An electrospinning technique was used for the preparation of a bilayered wound dressing consisting of a layer of aliphatic copolyamide nanofibers and a layer of composite nanofibers from chitosan and chitin nanofibrils filler. Processed dressings were compared with aliphatic copolyamide nanofiber-based wound dressings and control groups. Experimental studies (in vivo treatment of third-degree burns with this dressing) demonstrated that almost complete (up to 97.8%) epithelialization of the wound surface had been achieved within 28 days. Planimetric assessment demonstrated a significant acceleration of the wound healing process. Histological analysis of scar tissue indicated the presence of a significant number of microvessels and a low number of infiltrate cells. In the target group, there were no deaths or purulent complications, whereas in the control group these occurred in 25% and 59.7% of cases, respectively—and, in the copolyamide group, 0% and 11%, respectively. The obtained data show the high efficiency of application of the developed composite chitosan‒copolyamide wound dressings for the treatment of burn wounds.
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 results of the application of cold atmospheric plasma are discussed in the experimental study. The effectiveness of an experimental wound dressing based on chitosan nanofibers and copolyamide and a commercial wound dressing material based on hyaluronic acid hydrogel in the treatment of third-degree skin burns (ICD-10) is also evaluated. During the first phase of the study, an original method of inflicting thermal burn on the skin of small laboratory animals (rodents) was developed. The temperature of dehaired skin and the temperature of skin heated by resistive electrical element metal plate were obtained through a digital thermometer sensor. The source for the generation of cold atmospheric plasma was made by specialists of St. Petersburg Polytechnic University of Peter the Great. Biopsy material for histological assay was taken 3, 7, 12, 15, 21, and 28 days after treatment. Paraffinic microscopic sectioning was performed with hematoxylin and eosin; after this, microscopic assay was done. The use of cold atmospheric plasma decreases the frequency of purulent complications and also helps reduce the recovery time of the skin by 20% (p < 0.05) but is not sufficient to achieve the result that has been proclaimed after an early escharectomy and replacement of surgical defects by wound dressing materials based on natural polymers. It was demonstrated that the wound dressing based on aliphatic copolyamide and chitosan and hyaluronic acid hydrogel can help significantly accelerate the process of reparative regeneration and histogenesis in the heat-affected zone after escharectomy for up to 14.6%-46% (p < 0.05).
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