AIM OF STUDY Was to compare the dynamics of engraftment of skin micrographs in a burn wound when using protectors from an allodermal graft and from a hydrogel coating.MATERIAL AND METHODS The experimental study was conducted on 18 rats with a scab formed 3 days after modeling a deep burn with an area of 20% of the body surface. Partial fascial necrectomy was performed: two rounded sections of the sling with a diameter of 25 mm were excised. 6 automicrographs of skin 4x4 mm, 0.3 mm thick, were applied to each surface freed from the scab. In each animal, micrographs on one of the wounds were covered with a hydrogel protector, on the other with an allodermotransplant from another animal of the group. A secondary aseptic dressing was applied to the protectors. On the 5th and 20th days after the operation, the state of micrographs was studied: blood circulation — according to laser Doppler flowmetry, microstructure in vivo — using optical coherence tomography, microstructure ex vivo — according to histological examination of biopsies.ReSUlTS Differences in the rate of restoration of blood circulation of micrographs in the early stages of the postoperative period were found. In the first 5 days, the perfusion of micrographs under an allodermal protector exceeded the indicator in micrographs under a hydrogel coating by 44 [21; 51] % (p=0.031) due to the contribution of endothelial and neurogenic mechanisms of blood flow modulation. Starting from day 10, the differences in perfusion were levelled, but there were signs of more active endothelial regulation of blood flow under the skin (p=0.028). Histologically, the appearance of full-blooded capillaries was revealed earlier in micrographs under the alloderm than when using a hydrogel protector. By 20 days, under the condition of regular change of hydrogel coatings, the area of wound healing under the studied coatings did not significantly differ. However, the structure of the integumentary tissue under the alloderm according to the optical coherence tomography data was closer to normal skin than when using a hydrogel protector.CONClUSIONS From the point of view of the physiology of the wound process, alloderm is the preferred option of an autograft protector in comparison with a hydrogel coating, which is probably due to the paracrine biological activity of the alloderm. However, hydrogel coatings can provide a comparable level of efficiency, provided they are regularly changed and, potentially, given the properties of cytokine activity.

Background. Wounds inflicted by the teeth of animals and humans take a special place and have a number of characteristic features. There is still no generally accepted surgical tactics for the bite wounds treatment, and the issues of choosing the timing of wound closure, depending on their localization, remain unresolved. Aim. To analyze the clinical experience of bite wounds surgical treatment by applying primary and secondary sutures. Material and methods. From 2008 to 2018 409 patients with bite wounds of various localizations (289 female and 120 male) aged 16 to 84 years were under our supervision. The average age of the victims was 52.510.17 years. All patients were prescribed combined therapy, which was based on an urgent surgical care, since we attach a decisive role in the prevention and local treatment of wound infection to full primary or secondary surgical treatment. The analysis of the obtained data was performed using the statistical calculations in R 3.6.3 (R Foundation for Statistical Computing). To compare the average treatment time for primary and secondary sutures nonparametric MannWhitney test was used. Results. Analysis of the obtained clinical data showed that the largest number of bite wounds were dog bites (95%), which occured most often in spring (38%) and summer (38.1%), and, as a rule, at home (68%), these results were comparable with statistical data from other sources. The average duration of patients treatment with a primary suture was 13.2 days, and with a secondary suture 19.3 days. The authors proposed a differentiated approach to the choice of surgical tactics in the treatment of patients with bite wounds, depending on the timing of their admission to the hospital and the local status of the wound defect. Conclusion. The primary or primary delayed blind suturing should be used in the early stages (not later than in 12 hours after getting a bite), and secondary sutures are shown in late stages (more than 12 hours).

The aim of the study was to investigate the dynamics of the state of allo- and autografts of skin on a wound using optical modalities: diffuse reflectance spectroscopy (DRS), optical coherence tomography (OCT), and laser Doppler flowmetry (LDF). A deep thermal burn was simulated in 24 rats covering 20% of the body surface. On day 3 after the injury, a fascial necrectomy of two 500 mm2 areas on the left and right sides of the midline of the animal body were excised. Allografts and autografts were placed in the centers of these areas. Optical measurements of grafts were performed on the 0, 3rd, 6th, 10th, and 13th days after transplantation. The allografts demonstrated a pronounced decrease in oxygenation, blood content, and perfusion compared to autografts on the 6th day; in the following days of observation, these values returned to the average values of autografts. Water content gradually decreased from the beginning to the end of observation. In conclusion, optical diagnostics revealed changes in the morphological microstructure, the rate of restoration of blood circulation, and oxygen exchange in the early stages, specific for the allo- and autograft.

Introduction. In recent years, there has been a growing interest of clinicians in assessing the quality of life associated with the health of patients with chronic wounds, which is due to the need for an objective dynamic assessment of the patient's psycho-emotional state and the effectiveness of the therapy; on its basis strategic decisions can be made aimed at improving not only the results of treatment but also the quality of life, social functioning of patients (social adaptation).The aim of the study was to review research that investigates the impact of chronic soft tissue wounds on changes in the quality of life associated with the health of patients, in order to systematize a massive amount of information for use in everyday clinical practice, seeking to understand the personal needs of each patient in the context of his life.Material and methods. The authors performed a search for relevant papers in the electronic databases PubMed, Cyberleninka; this was followed by an analysis of the data obtained regarding the impact of chronic wounds on the psycho-emotional background of patients.Conclusions. The data obtained, their critical evaluation and analysis of scientific publications related to the subject of the study evidence that a dynamic assessment of the psycho-emotional state of patients with chronic soft tissue wounds is necessary in wide clinical practice in order to timely identify and prevent the development of psycho-emotional disorders, leading to a decline in health-related quality of life.

Importance. Surgical procedures have a lot of stress, causing significant violation of the non specific defense mechanisms of the body and the immune system, which requires the use of different pharmacological agents in order to increase natural resistance to infection.Purpose. An analytical review of experimental and clinical research in the direction of studying the effectiveness of the impact of enteral xymedon on reparative process of surgical wounds and tissue non-specific resistance of the organism to infection for the prevention of inflammatory wound complications.Materials and methods. The analysis of experimental and clinical data, dealing with the question of studying the effect of enteral and topical xymedon to repair tissue in the area of the surgical wound and the non-specific resistance to infection.The criteria for the effectiveness of the drug were clinical and laboratory parameters, and statistic methods.Results and their discussion. The analysis of experimental and clinical studies have shown that enteral and topical use xymedon in surgical patients stimulates wound healing surgical site and increases nonspecific resistance to infection by increasing the functional activity of neutrophils, their backup potentials normalize the concentration of a bioactive and immunoreactive fibronectin in blood plasma, improve antimicrobial activity of wound.Conclusions. Xymedon is recommended as an effective means of pharmacological support of wound healing in surgical patients to prevent postoperative wound complications.