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The problem of difficult airways remains relevant for many years. Complications associated with unpredictable difficult airways often lead to the lethal outcome or neurological problems. This article analyzes the causes of difficult airways in patients with burns of face and neck. Such patients face a higher risk to develop difficult airways and it is impossible to follow the traditional procedure for maintaining airway patency. The article expresses the opinion about the inability of modern methods for assessing airway patency to predict possible problems associated with tracheal intubation and ventilation of patients with burns of face and neck.

Aim. The aim of our work was to study characteristics and results of surgical treatment of patients with wounds and cicatricial deformities who underwent tube flaps grafting.Materials and methods. The analysis of the treatment of 15 patients aged 9 to 58 was made. All patients were treated in the Burn Unit of the Scientific Research Institute – S.V. Ochapovsky Regional Clinical Hospital №1 with thermal, electrical and mechanical injuries and their consequences in 2005-2017 years.Results. The average frequency of this method use was 1 time per year. Remoteness of the affected area from the site of tube flap preparation determined the number of migrations and the terms of treatment of patients. With the localization of the recipient zone on the upper extremities, migration of one of the supply legs was immediately combined with partial grafting, and the total number of migrations was two. The duration of treatment of patients from the moment of tube flap preparation to the completion of plastics averaged 134±36 days. In those cases when it was required to move a tube flap prepared on the trunk to the head or lower extremities, there were 3-4 migrations, and the treatment time was 312 to 644 days, on average 481±86 days. The total area of the replaced defect was from 40 to 220 cm2. Out of 15 operated patients, complications occurred in 3 (20%) cases when the tube flap was migrating. At the control examinations during the first year after grafting flap tissues were viable, adapted, without trophic disorders. In term from 1 to 6 years after grafting skin was elastic and well taken into the fold. There were insignificant differences in the pigmentation of displaced flaps from the surrounding tissue. Cicatricial deformities associated with the harvesting, transport of the flap and grafting, were not observed.Conclusion. Tube flap proposed more than one century ago is primarily of historical significance and is rather rare in modern clinical practice, but sometimes it is the optimal method for recovering lost or scarred skin.

The aim of the investigation was to assess the possibilities of application of the polymer matrix made from Reperen material for closing open wound surface on the mucous membrane of the oral cavity. Materials and Methods. Experimental investigation was carried out on 15 Chinchilla rabbits. Half of the created defect on the hard palate mucous membrane healed under the Reperen polymer matrix, and the other half healed by secondary intention. The results of the histological and cytological examination were assessed on day 3, 5, and 7. Results. The area of granulation and connective tissue in the specimens of mucosa, healing without the Reperen matrix on day 5 amounted to 25.0±1.2 and 15.0±1.1%, and on day 7 — 15.0±1.2 and 25.0±1.7%, respectively. Meanwhile, in the specimens of mucous membrane, healing under the Reperen polymer matrix, their values have essentially changed: they were 25.0±1.2 and 20.0±1.1% on day 3, and 10.0±1.3 and 40.0±1.7% on day 7. Conclusion. The Reperen polymer matrix promotes intensification of the local regenerative processes in the wound and can be used for closing large open wound surfaces on the mucous membrane of the oral cavity.