Efficacy of platelet-rich plasma lysate in the treatment of patients with post-traumatic eyelid scarring: an overview of clinical cases

Purpose: to evaluate the effectiveness of platelet-rich plasma lysate (PRP) in the treatment of patients with post-traumatic eyelid scarring by clinical examples. Material and methods. Patients with post-traumatic scarring changes in eyelid tissues causing a damage in the functional and cosmetic state of the auxiliary apparatus of the eye were treated in the Department of Plastic Surgery and Eye Prosthetics at the Helmholtz National Medical Research Center of Eye Diseases. Two of the patients, who had been traumatized shortly before the examination and one patient who had rejected surgery were offered treatment by PRP lysate manufactured at the Sklifosovsky Medical Research Institute of Emergency Medicine. After local infiltration anesthesia, each patient received a single injection of PRP lysate (2 ml) into the scar tissue. The result was evaluated at a follow-up that took place 3 months after the injection. Results. The clinical picture of the three patients showed a pronounced positive dynamic of the functional and cosmetic state of the auxiliary eye apparatus, which made the patients reject subsequent (additional) surgical treatment. Conclusion. An improvement tissue repair and regeneration processes after PRP lysate injection allows us to assess this method as an applicable alternative of reconstructive operations in certain cases.

A Contemporary View on the Anatomy of Parotid Gland

One of the up-to-date issues of contemporary medicine is the study of the features of individual anatomical structure variability of various organs. In recent years, the incidence of parotid gland diseases has been rising. This phenomenon can be associated with an absolute increase in this organ pathologies incidence as well as with the development of additional methods of examination and visualization of the gland. Most pathologies of major salivary glands, in particular the parotid gland, require surgical treatment. Knowledge of topographical relationship of the parotid gland with the adjacent vessels and nerve trunks is utterly necessary for planning and performing surgical interventions and reconstructive operations in the parotid region. According to the statistics, surgical interventions on the parotid gland take the leading place among the causes of damage to the facial nerve branches. This fact may also prove a large variation in the syntopy of the facial nerve and the parotid gland. The paper reviews the data of native and foreign literature on the anatomy of parotid gland and the place of radiation research methods in the study of its topographical and anatomical features. The analysis revealed a wide range of anatomical norm of parotid gland in many parameters, including shape, linear size, blood supply, and topographical features. The practice of using anthropometric studies aimed at structuring the existing knowledge and narrowing the borders of anatomical norm for various organs proved to be successful. However, in the pool of scientific papers, we have not found similar studies concerning parotid gland. The facts mentioned above make the background and justify further studies of parotid gland in the context of normal individual variability.

The quality of life of patients after reconstructive and reconstructive breast surgery

The quality of life indicators of 70 patients who underwent reconstructive and reconstructive breast surgery were studied. We used a depression test questionnaire and questionnaires on the quality of life. The patients were divided into 3 groups. It was found that a higher level of depression in group II compared to group I. Low level of depression in group III. Indicators of the physical component of health are the highest in group II compared to groups I and III. Low indicators of the physical component of health in group III patients. Indicators of the psychological component of health are higher in group III compared to groups II and I. Higher indicators of the psychological component of health in patients of groups II and III. Key words: quality of life, mammary glands, reconstructive and reconstructive operations, neoplasms, psycho-emotional status.

Analysis of bone-reconstructive surgery aimed at normalization of occlusal relationships of the jaws at the final stages of rehabilitation treatment of children with congenital cleft lips and palate (Literature review)

BACKGROUND: The completion of medical rehabilitation of children aged 1618 years with congenital cleft lips and palate is often impossible without surgical correction of occlusal relationships of the jaws and improvement of facial aesthetics. At the same time, the main efforts of the specialists engaged in the treatment of children with orofacial clefts are aimed at correcting local plastic operations of the upper lip, nose, oral cavity, and orthodontic, using non-removable arc equipment, correction of disturbed occlusion. AIM: Our aim is to study and analyze the problems of final bone reconstructive operations in patients with HRGN. MATERIALS AND METHODS: The article presents a review of the literature on this topic, based on 61 sources. The literature was searched by keywords in the databases such as PubMed, ScienceDirect, E-library, and Google Scholar from 1938 to 2020. The data on the treatment of children with combined maxillofacial anomalies and deformities with cleft lips and palate, who underwent reconstructive bone operations on the jaws in order to normalize their occlusal relationships, were analyzed. RESULTS: In order to achieve good morphofunctional and aesthetic results, as well as early socialization of patients with VRGN at the final stages of rehabilitation, complex hardware and surgical treatment are necessary. The indication for reconstructive operations on the jaws in patients is the face disorder and disharmony of the face, which cannot be corrected by orthodontic treatment. The operations should be based on careful planning, including CT modeling, the use of sparing techniques, including various modifications of Le Faure I osteotomy on the upper jaw, and retromolar sagittal osteotomy of the jaw and, according to indications, genioplasty on the lower jaw. CONCLUSIONS: Two-jaw orthognatic bone reconstructive operations on the jaws to restore the correct bite have recently been used in the complex medical rehabilitation of patients, especially in adolescents with VGN. At the same time, there are a number of unresolved issues of orthodontic and surgical treatment that require further study. There is a strong need for a clear understanding of the age of planning and timing of such operations considering the stage of completion of skeletal growth. The criteria for the patients readiness for surgery for multiple occlusive contacts also need to be evaluated. It is of paramount importance to determine the order of performing corrective operations on the soft tissues of the face and oral cavity. Hence there is a necessity to develop new methods of reconstructive operations on the jaws.

