The results of three-year research on the use of allogeneic mesenchymal stem cells of adipose tissue (AMSCs) in the treatment of skin burns of II-III degree are presented. in a complex with wounds dressing of nanofibers chitosan and copolyamide, hyaluronic acid. It was found that with surgical necrectomy, introduction of AMSCs and substitution of defects with natural polymer coatings, the healing time is reduced by 89% (p < 0.05). Isolated administration of MSC reduces the healing period by no more than 5% (p > 0.05). The combined use of wounds dressings of nanofibers chitosan and copo lyamide with MSC accelerates the regeneration process by 26% (p < 0.05), with the introduction of AMSCs accelerating the development of granulation tissue by the fifth day of observation by 83% (p < 0.01). Joint use of wound coverings on the basis of hyaluronic acid with AMSCs is accompanied by an increase in the number of vessels of the microcirculatory bed in the defect area by 185% (p < 0.01). Clinical evaluation of the effectiveness of drugs with stem cells – a gel for topical application and a suspension of MSC LC for injection administration demonstrate their ability to optimize regeneration in the burn zone. Application of gel with AMSCs reduces the duration of epithelialization of border (dermal) burns by 2.2-2.4 times, with the final healing period being reduced by 59% (p < 0.01) and the suppuration frequency by 30% (p < 0.05). The introduction of a suspension of AMSCs into the zone of deep burn increases the frequency of engraftment of autografts, stimulates angiogenesis and proliferation of fibroblasts in the superficial and deep layers of the dermis. In the area of MSC administration, the LC perfusion level and the amplitude of blood flow fluctuation are twice as high as the values in the zones without the introduction of cells.

The objective was to develop a methodology for predicting death in patients with burn injury using regression analysis methods.Methods and Materials. The analysis of the results of treatment of 330 burned with a shock injury, hospitalized in the Department of Anesthesiology and Resuscitation of the Department of Thermal Lesions of Saint-Petersburg I. I. Dzhanelidze research institute of emergency medicine in the period 2013–2019.Results. In the course of the study, 52 indicators were identified that characterized the condition of the victim with burn injury in the dynamics of treatment measures. To build a predictive model, only statistically significant parameters (p<0.05) were used, which were used to build a model of logistic regression. The final algorithm included 18 predictors. The model allows predicting a positive outcome of treatment and the likelihood of a fatal outcome with an accuracy of 93 and 87 % respectively.Conclusion. The use of a multivariate mathematical model made it possible to develop a method for predicting a fatal outcome, taking into account the peculiarities of the pathogenesis of burn disease and the principles of therapeutic measures in the first three days after injury. The use of linear regression analysis using new indicators of thermal injury in a retrospective cohort of 330 patients allowed us to achieve a high predictive value.

The paper presents the results of an experimental study on the effect of a variable frequency-modulated electric field on the course of a wound process in a burn wound. The evaluation of the effectiveness of the antimicrobial action of wound healing agents against the background of an alternating frequency-modulated electric field has been carried out. The bacteriostatic effect of some wound healing agents used in combination with electrical physical and antiseptic action has been proven.

Purpose. To evaluate the results of the application of allogenic fibroblasts in patients with extensive thermal burns. Methods. The study included 34 patients with burns over 20% TBSA, treated in the burn ICU. In accordance with the indications for transplantation of fibroblasts, all patients were divided into 4 groups: stimulation of regeneration of superficial burns (n = 10), stimulation of regeneration after meshed skin graft (n = 14), reduction of healing time for donor wounds (n = 6) and acceleration growth of granulations after the escharectomy (n = 4). Results. A positive effect of fibroblast transplantation was found in 7 (70%) patients of the first group, 13 (93%) of the patients in the second group, 2 (33%) of the third group and 2 (50%) in the fourth study group. Conclusion. The maximum positive effect of transplantation of human dermal fibroblasts can be observed when performing the meshed skin graft and treating the superficial burns.

Background. The treatment of victims with wound defects is an urgent problem of clinical medicine that doctors of various specialties, mainly surgeons and traumatologists, must face. Regardless of the etiology of the traumatic agent, the wound process is always subjected to fundamental pathophysiological processes. Despite the advances made by medical science in the local treatment of wounds (cell technology, modern wound coverings, and others), surgical procedures remain the main methods, and the search for new techniques to optimize reparative regeneration continues. This ongoing search indicates the absence of a universal algorithm for treating such defects. This lack of a universal treatment algorithm is of particular importance for assisting victims with extensive defects, which often leads to a shortage of donor resources. Aim. The aim of this study was to increase the efficiency of microautodermoplasty due to the use of allogeneic mesenchymal stem cells and wound dressings based on aliphatic copolyamide. Materials and methods. This paper presents the results of an experimental study involving 50 rats. All animals were divided into groups considering the choice of the method of the local treatment. The experimental wound was modeled according to its original technique. The evaluation of the effectiveness of the analyzed methods was performed using planimetric and histological research methods, and by calculating the healing index. Results. The most effective methods for treating experimental wounds using microautodermoplasty (MADP) are wound dressings based on aliphatic copolyamide (CoPA) and adipogenic mesenchymal stem cells (AMSC). By 28 days of treatment after performing MADP + CoPA wound dressings + AMSC, it was possible to reduce the defect area by 16 times compared with the control, and the healing index was the maximum value among all methods 12.5 units. The high regenerative potential was also confirmed by the results of the histological examination. The worst results were found in the MADP group with AMSK that did not cover the wounds with skin or wound dressing. Conclusion. The introduction of the analyzed methods into clinical practice will improve the results of treatment of patients with wound defects of various etiologies.