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The aim of the investigation was to develop a technology of manufacturing bone implants based on a hybrid polymer construction composed of poly(3-hydroxybutyrate) and sodium alginate for guided bone regeneration using 3D printing method.Materials and Methods. Complex shaped bone implants based on poly(3-hydroxybutyrate) and sodium alginate were manufactured by the method of two-stage leaching using a mold obtained by 3D printing. The appearance, morphology and structure of the obtained scaffolds were analyzed by means of scanning electron microscopy. Biocompatibility in vivo was determined based on the histology data of scaffolds implantation as bone substitutes.Results. The study of the developed hybrid 3D scaffolds from poly(3-hydroxybutyrate) and sodium alginate showed that they perform a restrictive function providing conditions for regeneration of flat cranial bones in rats.Conclusion. The developed hybrid 3D scaffolds do not interfere with normal osteogenesis and provide beneficial conditions for regeneration.

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The aim of the investigation was to study the course of the reparative process in the early postoperative period after the abdominal wall prosthetic repair using light and ultra-light materials in bacterial contamination in experiment. Materials and Methods. Retromuscular abdominal wall repair was modeled on rats using light (ultra-light) endoprostheses contaminated by Staphylococcus aureus and Escherichia coli in the Central Research Laboratory of Nizhny Novgorod State medical Academy. The course of the early postoperative period has been studied, characteristic features of the inflammatory reaction depending on the microorganism cultures and mesh used have been evaluated with the help of the original rating scale. Results. Prosthetic repair in bacterial contamination in experiment is accompanied by a marked inflammatory reaction. Changes are statistically more significant after infecting by E. coli culture. The most intensive inflammation is observed on day 3 (S. aureus) and day 5 (E. coli) after the intervention with the regression of the process by day 14. on day 3-7 after the operation in group E. coli the inflammatory reaction was more expressed after Timesh implantation relative to PP Light application, whereas in group S. aureus it was more significant in case of PP Light application. Conclusion. Using light and ultra-light mesh in a compromised area of surgical intervention in abdominal wall prosthetic repair is possible by stringent indications taking into account potential usefulness and high risk, possessing adequate experience, and observing a number of conditions. Endoprosthesis should not be placed in contact with the zone of maximum contamination.

The application of ultra-lightweight materials for abdominal wall hernia repair has not been controlled so far, and the capabilities of synthetic and titanium-containing endoprostheses, as well as the peculiarities and possible differences in connective tissue development in an implantation area are not adequately investigated.The aim of the investigation was to study in experiment strength properties of connective tissue formation in the area of synthetic and titanium-containing endoprostheses implanted during abdominal wall prosthetic repair.Materials and Methods. Abdominal wall prosthetic repair was simulated in rabbits. The first series animals underwent retromuscular (sublay retromuscular, SRM) implantation, the second series -intraperitoneal (intraperitoneal onlay mesh, IPOM). We used the model including implantation of two meshes situated in close proximity to each other. Group 1 animals were implanted synthetic lightweight polypropylene meshes (90 µm fiber), group 2 -ultra-lightweight titanium-containing meshes (made of lightweight polypropylene titanium-coated, 65 µm fiber), group 3 were implanted titanium (65 µm fiber) endoprostheses. 30 and 60 days later the animals were sacrificed, their abdominal wall strength being studied in the contact area of meshes. Intact abdominal wall areas were control.Results. Connective tissue strength in group 2 was higher (13.12 N/cm) compared to group 1 (9.2 N/cm) in both series, p=0.001. In group 3 the parameter under study was maximal (15.89 N/cm), which differed significantly from that in group 1 (p=0.0000) and 2 (p=0.002). The comparison showed connective tissue strength after SRM to be higher (13.32 N/cm) than after IPOM (12.88 N/cm); p=0.976. The parameter was significantly higher on day 60 of the experiment (13.9 N/cm) compared to that on day 30 (12.4 N/cm); p=0.008. On day 30 the abdominal wall strength along the implantation perimeter was significantly lower (12.4 N/cm) compared to inrtact areas (14.84 N/cm); p=0.0004. No significant differences in strength between the areas under study and intact areas (13.9 N/cm) were found by the 60 th postoperative day; p=0.08.Conclusion. The application of lightweight and ultra-lightweight synthetic and titanium-containing endoprostheses for abdominal wall repair is accompanied by the formation of connective tissue of adequate strength. The abdominal wall along the implantation perimeter has satisfactory parameters of tensile strength comparable with intact abdominal wall strength, and by day 60 after surgery the parameters are For contacts: Vladimir V. Parshikov,

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Aim. To study the effect of pyrimidine medication hydroxyethyldimethyldihydropyrimidine on the systemic inflammation after prosthetic repair of the anterior abdominal wall hernia. Methods. We prospectively analyzed two groups of patients aged between 18 and 80 years, who underwent prosthetic repair of the aponeurosis defect in the anterior abdominal wall hernia with a standard polypropylene mesh implant. The main group (n=16) was given 0.5 g hydroxyethyldimethyldihydropyrimidine per os 3 times a day before meals for 57 days from the first day after the operation. In the control group (n=16), patients received basic therapy without hydroxyethyldimethyldihydropyrimidine. Results. The postoperative period in patients after elective prosthetic hernioplasty of anterior abdominal wall was associated with an imbalance of the immune system with a tendency to lymphocytopenia (count in blood changed by 27.0%; p=0.20, Wilcoxon criterion) without significant leukocytopenia (count in blood changed by 4.9%; p=1.00, Wilcoxon criterion) and an 82.8% increase in C-reactive protein content (p=0.2, Wilcoxon criterion) compared to baseline values before the surgery. The proposed pharmacological support of prosthetic hernioplasty of the anterior abdominal wall with hydroxyethyldimethyldihydropyrimidine allowed to correct the postoperative lymphocytopenia (p=0.04, U-criterion) and reduce the concentration of C-reactive protein by 223.6% (p=0.03, U-criterion) compared with the control, which was also associated with a decrease in the number of local complications of prosthetic hernioplasty. Conclusion. The use of hydroxyethyldimethyldihydropyrimidine in patients after prosthetic hernioplasty is associated with a significant decrease in the C-reactive protein level, prevention of postoperative lymphocytopenia and a decrease in the number of local wound complications; C-reactive protein level can serve as one of the early and significant indicators of postoperative complications in this category of patients.