Usage of the Medical Product Ketanov in the Maxillofacial Surgery

Pain is the psychophysiological condition of a person arising in as a result of the action of ultra-strong or destructive irritants causing organic or functional disturbances in the organism. The purpose of our research was to evaluate analgesic efficiency of the medicinal product ketanov (ketorolac tromethamine), produced by the firm “Ranbaxy” in patients with diseases of the maxillofacial region. We monitored 127 cases, which we divided into the following groups: Group I of 44 patients after performing dental surgery (extraction of tumors and tumor-like formations of jaws and soft tissues, plastic and reconstructive operations); Group II – 23 patients with mandibular fractures; Group III – 27 patients with inflammatory diseases of the soft tissues; Group IV – 19 patients with rhythmic diseases of the maxillofacial region (odontogenic neuralgia, post-traumatic and post-operative neuralgo-neuritis); Group V – 14 patients who have undergone the surgical phase of dental implantation. Ketanov (ketorolac tromethamine) is a highly effective analgesic and is recommended for use in the post-operative period after removal of tumors and tumor-like formations of the jaws and soft tissues of the face and neck, after plastic and reconstructive operations, in case of jaw fractures, purulent inflammatory processes, odontogenic neuralgia, postoperative and post-traumatic neuralgo-neuritis of peripheral branches of the trigeminal nerve, as well as after the surgical stage of dental implantation.

Surgical treatment of upper urinary tract obstruction in tuberculosis of the urinary system

Introduction. Currently, the basis for effective treatment of urinary tuberculosis (UT) is a combination of specific chemotherapy with reasonable surgical intervention and strict follow-up of the patient. Materials and methods. This literature review presents the evolution of methods of surgical treatment of renal and upper urinary tract tuberculosis over of 127 sources found for the review, 63 were selected. Results. Since UT is a very slowly progressive disease with minimal and imperceptible symptoms, often leading to irreversible organ damage, up to 75% of patients with this pathology undergo surgery. As follows from the results of recent studies, the emphasis of surgical treatment is increasingly shifting from ablative and organ-carrying techniques to reconstructive operations. Surgery for upper urinary tract tuberculosis continues to develop, but its results in advanced cases of destruction of renal tissue often remain unsatisfactory. Conclusions. The search for new methods of reconstructive interventions, the purpose of which is to preserve functioning renal-ureteral units and improve the quality of life of patients, remains relevant.

Early postoperative complications in patients operated on for breast cancer using different surgical techniques

Background. Given the steady and intense increase in the incidence of breast cancer, the problem of the development of early complications of reconstructive operations, depending on the characteristics of surgery, remains urgent.Objective: to analyze the characteristics of the early postoperative period in patients operated on for breast cancer using different surgical techniques.Materials and methods. A comparative analysis of clinical examination data was carried out, as well as laboratory and instrumental diagnostic methods for 353 women with stage I to IIIA breast cancer after various surgical treatment options and 40 patients after mammoplasty.Results and conclusions. It has been shown that neither single-step nor delayed reconstructive operations after radical mastectomy increase the incidence of complications in the early postoperative period. Single-step breast reconstruction with the help of an expander can be used in patients with I–IIIA stages of the tumor process.

