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.
BACKGROUND: Reconstruction of extensive defects to bone tissue is one of the important problems of orthopedics and traumatology. Especially in acuteis, the problem is associated with the restoration of bone tissue in conditions of its deficiency in pediatric patients. AIM: The aim of the study is to analyze modern methods of surgical treatment in children with extensive bone tissue injuries based on the published literature. MATERIALS AND METHODS: Our report presents a review of the literature of methods of surgical treatment of extensive bone defects. The literature search was carried out in several databases such as PubMed, ScienceDirect, E-library, GoogleScholar for the period from 2005 to 2020, using the keywords given below. As a result of the search, 105 foreign and 37 domestic sources were found. After exclusion, 56 articles were analyzed, all presented works were published in the last 15 years. RESULTS: The gold standard for replacing bone defects is still the use of autografts, including the use of technologies on a vascular pedicle. Various types of xenografts and allografts of bone tissue are increasingly being replaced by various kinds of synthetic implants. CONCLUSIONS: To date, there is no single generally accepted standard for the surgical treatment of extensive bone defects. The option of surgical treatment of extensive bone tissue defects using tissue-engineered bone implants with axial blood supply seems to be extremely interesting and promising.
Background. Despite the wide range of studies, the development of osteoplastic material, which has not only osteoconductive but also osteoinductive properties, remains an extremely topical issue in modern medical materials science. This work is devoted to experimental evaluation of the effectiveness of synthetic osteoplastic composite material based on chitosan and hydroxyapatite. Aim. This study aimed to determine the effects of spongy implants based on chitosan and its composite with hydroxyapatite nanoparticles in an amount of 50 wt. % on early osteogenesis in the area of the through defect of the ileum. Materials and methods. The studied materials were sponge implants based on chitosan and its composite with hydroxyapatite nanoparticles in an amount of 50 wt. %. Comparison groups include those without implant placement and those with replacement with commercial Reprobone osteoplastic material. Materials were implanted into the zone of the through defect of the ileum of rabbits for a period of 28 days. Results. A high rate of resorption of materials based on chitosan in bone tissue and active growth of reticulofibrotic bone tissue along the edges of the defect was established, and the formation of cartilaginous islands and bone marrow was recorded in the group of chitosan implants with hydroxyapatite. The aseptic effect was observed with the use of implants made of chitosan and hydroxyapatite. Conclusions. The data obtained allow us to argue about the osteoconductivity of the studied materials and the prospects for further development in this direction.
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