The treatment of chronic wounds is a continuously developing research focus. The problems of excessive mechanical forces, infection, inflammation, reduced production of growth factors, and lack of collagen will affect the results of treatment. The purpose of this study was to analysse the elements that lead to long-term non-healing of chronic wounds and trophic ulcers, including diabetic foot syndrome, by determining the optimal treatment algorithm. The paper presents an analysis of the world literature on the etiopathogenesis and principles of chronic wound treatment in diabetic foot syndrome. The epidemiology of chronic wounds of different genesis is presented. The issues of physiological and metabolic disorders in chronic ulcers affecting the process of wound healing are discussed. Particular attention is paid to collagen, which is a protein that forms the basis of connective tissue; collagen ensures the strength and elasticity of the skin, which confirms the importance of its role not only in aesthetics but also in the process of wound healing. Different types of collagen and their roles in the mechanisms of chronic wound healing in diabetic foot syndrome are described. The results of clinical studies evaluating the effectiveness of medical products and preparations, consisting of collagen with preserved (native collagen) and fractionated structures, in treating chronic wounds of diabetic foot syndrome are analysed. It has been shown that the use of native collagen preparations is a promising treatment for chronic ulcers and wounds, including diabetic foot syndrome, which makes it possible to increase the effectiveness of treatment and reduce the economic costs of managing these patients.

Purpose To study the effects of inflammation on the healing process of rats’ acute skin wounds during treatment with different injections. Methods The study was carried out on Wistar rats, on which square wounds were simulated in the back region. Four groups of wounds were studied. On the day of the simulation (day 0), solutions of the drugs were injected into the wounds: an isotonic sodium chloride solution (Control group), mesenchymal stem cells (SC group), collagen (Collagen group), and a deproteinized hemoderivative of calf blood (DHB group). Within 2 weeks, the wound healing process was assessed by observing and calculating changes in the wound areas, temperatures, and epithelialization levels. On days 3, 7, and 14, wound tissue samples were taken for histological examination, morphological analysis of the healing process, and quantitative assessment of granulation layers’ leukocyte infiltration. Results A correlation between the process of inflammation and epithelization during the healing of skin wounds was established. The anti-inflammatory effect of SC injection on the wound edge tissues was determined, as well as the pro-inflammatory effect of DHB, and the absence of effects on the inflammation course under the collagen treatment. Compared to the control group, the transition from the exudative phase of inflammation to the proliferative phase was faster, as well was wound epithelialization in the SC and Collagen groups. A negative correlation between the level of tissue temperature in the center of wounds and their area were recorded, which intensified over time. Conclusion The severity and duration of the inflammation process during wound healing were ambiguous with the use of different injection treatments. This should compel clinicians to use different markers of drug therapy effectiveness during wound healing. Excessive leukocyte infiltration with a low temperature of wounds and a large scab were markers of delayed wound healing.

The healing of wounds is a dynamic function that necessitates coordination among multiple cell types and an optimal extracellular milieu. Much of the research focused on finding new techniques to improve and manage dermal injuries, chronic injuries, burn injuries, and sepsis, which are frequent medical concerns. A new research strategy involves developing multifunctional dressings to aid innate healing and combat numerous issues that trouble incompletely healed injuries, such as extreme inflammation, ischemic damage, scarring, and wound infection. Natural origin-based compounds offer distinct characteristics, such as excellent biocompatibility, cost-effectiveness, and low toxicity. Researchers have developed biopolymer-based wound dressings with drugs, biomacromolecules, and cells that are cytocompatible, hemostatic, initiate skin rejuvenation and rapid healing, and possess anti-inflammatory and antimicrobial activity. The main goal would be to mimic characteristics of fetal tissue regeneration in the adult healing phase, including complete hair and glandular restoration without delay or scarring. Emerging treatments based on biomaterials, nanoparticles, and biomimetic proteases have the keys to improving wound care and will be a vital addition to the therapeutic toolkit for slow-healing wounds. This study focuses on recent discoveries of several dressings that have undergone extensive pre-clinical development or are now undergoing fundamental research.

We have proved the efficacy and safety of collagen biomaterial topical application in a diabetic foot syndrome treatment.

Expression of markers, collagens, and HLA-1 by human skin fibroblasts and fibroblast-like cells isolated from the umbilical Wharton's jelly was compared. Skin fibroblasts express collagens (proteins characteristic of differentiated cells of this histogenetic series) and HLA-1, while umbilical cells express, in addition to collagens, juvenile surface markers and almost no HLA-1. This indicates that fibroblast-like cells isolated from different sources are different and can serve as sources for the creation of cell preparations with different characteristics in future.

The aim of this study was to assess the patterns and pattern disruptions of free radical processes in patients with obstructive jaundice of various origins, and the severity of jaundice before and after decompression. Oxidative stress markers were determined in 128 patients with obstructive jaundice with a tumor genesis (23.4%) or non-tumor genesis (76.6%). The patients were hospitalized at different stages of clinical signs of jaundice. We studied the anti-peroxide activity in plasma, basal and stimulated indicators of the chemiluminescence intensity in leukocytes, leukocyte activity coefficients reflecting the level of reactive oxygen species generated by leukocytes, malondialdehyde levels indicative of the degree of lipid peroxidation and cellular destruction, liver enzymes (markers of cytolysis) and bilirubin levels. Data for hepatocyte death and markers of oxidative stress correlated with the severity of jaundice, its duration and the method of its surgical correction. It is proposed that using markers of free radical processes to assess the prognosis and effectiveness of treatment and to personalize treatment measures will improve the results of jaundice treatment.

Biomaterial Collost using in complex treatment of diabetic foot syndrome resulted in more rapid and effective healing of the ulcer. The treatment success increased from 43% to 72%. Complete epithelialization was achieved by 2.6 times more rapidly in conjunction with reduction the incidence of unsuccessful treatment results by 4.1 times.

Purpose An assessment of the effectiveness of progenitor mesenchymal stem cell as injections and as part of a polymer hydrogel for the wounds treatment. Materials and Methods Fixed-size wounds (average area of 135.8 mm 2 ) were modeled on the back of white Wistar rats, aged 9 months. Mesenchymal stem cells (MSC) isolated from a human umbilical cord were injected into the wounds once on the modeling day (SC group). In other animals, MSC were periodically applied externally as one of the components in the polymer hydrogel (Polymer_sc group). The systemic effect of the cells was assessed via the analysis of intact contralateral wounds located on the opposite side of the same animal’s back (groups Control_sc and Control_Psc, respectively). The reference intact wounds belonged to the Control_0 group. The wound area was studied in dynamics. Descriptive microscopy was supplemented by an assessment of the collagen fibers’ maturity, the epidermal layers, and the number of fibroblasts and leukocytes in different parts of the wounds. Results Both the local and systemic application of MSC led to an improvement in wound regeneration. During the acute inflammatory phase (up to 3 days), the method and place of application did not affect the dynamics of wound healing. The use of Polymer_sc ultimately demonstrated the best effectiveness. The anti-inflammatory effect of MSC was confirmed by a decrease in leukocyte infiltration in the wound centers (Polymer_sc and SC groups) and edges (all groups, with the greatest extent in the Polymer_sc group). The proliferative phase that expresses itself via accelerated growth in fibroblast number and collagen production was affected in the Control_Psc group and mostly in the Polymer_sc group. Conclusion The applications of MSC in various ways improve and accelerate wound healing even in old animals. The best performance was achieved in the Polymer_sc group.