Affiliation:
1. Grodno State Medical University
Abstract
The problem of treatment of the patients with deep frostbite is still relevant due to its great social and economic significance, which necessitates further research. In general injuries structure, the proportion of cold injury can reach 10 %. The variety of the pathophysiological cryotrauma mechanisms explains the treatment complexity, which leads to frequent complications and significant disability of patients, among them the persons of working age are predominate. However, the generally accepted practice of managing patients with deep frostbite has not yet been developed, for example, the effectiveness of various drugs for local treatment has not been substantiated, the timing and scope of surgical benefits have not been determined. The aim of the study was to examine the effectiveness of wound coatings with chitosan nanofibers in combination with necrectomy on the 5th day during deep contact frostbite treatment. On the 5th day after modeling the standard deep experimental frostbites in 45 laboratory rats, the non-viable tissues in the cryopreservation zone were removed. For treatment of wound defects, the Mekol ointment, sterile gauze napkins, and wound coatings with chitosan nanofibers “Hitomed-wound healing” were used. Reparative processes in the frostbite area were assessed histologically, morphometrically, and statistically. The effectiveness of wound coatings with chitosan nanofibers in combination with necrectomy of the cryoinjured zone on the 5th day in the deep frostbite treatment was established.
Publisher
Publishing House Belorusskaya Nauka
Reference20 articles.
1. Mikhailichenko M. I., Shapovalov K. G., Mudrov V. A. Predicting complications in patients with local cold injury. Vestnik Natsional’nogo mediko-khirurgicheskogo tsentra imeni N. I. Pirogova [Bulletin of Pirogov National Medical Surgical Center], 2020, vol. 15, no. 2, pp. 92–97 (in Russian).
2. Gao Y., Wang F., Zhou W., Pan Sh. Research progress in the pathogenic mechanisms and imaging of severe frostbite. European Journal of Radiology, 2021, vol. 137, art. 109605. https://doi.org/10.1016/j.ejrad.2021.109605
3. McIntosh S. E., Freer L., Grissom C., Auerbach P., Rodway G. W., Cochran A. [et al.]. Wilderness medical society clinical practice guidelines for the prevention and treatment of frostbite: 2019 update. Wilderness and Environmental Medicine, 2019, vol. 30, no. 4S, pp. S19–S32. https://doi.org/10.1016/j.wem.2019.05.002
4. Hong-Xu J., Yue T., Jing D., Xiao-Dong Zh. Expert consensus on the prevention, diagnosis and treatment of cold injury in China. Military Medical Research, 2021, vol. 8, art. 6. https://doi.org/10.1186/s40779-020-00295-z
5. Melamed V. D. Innovative wound dressings with chitosan nanofibers. Novoe v khirurgii: nauka, praktika, obuchenie: sbornik tezisov dokladov Respublikanskoi nauchno-prakticheskoi konferentsii s mezhdunarodnym uchastiem, posvyashchennoi 100-letiyu kafedry obshchei khirurgii BGMU (Minsk, 24 sentyabrya 2021) [New in surgery: science, practice, education: collection of abstracts of the Republican scientific and practical conference with international participation, dedicated to the 100th anniversary of the Department of General Surgery of the Belarusian State Medical University (Minsk, September 24, 2021)]. Minsk, 2021, pp. 183–186 (in Russian).