Introduction. In recent years, endovenous laser coagulation (EVLC) has become the primary method for treating varicose vein disease of the lower extremities. However, the long-term clinical outcomes of EVLC are similar to those of classical surgical interventions, while the anatomical causes of recurrence identified through duplex scanning differ.

Aim. To compare the recurrence rates of varicose vein disease after isolated EVLC of the great saphenous vein (GSV) and a combined procedure that includes the anterior accessory vein (AASV) in the long-term postoperative period.

Materials and methods. A comparative study was conducted involving 162 individuals with varicose veins in the legs. All participants underwent EVLC of the GSV. The patients were divided into two groups: Group I consisted of 81 individuals who underwent isolated EVLC of the GSV; Group II included 81 individuals who underwent combined EVLC of the GSV and AASV.

Results. Early postoperative complications revealed no statistically significant differences between the groups. According to the results of follow-up ultrasound duplex scanning performed three years after the surgery in Group I (EVLC of GSV), the reflux rate in the thigh area was statistically significantly higher at 15 (18.5%) compared to Group II 1 (1.2%) (EVLC of GSV + AA SV). This difference was statistically significant (p < 0.05).

Discussion. The studies show that preventive EVLC of the AASV significantly reduces the recurrence rates of varicose vein disease by 25%.

Conclusions. Obliteration of the AASV, regardless of the presence of reflux and their size, is a justified strategy for reducing the number of recurrences in the long-term postoperative period.

Introduction. Mesh has become the standard for herniorrhaphy – it helps to reduce recurrence and the development of side effects. The regulation of immunocompetent cells migration determines the therapeutic strategy to modulate the inflammatory response.

Aim. To conduct a clinical and morphological analysis of the effect of platelet-rich plasma (PRP) on the course of reparative process in allogernioplasty.

Materials and methods. 47 Wistar rats were divided into 3 groups: with PRP in optimal dosage (n = 15), maximum dosage (n = 15), without PRP (n = 15), two rats were used for terminal blood sampling for PRP manufacturing. All animals were operated on, creating an aponeurosis defect that was closed with a mesh implant followed by PRP application. The severity of postoperative pain syndrome was assessed using the developed by us summary scale of physiological status, behavioral reactions, and facial expressions; the state of the postoperative scar, the terms of postoperative wound hair loss were evaluated. Material for morphologic evaluation was taken on days 7, 14, 21, 28, 60.

Results and discussion. The positive effects of PRP were morphologically confirmed. The biopsy specimens after PRP revealed: absence of rough fibrosis, more abundant vascularization, early formation of a “delicate” scar and lymphatic collectors in the peri-implant zone, absence or minimal expression of degenerative changes of nerve trunks. There is a reduction of the alteration phase and acceleration of repair processes. In animals of group PRP overdose in the postoperative period a pronounced destructive-inflammatory reaction with microbial contamination prevailed, up to the formation of chronic abscesses. We attribute these changes to excessive recruitment of neutrophils and macrophages secreting proteases and proinflammatory cytokines.

Conclusion. The use of PRP in the optimal dosage allows to improve the integration of the mesh implant during allogerniopalasty, prevents rough fibrosis, deformation and shriveling of the implant; reduces the probability of chronic pain syndrome development.

Introduction. Currently, improvement of skin flap cutting techniques is relevant in various fields of surgery.

Aim. To evaluate the effectiveness of cutting out a skin flap under the control of luminescent spectroscopy in an experiment.

Materials and methods. A prospective, non-randomized, direct study was conducted on 17 mongrel rabbits at the experimental vivarium of Kabardino-Balkarian University from March to April 2025. The first step was to separate the skin on the abdomen with a length of 12 cm. After its exposure, a total biopsy was performed, histological preparations with further morphometry were made. The obtained values were compared with the luminescence intensity. In the second stage, 14 mongrel rabbits were operated on, divided into equal groups. In the 1^st group, after peeling off the flap, it was fixed to its original place without shortening, in the 2^nd group, the cut flap was shortened under luminescent control. The duration of the experiment was 21 days. The clinical and laboratory dynamics, the number and area of purulent complications were evaluated. The SPSS 17.0 software was used for statistical data processing.

Results. With a signal amplitude of 0.95 ± 0.15 × 10⁵ photons, the micro-preparations showed a minimal area of necrosis. In the control group, wound suppuration was noted in 5 animals (area – 4.35 ± 0.11 cm²), in 2 animals from the experimental group (area – 1.34 ± 0.14 cm², p = 0.005). Necrosis of the skin flap was not observed in the experimental group. A biopsy of the wound with morphometry of histological preparations on day 21 revealed a more intensive development of connective tissue in the experimental group and a greater severity of local inflammation in the control group. After withdrawal from the experiment, signs of acute sepsis were detected in the control group in the section of animals.

Conclusions. The use of ultraviolet luminescent spectroscopy is effective in determining the boundaries of the cutout of the skin-fat flap in rabbits.

Introduction. As diabetes progresses, systemic vascular damage occurs, followed by the possible formation of diabetic foot syndrome and a high risk of developing ulcers and gangrene.

