Vol 44, No 3 (2025)

The paper marks the 225th anniversary of the Department of General Surgery of S.M. Kirov Military Medical Academy. This memorable occasion highlights the department’s invaluable contribution to surgery and medical education in Russia. Despite inconsistencies in available historical records, the official date of establishment of the department is September 17, 1800, when Professor Ivan F. Bush, the first department head, delivered an introductory lecture. Throughout its lengthy history, the department has changed its name several times: from the Department of Theoretical Surgery to the Department of Theoretical and Practical Surgery, and then to the Department of Surgical Pathology to the Department of General Surgery. However, its purpose has always been the professional training of future surgeons. The department has always been led by prominent surgeons, each contributing significantly to its development. The majority of department heads had the appropriate military experience to teach there. The department has a long legacy of research into wound healing, wound infections, combat injuries, and other relevant issues of military surgery. Currently, the training of all students, from cadets to military physicians, remains focused on military medicine. The accumulated clinical experience is widely incorporated in training and serves as the foundation for research into relevant issues of military surgery, wound healing, and combat injuries. As a result, the Department of General Surgery successfully combines military physician training with specialized and high-tech care for wounded patients, emphasizing the inextricable link between its teaching and research activities and the practical needs of military medicine.

BACKGROUND: Endovideosurgery is not widely used in the diagnosis and treatment of abdominal and pelvic gunshot wounds, and the data are limited.

AIM: This study aimed to assess surgical injuries in patients with penetrating abdominal wounds and to demonstrate the use of endovideosurgery in real-world specialized surgical care for penetrating abdominal wounds.

METHODS: The use of endovideosurgery in specialized surgical care for abdominal wounds was analyzed. Indications and contraindications for laparoscopy in patients with penetrating abdominal and pelvic wounds were proposed.

RESULTS: Laparoscopy is a reliable direct visualization tool that allows for precise diagnosis of lesions in questionable clinical cases. The transition from diagnostic to therapeutic laparoscopy enables a timely primary surgical intervention with a minimal risk of surgical injury, which is beneficial for the postoperative period and facilitates subsequent evacuation of the wounded patient.

CONCLUSION: Diagnostic laparoscopy is an additional diagnostic tool in questionable clinical cases, where physical and subsequent imaging examination findings do not rule out a penetrating abdominal gunshot wound. The analysis indicates that endovideosurgery is used as a diagnostic tool in 20% of cases and enables the required surgical intervention in 56.7% of cases.

BACKGROUND: According to World Health Organization estimates, the number of patients with diabetes mellitus may reach 853 million by 2050. In 2024 alone, this condition caused 3.4 million deaths. Despite advancements in the treatment of diabetic foot complications and innovative high-tech techniques, incidence and amputation rates continue to increase.

AIM: This study aimed to analyze treatment outcomes in patients with purulent-necrotic diabetic foot complications and reduce the number of mutilating surgeries.

METHODS: A total of 180 clinical cases were analyzed in patients admitted to the Department of General Surgery of S.M. Kirov Military Medical Academy over a 10-year period. The proposed diagnostic algorithm and treatment strategy with innovative physical therapies for wound healing (ultrasonic cavitation, ozone therapy) were used. The control group included 40 patients who received conventional general and topical therapy based on the wound healing stage. Objective assessment included cytological and bacteriological analyses, as well as computed tomography-based planimetry to assess changes during physical therapy (ultrasonic cavitation, ozone therapy). This approach provided reliable results and enabled objective assessment of the efficacy of the proposed treatment algorithm.

RESULTS: A comprehensive approach which includes contemporary physical therapy options significantly improves treatment outcomes in patients with diabetic foot while reducing the duration of treatment and the number of radical and mutilating surgeries.

CONCLUSION: The management of diabetic foot complications remains a major concern in purulent surgery, necessitating further research and implementation of contemporary techniques to assess the course of wound healing and use additional topical wound treatment techniques.

BACKGROUND: Currently, the diagnosis of depressive disorders is primarily based on clinical and psychopathological assessment of specific clinical symptoms. Although promising, molecular biological techniques are still not widely used in real-world practice. This necessitates developing and integrating techniques for qualitative assessment of biomarkers associated with depressive disorders. This will help to identify potential therapeutic targets. Furthermore, biomarkers can be used to assess the efficacy of drugs. The research into biomarkers of depressive disorders in People’s Army of Vietnam personnel is limited.

AIM: This study aimed to identify potential biomarkers of depressive disorders in People’s Army of Vietnam personnel using biochemical and psychophysiological techniques.

METHODS: Clinical, laboratory, and psychophysiological examinations were performed in military personnel with a confirmed depressive episode (ICD-10 code: F32) and healthy military personnel. The Hamilton Depression Rating Scale was used to assess the severity of depression. Neurotrophic factors were identified using commercial sandwich ELISA kits and calibration curves. Psychophysiological status was assessed by heart rate variability, visual motor response, reaction to a moving object, and dotting test scores (according to Ilyin).

RESULTS: Significant associations were found between depressive disorder and the assessed psychophysiological and biochemical markers.

CONCLUSION: Our findings support the use of biochemical and psychophysiological techniques in the diagnosis of depressive disorders in military personnel. Further research is warranted to assess the potential use and efficacy of these biomarkers for the prevention of mental disorders in psychophysiological support of People’s Army of Vietnam personnel.