Surgical methods to correct arteriogenic erectile dysfunction

The study objective is to define the state of the problem of surgical methods for the treatment arteriogenic forms of erectile dysfunction (ED) in the Republic of Belarus, to systematize surgical methods for the correction of arteriogenic ED, to evaluate the results of interventional, surgical and combined methods of the treatment of arteriogenic forms of ED in the Republic of Belarus.Materials and methods. A comprehensive examination was carried out 65 men with arteriogenic ED (average age 52.2 ± 2.2 year, International Index of Erectile Function – 9.6 ± 1.3 points; the hardness of erection – 2.2 ± 0.3 according to the Yunem scale) included ultrasound, multispiral computed angiography, as results of stenosing and occlusive lesions of the aorto-iliac segments, internal pudendal artery (IPA) and distal branches were revealed. Of these, as a result of atherosclerotic damage to arteries – 59 (91 %) patients, hypoplasia of the IPA – 4 (6 %) patients and in 2 (3 %) – cases due to post-traumatic damage to the IPA during fracture of the pelvic bones. Pro- and retrospectively performed analysis of the results of endovascular, surgical and combined correction of chronic arterial insufficiency of penis. Based on the results of the study, blood flow deficiency was simulated in order to determine the possible level and method of its elimination. Subsequently, 34 reconstructive operations were performed, including endovascular: superselective stenting of IPA – in 1 case, angioplasty of IPA – one-bilateral – in 4 cases, stenting of the iliac arteries – in 14 cases, in 4 cases – aorto-femoral bypass or prosthetics. Microsurgical operations with epigastric-penile anastomosis were performed in 9 cases (Virag II type in 8 cases, Michal II – Scharlip in 1 case), including in 3 cases as a second stage to increase arterial perfusion of penis after endovascular interventions. In 3 cases, for severe arteriogenic ED and endothelial insufficiency, endophalloprosthesis was implanted (AMS-Spectra).Results. According to the results of testing of patients after endovascular intervention or microsurgical reconstruction, as well as after a two-stage correction that included both methods, patients showed a statistically significant improvement in erectile function on the scale of the International Index of Erectile Function – from 9–12 points (10.0 ± 0.31 points) before surgery to 16–19 points (17.5 ± 0.25 points) 12 months after surgery (p = 0.0009).Conclusions. Interventional methods of correction after micro surgical and combined operations in patients with arteriogenic ED allow achieving a satisfactory result during the first year after surgery, provided that patients are carefully selected using a comprehensive examination, including various ultrasound techniques, multispiral computed angiography, as well as the selection of an appropriate type of revascularization.

Oncologic outcomes of pelvic bone sarcomas surgical

Despite the development and implementation of new regimens and methods of adjuvant therapy, one of the complex problems of modern oncology is the treatment of malignant tumours of the pelvic bones, which is reflected in low survival rates and a high percentage of postoperative complications. The article provides a review of the literature on the problem of diagnosis, pathology, and preoperative planning of intraoperative navigation with the definition of the resection zone in pelvic bone sarcomas. Due to the complex anatomical structure of the pelvis, as well as the rare occurrence of pelvic bone sarcomas, a single approach to the treatment of this category of patients has not been developed. The authors conducted a deep analysis of the effectiveness of various types of reconstructive operations from 4 types of pelvic bone resections, depending on the location of the tumour.

Is There a Borderline Value in the Radiological Findings of Patients With Calcaneal Malunion That May Help to Select an Appropriate Treatment Option?

Background: Despite the constant evolution of technological support, operative techniques, and rehabilitation techniques after conservative treatment and operative treatment, a considerable number of patients with calcaneal fractures have constant pain, frequently resulting in loss of occupation. There are numerous options for the operative treatment of painful calcaneal malunion; however, very few publications suggest specific radiological measurements for pre- and postoperative planning—even fewer have statistically analyzed how these radiological measurements affect clinical outcomes. Methods: We performed a retrospective study of 100 patients after operative treatment of calcaneal malunion to determine the correlation between radiological measurements and clinical outcomes. Data were used to create an algorithm that would help to choose between in situ subtalar arthrodesis and complex reconstructive operations. The algorithm was then used to treat 27 prospective patients. The American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score and visual analog scale (VAS) were used for clinical assessment, whereas standard weightbearing anteroposterior (AP), lateral (LAT) ankle x-rays, and long axial hindfoot view were used for radiological assessment. Results: The talar declination angle was positively correlated with clinical outcome. Patients with talar declination angles less than 6.5 degrees showed worse results in AOFAS score than patients with a greater angle did (57.3 ± 15.3 and 81 ± 15.6, respectively). Conclusion: The combination of subtalar arthrodesis with distraction bone block or calcaneal osteotomy in patients with calcaneal malunion and a talar declination angle less than 6.5 degrees showed better results than isolated in situ arthrodesis. Level of Evidence Level III, retrospective cohort study, case series.