Aim. To study and evaluate the contribution of monitoring of functional-metabolic activity of neutrophils and antiendotoxin immunity parameters in purulent-necrotic feet inflammation with underlying diabetes.

Materials and methods. The study included 157 patients (67.1 ± 14.2 years) with purulent-necrotic inflammation of the feet, including 72 with transmetadarsal amputation of the foot and amputation at the level of the lower leg (main group) and 85 with necrectomy and plastic closure of wounds on the foot (comparison group). The reactivity of neutrophils was determined by the reaction of spontaneous (sLZHL) and induced (iLZHL) luminol-dependent chemiluminescence reaction. Indicators of antiendotoxin immunity were recorded in all patients using enzyme immunoassay. Glycolipid (GLP), a structural unit of endotoxin (Re-mutant Salmonella Minnesota), was used as an antigen.

Results and discussion. With the progressive course of purulent-necrotic inflammation of the feet, the indicators of sLPHL of neutrophilic granulocytes (NG) increased sharply (1775.5 ± 7.133 imp/min). Depression in the generation of reactive oxygen species was recorded according to the level of iLHL (68.4 ± 9.61 pulses/min), a deficiency in the concentration of antibodies to GLP (5.02 ± 0.29 μg/ml) and significantly differed from the results of patients in the comparison group (1266, respectively, 5 ± 5.897, 87.15 ± 16.2 imp/min and 6.21 ± 0.11 µg/ml). A direct correlation was established between the biocidal parameters of NG and the concentration of high-strength antibodies to GLP (r + 0.62, p < 0.001) in patients with a widespread purulent-necrotic process on the foot.

Conclusions. The results allow to consolidate the severity of the purulent-inflammatory process of the feet in patients with diabetes with markers of neutrophil metabolism and the level of antiendotoxin protection. The nature of destructive changes is closely related to the reactivity of NG, the severity of their endogenous activation and depression of the antimicrobial reserve.

Introduction. In the aspect of surgical treatment of purulent complications of soft tissues of the extremities in systemic connective tissue diseases accompanied by Raynaud’s syndrome with purulent complications, the issue of tissue trophic restoration is relevant.

Aim. To evaluate the effectiveness of periarterial sympathectomy on the regeneration process of chronic infected wounds in patients with systemic sclerosis.

Materials and methods. A prospective, open, non-randomized study in the purulent surgery department of the Republican Clinical Hospital involved 30 patients with hand phlegmon of various localizations on the background of systemic scleroderma with lesions of the hands and forearms. On the 7^th day after opening the abscess, local treatment and visual cleansing of the wound with the formation of young granulation tissue in the edges and bottom of the wound, and removal of drains, the patients were divided into 2 groups. The main group (n = 15) included patients who underwent periarterial sympathectomy at the level of the brachial artery with daily local treatment. The control group (n = 15) included patients who received only topical treatment (iodopyron or levomycetin ointment). All patients were women receiving prednisone in a maintenance dosage of 25.5 ± 9.5 mg orally.

Results. The rate of maturation of granulation tissue and the rate of epithelialization were statistically significantly higher in the main group (p < 0.05). By the 11^th day after sympathectomy, all patients in the main group showed healing of infected wounds by secondary tension, which in the control group was observed only in 13.3% of cases. When assessing the microbial landscape of wounds at the time of discharge from the hospital, the absence of pathogenic flora in the main group is noted, which distinguishes it from the control group.

Conclusions. Periarterial sympathectomy performed at the stage of epithelialization of infected wounds with hand phlegmon in patients with systemic scleroderma with Raynaud’s syndrome leads to an acceleration of their regeneration processes and a decrease in bacterial contamination.

Introduction. The development of new methods for the treatment of purulent wounds of various etiologies in surgical practice is an urgent task.

Aim. Тo study the effect of noninvasive electromagnetic therapy on the healing process of purulent wounds in rabbits.

Materials and methods. The experiment was conducted on the 14 mongrel rabbits. After modeling purulent skin wounds, rabbits were divided into 2 equal groups on day 5. The control group of animals underwent only local wound treatment with saline solution, the experimental group – this manipulation was combined with electromagnetic therapy. The duration of the experiment was 17 days, and the follow-up was 30 days. Clinical monitoring of the animals’ condition was carried out, clinical blood analysis was monitored, and wound discharge was seeded. Wound healing was assessed using the planimetric method. Biometric values were determined in the statistical analysis of the results, and the R.B. Strelkov table was used.

Results and discussion. By day 9 of the experiment, normothermia was noted in the animals in the experimental group, while hyperthermia persisted in 14.3% of the rabbits in the control group. On day 7, in 57.14% of the animals in the control group, the wound decreased by 1.0 cm, and in the experimental group, a decrease from 0.5 to 1.0 cm was detected in 71.42%. On day 14, in the experimental group, in contrast to the control group, no microflora was detected in the wound. On day 5, leukocytosis exceeded the norm by 3.0% in the control group and by 67.7% in the experimental group. In the experimental group, thrombocytosis was observed throughout the experiment, which exceeded the initial values by 70.78% by the end of the experiment.

Conclusions. The use of noninvasive electromagnetic therapy in the treatment of purulent wounds in rabbits accelerates their healing processes.