technologies in surgery has opened up broad horizons for the implementation of complex surgical interventions. At the same time, the duration of operations was reduced, the invasiveness decreased, and broad operational approaches began to go into the past. However, the infectious process in the area of operative action remains an acute problem of surgery today. Infections of the surgical area (OSIW) are infections that develop within 30 days after surgery or within a year after installing the prosthesis (heart valves, blood vessels or joint).
Aim. Develop an algorithm for perioperative antibiotic prophylaxis for open tubular fractures based on experimental research.
Methods. An experimental study was conducted on 60 adult guinea pigs, which created a model of an open femur fracture. All animals were divided into 3 groups depending on the timing of the introduction of antibacterial drugs. The degree of local manifestations was assessed according to the developed scale from 0 to 2 points, where 0 is the total absence of inflammatory manifestations, and 2 points is their maximum manifestation. The signs of inflammation were also evaluated in the general clinical blood test.
Results. During the experiment it was revealed that the introduction of antibacterial drugs for open fractures of tubular bones is necessary for prophylactic purposes. An increase in the timing of the introduction of antibiotics to three days or more is not rational, since there are no significant differences compared with a shorter course of antibiotic prophylaxis.
Conclusions. Experimental perioperative antibiotic prophylaxis (PAP) on the model of an open fracture of the tubular bone indicated the possibility of introducing the PAP algorithm for open hand injuries in children.

Journal of Experimental and Clinical Surgery. 2019;12(3):187-192
pages 187-192 views

Review of literature

The Opportunities for developing a new biologically active suture material in surgery (literature review)

Morozov A.M., Mokhov E.M., Lyubsky I.V., Sergeev A.N., Kadykov V.A., Askerov E.M., Peltikhina O.V., Horak K.I.


The main method of joining the wound edges in surgery remains suturing with the help of threads. Unfortunately, suture materials used in surgery have a number of disadvantages. The percentage of postoperative wound complications remains high. One of these consequences is the failure of the seam, depending also on the material used in the operation. Suture material, as a genetically alien object, that is a foreign body, with a long stay in the tissues can lead to the development of complications: causes suppuration of wounds, formation of abscesses, peritonitis.

Materials and methods: The analysis of modern Russian-language and foreign literature, also Internet sources devoted to the issue of issues and modern developments of antiseptic suture material.

As a result, the choice and development of an ideal suture material that meets all the requirements, remains an unsolved and socially significant problem in surgery. Despite the variety of variations already offered, there is currently no suture material with antimicrobial activity on the market that would fully reduce the risk of developing infections in the surgical area. But the achievements of modern chemical production make it possible to develop biologically active suture materials that have the ability to resist the development of infectious complications in a wound and improve tissue regeneration without adversely affecting the body.

In addition, the analysis showed an increased interest of developers to chitosan, due to its exceptional biocompatibility, bioresorbability, non-toxicity, antibacterial properties and hemostaticity.

Journal of Experimental and Clinical Surgery. 2019;12(3):193-198
pages 193-198 views

Evolution of upper urinary tract drainage method

Zolotuhin O.V., Madykin Y.Y., Fedorov A.A.


Despite the achievements of modern medicine, the method of drainage of the upper urinary tract with obstruction remains an urgent problem in urgent urological practice. The article presents a brief literature review of classical methods of upper urinary tract drainage, such as open nephrostomy and ureteral catheter installation. Special attention is paid to modern methods of drainage of the upper urinary tract. Percutaneous puncture nephrostomy today is one of the most frequently performed operations for the purpose of upper urinary tract drainage in urology, which is used both for medical and diagnostic purposes, which characterizes it as a fairly simple operation and safe for the patient, which has a number of significant drawbacks (wearing a urinal, possible purulent-septic complications, traumatization of the renal parenchyma). In contrast to percutaneous puncture nephrostomy, the urethral stent is devoid of the above disadvantages, however, it has no less significant disadvantages in use (migration, inlay, reflux).


Journal of Experimental and Clinical Surgery. 2019;12(3):199-202
pages 199-202 views


Ivan Danilovich KOSACHEV - Colonel of medical service, Professor, Honored doctor of the Russian Federation. To the 80th of birthday


The article is devoted to the brilliant Russian military surgeon I. D. Kosachev. His way of life, combat and labor achievements are described in it.

