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. The frequency of occurrence of dislocation of the shoulder joint is the highest among that for all other limb joints. Simultaneously, recurrent instability of the shoulder joint develops majorly in children and adolescents, which, in the future, lead to the development of persistent pain syndrome. Past evidence indicate that the features of the spatial positioning of the articular process of the scapula can be considered as a risk factor toward the development of instability in the shoulder joint among adult patients. However, there is no reliable data in the literature regarding the influence of tilt and rotation of the shoulder blade glenoid on the occurrence of instability in the shoulder joint among children and adolescents. Encouraged, we undertook this subject for our study. Aim. To clarify the impact of changes in the version and inclination of the glenoid on the instability of the shoulder joint among children. Materials and methods. We analyzed the survey data of 42 children with a habitual dislocation of the shoulder of traumatic and atraumatic origins. The average ages of the examined children were 15.57 1.75 and 15.07 1.64 years, respectively, for those with shoulder instability of traumatic and atraumatic origins, respectively. Results. Statistical data processing revealed no significant differences in the versioning and inclination of the glenoid process between the groups with traumatic and atraumatic instabilities of the shoulder joint. Notably, the average values of versioning and inclination indicators were in the normal range. Conclusion. Based on our results, we suggest that, in the childhood, the dynamic and static soft tissue stabilizers of the shoulder joint play the leading role in the formation of instability of the shoulder joint.
BACKGROUND: Restoration of significant anatomical and functional bone defects is one of the most urgent problems of reconstructive surgery in children. Various options for plastic surgery of bone defects are considered. However, some publications present both positive and negative aspects of using vascularized bone autotransplants. AIM: This study aimed to conduct a systematic analysis of foreign literature data on the use of blood-supplied fibular grafts with a functioning growth zone. MATERIAL AND METHODS: A systematic literature search was performed in the PubMed information data base and Google Scholar from 1988 to February 7, 2021. Based on the criteria for the selection of literature sources, 21 literary sources were identified. In the analysis, special attention was paid to the age of patients at the time of reconstructive surgery, type of vascularized bone graft used with vessels that are part of the feeding leg, follow-up period, complications in the area of the surgical intervention, as well as the functional result and functioning of the graft growth zone. RESULTS: In this study, 21 articles comprised the sample, of which 14 were descriptions of clinical observation and seven were descriptions of clinical series. These publications include information on the follow-up of 54 patients with an average age of 6.86 years (minmax, 115 years). The average duration of postoperative follow-up was 56 months (minmax, 622 years). Indications for surgical interventions were extensive bone defects formed as a result of the tumor process (n = 44), trauma (n = 4), infectious process (n = 1), and birth defects (n = 5). CONCLUSIONS: In pediatric orthopedics, bone-vascularized fibular grafts with a functioning growth zone are used for the reconstruction of extensive bone defects in complex clinical situations if standard bone auto-/alloplasties are impossible. According to the literature, this technique allows us to achieve satisfactory functional results in most cases. Despite the positive functional results, postoperative complications are quite common in patients.
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