Purpose – development of practical recommendations for prevention and treatment of infectious wound complications at prosthetic hernioplasty, based on the peculiarities of blood supply of the front abdominal wall. Materials and methods. 851 surgeries of prosthetic hernioplasty were made in Propaedeutic Surgery Clinic of Samara State Medical University throughout 2010–2013. The most of infectious complications developed after tension-free hernioplasty of big postoperative ventral hernias, with size of hernia orifice of 10 cm and more (W3–W4, Chevrel–Rath, 1999). 118 hernia repairs have been done for such hernias. These surgeries are peculiar by wide mobilization of cutaneous fat flaps and implant contact with the subcutaneous tissue. The imaging of blood vessels in median masses of the anterior abdominal wall was carried out using anatomic material. Results. Very interesting results were obtained with respect to peculiarities of blood supply to the skin and subcutaneous tissues of anterior abdominal wall, upon pumping of zinc sulfide and lead acetate to the epigastric arteries. The infectious wound complications after prosthetic hernioplasty are mostly concerned with the ischemia of cutaneous and subcutaneous flaps, which wide mobilization causes considerable blood supply disturbance and cellular tissue hemorrhages. In cases of hernia orifices size of 10 cm and more, the occurrence rate of infectious wound complications was 13,6 %. Conclusions. In case of wide mobilization of cutaneous fat flaps, the excision of deep layers of subcutaneous cellular tissue is possible and the aspiration drainage is mandatory. The ischemic genesis of complications causes a possibility of restricted surgical activity. Even development of infectious complications does not prevent the implant survival.

Самарский государственный медицинский университет (ректор-акад. ран Г.п. Котельников) минздрава рФ, Самара, россия Ключевые слова: портальная гипертензия, эндоваскулярная хирургия, тромбофилия. Complex endovascular treatment of Budd-Chiari syndrome A.G. SOniS, v.v. SukhOrukOv, yu.L. kEtSkO, i.v. kOLESnik, B.d. GrAChEv, i.v. kurtOv, t.A. GritSEnkO, O.v. tErEShinA Samara State medical university (rector-academician of rAS G.p. kotelnikov) health ministry of the russian Federation,

Femoral hernias make up 2–4 % of the total number of patients with hernias [1], the results of their treatment do not tend to improve [2–6].The aim of the study was to establish the incidence of atrophy of the pubic periosteum in patients with femoral hernia and to analyze the possible methods of surgery in their treatment.Material and methods. The analysis of the treatment of 249 patients with femoral hernias for the period from 1996 to 2021 was carried out. There were 61 men (24.5%), women – 188 (75.5%). in 14 (5.6%), atrophy of the pubic periosteum was revealed during operations. Since 2009, patients with femoral hernia and atrophy of the pubic periosteum began to use the "Method for the treatment of inguinal and femoral hernias" (patent for invention No. 2445002, authors V.I. Belokonev, A.V. Vavilov, A.V. Zharov, Yu. V. Ponomareva, A.G. Nogoga) [11], which was performed by inguinal access.Conclusions. In 5.6% of patients with femoral hernia and a long history, under the influence of the hernial sac, atrophy of the pubic periosteum occurs.A method of treating femoral and inguinal hernias by closing the hernial orifice with an elastic mesh with a protrusion at the medial edge of the mesh corresponding to the distance from the medial edge of the pupar ligament at the level of the femoral vein to the lower edge of the superior horizontal branch of the pubic bone (patent for invention No. 2445002) is an effective method of treating patients with hernias with destruction of the pubic bone periosteum in the femoral canal.