Modern rehabilitation system in the Russian Federation is developing based on a comprehensive and interdepartmental approach, however, comprehensive rehabilitation as a component of disability prevention remains insufficiently studied. In Russian practice, comprehensive rehabilitation was predominantly studied in persons with established disabilities, whereas rehabilitation aimed at preventing disability development was investigated only within individual components, primarily medical. Analysis of key aspects (organizational-managerial, interdepartmental interaction, human resource provision, financing, digitalization) was conducted separately. This study is based on systematic analysis of literature (2020–2025) from eLibrary.ru, PubMed, Scopus, content analysis of regulatory documents, comparative legal analysis of rehabilitation types, structural-functional analysis of organizational models, and analysis of official statistics of government agencies. It was found that comprehensive rehabilitation develops according to a proactive approach, ensuring broad coverage of patient needs. However, significant risks of fragmentation and inconsistency persist, due to organizational differences between departments, diversity of financing sources, and uneven development of digitalization. The study revealed that systemic problems of coordination are due to insufficient coordination between departments, insufficiently addressed in fragmented analysis of individual rehabilitation types. A unified coordination mechanism with an integrated digital platform and artificial intelligence tools is necessary for predicting patient needs in rehabilitation types and services, optimizing rehabilitation pathways, and improving interdepartmental interaction effectiveness. The results substantiate the need for transition from departmental to system-coordinated disability prevention model and provide scientific basis for developing organizational-managerial solutions.

Pertussis is an acute respiratory disease caused by Gram-negative bacteria Bordetella pertussis. Pertussis is highly contagious for all age groups; however, it primarily affects children under the age of one year. Despite decades of high vaccine coverage, pertussis has currently resurged, with a rising prevalence in adolescents and adults. This study aimed to assess possible causes of increased incidence of pertussis and the efficacy of existing strategies for preventing its resurgence and spreading. Furthermore, the work examined promising areas of pertussis immunoprophylaxis in the current setting. The study identified the main causes of increased incidence of pertussis and changes in the incidence pattern. These include insufficient efficacy of available immunobiologicals for pertussis prevention, rapid decline in acquired immunity (primarily due to incorrect vaccination schedule), increased prevalence of atypical forms of pertussis, and the emergence of new pathogen strains with higher resistance to existing vaccines. Improving specific pertussis immunoprophylaxis necessitates a broader vaccine coverage to include women in the third trimester of pregnancy, families with children (especially young ones), those who work with children, and healthcare professionals. Reimmunization in older individuals (>65 years old) must be performed every 10 years. Furthermore, innovative pertussis vaccines are required. Molecular biology techniques and a thorough assessment of the disadvantages of existing vaccines are essential for developing new drugs that are effective against modified strains. Moreover, selecting and using vaccine adjuvants that activate both innate and acquired immunity is crucial for developing new vaccines. These strategies will provide more effective control over this vaccine-preventable disease and prevent its resurgence.

Burn injuries continue to be a significant concern due to their high prevalence and delayed healing caused by extensive tissue damage and prolonged regeneration. This work focused on a comprehensive analysis of the advantages and disadvantages of existing therapeutic options for burn injuries of varying degrees, as well as promising areas of regenerative medicine. Published data were analyzed to examine pathophysiological mechanisms of burn injuries and their severity grading. Modern burn management includes surgical and topical conservative approaches. Surgical treatment includes necrectomy and skin grafting, which requires donor tissue sites. Topical conservative treatment employs various drugs and medical devices, such as antiseptics, regenerants, and wound dressings. The range of available drugs for burn injury management is limited. These limitations, along with individual disadvantages of existing therapeutic options, necessitate the search for innovative approaches to burn injury management. One promising area is tissue engineering, which uses biologically engineered products to activate a patient’s stem cells. Human umbilical cord Wharton’s jelly is one of the most promising biomaterials. This extraembryonic hard, mucous connective tissue has a remarkable regenerative capacity. Its acellular scaffold promotes cell migration and proliferation, presents growth factors, and stimulates angiogenesis. Human umbilical cord Wharton’s jelly contains collagen, hyaluronic acid, fibronectin, and growth factors that promote regeneration. The proposed technique for producing human umbilical cord-derived acellular scaffold and hydrogel preserves structural and functional components of native human umbilical cord Wharton’s jelly in the finished product. Preclinical and clinical trials have demonstrated the product’s efficacy and safety in treating deep wounds and promoting healing and autograft survival. Human umbilical cord-derived acellular hydrogel is a promising solution for developing new dosage forms and managing burn injuries.

This article is the first in a series of historical writings commemorating the 220th anniversary of the Military Medical Academy’s Department of Biology (1808) and delves into lesser-known aspects of its history. Over more than two centuries of its history, the department has undergone numerous changes in response to transformations of the Academy and advancements in science and medical education. However, its purpose has always been to provide students with medical and biological knowledge that serves as the foundation for medical thinking. The most significant events in the department’s history are associated with the work of Academician Evgeny N. Pavlovsky (1884–1965), who rose from academy student to department head and went through all stages of professional and personal development as a researcher and teacher at the Imperial Military Medical Academy. The article includes excerpts from Pavlovsky’s handwritten memoir about his admission to the Military Medical Academy and his first research endeavors, which took place during revolutionary turmoil and the outbreak of World War I. The article features the scientist’s recollections of his summer internship at the Sevastopol Biological Station, his first scientific report, and a trip to Samarkand. It describes the circumstances of his graduation from the Academy, as well as his participation in the Imperial Military Medical Academy conference competition for a gold or silver medal for a scientific essay. This work is based on Pavlovsky’s memoir, which vividly depicts various aspects of the Academy’s life in the early 20th century, as well as the memories of his colleagues and students. The article includes unique materials from the archives of the Department of Biology, which is named after Academician Pavlovsky.