Journal of Experimental and Clinical Surgery. 2019;12(3):203-205
pages 203-205 views

Henri Marie Rene Leriche – a French surgeon and physiologist, member of the Paris Academy of Sciences (to the 140th of birthday)


Rene Lerish was born in 1879, graduated from the Maristes School. In 1893 he received a bachelor's degree in rhetoric. In the years 1899-1900 Lerish served military service. In 1902, after graduating from the Faculty of Medicine in Lyon, he worked as an external student. In 1906, Lerish wrote a doctoral thesis on gastric resection for cancer. In the First World War, Lerish was at the front, where, among other things, he headed the school for the improvement of military field surgeons, wrote a number of works on the treatment of fractures, suggested organizing a center for vascular surgery. After the war, Leriche worked in Lyon until 1924, when he received the department of clinical surgery at the University of Strasbourg. In 1937, he took the place of professor at the College de France. Rene Leriche investigated the problem of pain, studied the sympathetic nervous system, including. Leriche developed access to the parathyroid glands, methods of resection of the stomach and treatment of trophic ulcers with varicose veins, periarterial sympathectomy (1913), operations for endarteritis obliterans and post-thrombophlebitic syndrome, described the syndrome of Leriche and proposed a method for its treatment. His work has also been devoted to problems of orthopedics, surgical endocrinology and anesthesiology. Leriche was the author of the concept, which called for restoring not so much the structure, but the function of the affected organ. Returning to Lyon in 1940, he resigned from the post of Minister of Health and until 1952 worked at the Center for Vascular Surgery in Lyon. He was the founder and first president of the European Society of Cardiovascular Surgeons. In 1955, Rene Lerish died. He published about 1,200 scientific papers, including 21 monographs. Leriche was a member of the Paris Academy of Sciences (1945), the National Academy of Medicine and the Academy of Surgery of France (1946), received the title of honorary doctor of thirty foreign universities. In 1958 in France a postage stamp was issued with his name and a portrait on it.

Journal of Experimental and Clinical Surgery. 2019;12(3):206-206
pages 206-206 views

Andrey Gavrilovic Rusanov – the first Chairman of the Voronezh medical surgical society (to the 145th of birthday)


Andrew G. Rusanov (03.02.1874–9.10.1949) was born on 3 February 1874 in the city of Ostrogozhsk of the Voronezh province. Andrey Gavrilovich graduated from the 1st Voronezh classical gymnasium with a silver medal and the medical faculty of Moscow University (1989). In 1900 he passed the test for a senior doctor of medicine and in 1902 became a Zemstvo doctor and then head of hospitals in the Penza and Ekaterinoslav provinces. Andrey Gavrilovich Rusanov moved to Voronezh in January 1907 and took the position of senior doctor of the provincial Department and surgeon of the provincial hospital (1907-1919), organized and headed the Voronezh medical surgical society, created a paramedic and obstetric school. In 1912, Rusanov prepared and defended his doctoral thesis. In 1918, Rusanov Was elected head of the hospital surgical clinic of the Voronezh state medical Institute. During the great Patriotic war of 1941-1945 he worked in the hospitals of Voronezh, Tambov and Ulyanovsk. In December 1943 he returned to Voronezh and again headed the Department of hospital surgery. In Voronezh, he was the first to do an appendectomy, the surgery to children about brain herniation, successfully produced orthopedic intervention, first in the USSR made a successful resection of the stomach about a perforated ulcer. One of the first to apply bestmoney method of treatment of wounds. A. G. Rusanov the author of over 70 scientific papers, 3 monographs, under his leadership were defended 3 doctor's and 19 candidate's theses. Rusanov was awarded the Order of the red banner of labor and medals. In 1946 he was elected to the Supreme Soviet of the USSR. In 1949, Andrey Gavrilovich died. A. G. Rusanov named lane in Voronezh (1962). In the state archive of the Voronezh region there is a personal Fund of Rusanov (P-2980). Memorial plaques are devoted to it: on buildings of the 2nd and 3rd city hospitals of the city of Voronezh.

Journal of Experimental and Clinical Surgery. 2019;12(3):207-207
pages 207-207 views


Vasily Danilovich ZATOLOKIN - Honored worker of science of the Russian Federation (1937-2019)



Journal of Experimental and Clinical Surgery. 2019;12(3):208-208
pages 208-208 views

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