Резюме. У статті представлені результати вивчення мікроциркуляторних змін у 38 хворих з гнійно-некро-тичними ускладненнями цукрового діабету 2 типу, які достовірно вказують на ефективність їх корекції та регенерації ран за допомогою препаратів, що впливають на мікроциркуляцію. Ключові слова: цукровий діабет, мікроциркуляція, Пентоксифілін.
Objective. To study the effectiveness of platelet-enriched plasma application in patients with deep burns at the stage of wounds preparation for autodermoplasty. Materials and methods. The study was performed on 23 patients with burns IIA, IIB and III degrees taking 25 - 40% of the body surface. Comprehensive local treatment of patients of the main group included injection of platelet-enriched plasma at the stage of preparation of postoperative wounds for autodermoplasty. In patients of the control group, local treatment was limited by dressings with antiseptic solution. Examination of patients included visual inspection of the damaged area, microbiological examination of wound contents and histological examination of damaged tissues. Results. Applying the suggested method of burn wounds local treatment resulted in reducing time of wounds preparation for closure by autologous skin grafts, reducing of their healing period, decreasing of tissues inflammatory activity, blood flow improvement, and stimulating processes of tissue granulation, proliferation, epithelialization. Conclusions. The application of the autologous platelet-enriched plasma can be considered as an effective biotechnology that can increase the effectiveness of the skin integrity restoring in patients with burns.
Patients with purulent-inflammatory diseases of soft tissues on the background of diabetes type 2 are resistant changes in various parts of the immune system. Hyperglycemia, hyperlipidemia, insulin resistance and adaptive hyperinsulinemia affect the cells of the immune system, promote the development of metabolic immunosuppression with the formation of stable immune dysfunction. The purpose of the study to investigate and analyze the metabolic state of immunocompetent cells in patients with purulent-inflammatory diseases of soft tissues on the background of DMD type 2. The study was conducted in 47 patients (the main group) with purulent-inflammatory diseases of soft-tissue on the background of diabetes mellitus, and 20 healthy volunteers (the comparison group) using the cytohistochemical restoration method of NST based on the percentage composition of neutrophils that have cytoplasm of formazan granules. The spontaneous neutrophil response was studied, as well as the parameters of the NST-test in stimulation of neutrophil granulocytes in vitro to assess the bactericidal, resource potential and their ability to complete phagocytosis. Results of the study showed that the decrease in the activity of myeloperoxidase and the NST-test in the conditions of stimulation of neutrophil granulocytes is a sign of unsatisfactory state of the bactericidal system of cells, which may be the cause of acute inflammatory processes in the body that accompany type 2 diabetes, which leads to functional exhaustion of the macrophage level of the immune body protection. At GZZMT against the background of DM 2 type compared with the norm, the “spontaneous” NST-test of neutrophils is high, which is due to the presence of inflammatory process. The index of stimulation of neutrophils is lower in the main group (1.6 times: 5.3±0.2% in the main group versus 8.4±0.4% in the control, p≤0.05), which is an indicator of a relatively weaker stimulation of those populations of neutrophils that were responsible for high indices in the “spontaneous” NST test, and the impaired state of cellular metabolism. So, in patients with type 2 diabetes, a violation of the bactericidal system of organism protection, which is one of the causes of the development of infectious and inflammatory processes.
Relevance. According to the study’s results, steady changes in various parts of the immune system: cellular, humeral, phagocytic activity is revealed in patients with type 2 diabetes. Hyperglycemia, hyperlipidemia, insulin resistance, and adaptive ehyperinsulinemia affect the cells of the immune system, promoting the development of metabolic immunosuppressant and forming a stable immunological disorder. The purpose of the study into the morphometric and morphofunctional state of peripheral blood leukocytes in patients with type 2 diabetes to determine their significance in the development of purulent-inflammatory diseases of soft tissues are research. Materials and methods. In this work, the analysis of morphometric, cytogystochemical and laboratory study results of the control (20 healthy volunteers) and thematic (47 patients with supportive soft tissue disease son the background of type 2 diabetes mellitus) study groups with the statistical processing of the obtained results was used. Results. The investigation of morphofunctional features of nonspecific and specific protection cells for purulent inflammatory diseases of tissues on the background of type 2 diabetes showed that the basis of diabetic complications are there vealed changes in the bactericidal activity of segmented neutrophils. The trend of indicators of leukocyte formula and the distribution curve of mononuclear cells by size, as well as the growth of the lymphocyticgranulocytic index, indicate a chronic formation of endotoxin synthesize of diabetes. Conclusions. Lowering the level of cationic proteins, the activity of myeloperoxidase and the NBT-test under stimulation of neutrophil granulocytes bylectinsis a sign of unsatisfactory state of the bactericidal cells system, which may be the cause of chronic and acute inflammatory processes in the body that accompany type 2 diabetes, to a functional exhaustion of the macrophage link in the organism immune defense. Keywords: type 2 diabetes, purulent-inflammatory diseases of soft tissues, immunogenesis, cytomorphometry, cytogistochemistry, immunocompetent blood cells.
Purpose of the study. Justification of the effective treatment tactics of the wounded with the gunshot fractures of the long bones.Materials and methods. The examination and treatment of 123 wounded with gunshot fractures were performed. All wounded were divided into 3 groups according to clinical observation. For the first clinical group the traditional treatment of the combat fractures with osteometallosynthesis out of injury zone was done. In the second group, treatment was added with negative pressure therapy. In the third clinical group Wounded got a VAC-associated therapy with the proposed of counter-drainage of wounds with the flow-washing irrigation with antiseptic solutions Decasan + 3% hydrogen peroxide. A bacteriological study of the wounds` exudates was carried out, and the sensitivity of microorganisms to antibiotics was determined.Results. The assay of microbiological investigation of the wounds of patients, which got explosive and mine-explosive injuries, demonstrated a predominance gram-negative microflora in the wound microbiocenoses such as Acinetobacter spp. (53% of cases) and Pseudomonas spp. (15% of cases). Gram-positive cocci were isolated from 22,2% of cases. The analysis of the antibiotic sensitivity data of gram-negative non-fermentative rods showed a high level of resistance to most antibacterial. All strains of acinetobacteria and pseudomonads were susceptible to polymyxin B and colistin, but resistant to unprotected and protected aminopenicillins (amoxicillin/clavulanate, ampicillin/sulbactam). Acceleration of regenerative processes in the wound under the influence of VAC-therapy (formation of healthy granulations, disappearance of edema) in patients with negative pressure suppression (II HS, III HS) led to a reduction of hospitalization period, which took in average 7,8 ± 1,2 days, that was 5,2 ± 0,8 days less than in a control group. In the third group of wounded, a mixture of Decasan and 3% hydrogen peroxide in the proportion of 3 : 1 was used for rinsing of wounds. On the third day tissue edema decreased in 94,45% of the wounded in that observation group, while in the second clinical group it was observed in 88,89% of patients. The duration of the hydration phase in the wound process was reduced to 5,7 days. The period of complete healing of the wounds was shorter for 2,5 days. The period of indoor stay of the wounded of this group in the hospital decreased from 14,97 to 10,8 days.Conclusions. Prevalence of gram-negative microorganisms in a gunshot wound and their high degree of resistance to antibiotics should be noticed when one takes a decision about empirical antibiotic therapy in the wounded. Observed clinical results of the proposed negative pressure therapy with counter-drainage of wounds by setting of flow-washing irrigation with a mixture of antiseptics Decasan and 3% hydrogen peroxide allow recommending this scheme for treatment of wounded with gunshot fractures of long bones.Keywords: Gunshot wound, antiseptics VAC-therapy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.