CC BY
9
WAYS OF COMPLEX TREATMENT OF BURN WOUNDS Salakhiddinov K.Z.1, Gofurov Z.K.2, Salakhiddinov Z.3-
1Salakhiddinov Kamoliddin Zuhriddinovich - Doctor of Medical Sciences, Associate Professor; 2Gofurov Zokhid Karimovich - Candidate of Medical Sciences, Assistant, DEPARTMENT OF FACULTY AND HOSPITAL SURGERY; 3Salahiddinov Zukhriddin - Doctor of Medicine, Professor, DEPARTMENT OF THERAPY, ANDIJAN STATE MEDICAL INSTITUTE, ANDIJAN, REPUBLIC OF UZBEKISTAN
Abstract: this article deals with the prevention and treatment of burn wound complications. Studied the course of the wound process, microbial contamination.
They discuss events related to the healing of burn wounds, and consider modern complex methods of treatment that have been used for burn wounds. We discuss the effectiveness of wound dressings and cellular technologies in the healing of burn wounds.
Keywords: burns, skin restoration, complications, reconstructive surgery, complex treatment, lymphatic therapy, wound coverings
СПОСОБЫ КОМПЛЕКСНОГО ЛЕЧЕНИЯ ОЖОГОВЫХ РАН Салахиддинов К.З.1, Гофуров З.К.2, Салахиддинов З.3
1Салахиддинов Камолиддин Зухриддинович - доктор медицинских наук, доцент; 2Гофуров Зохид Каримович - кандидат медицинских наук, ассистент, кафедра факультетской и госпитальной хирургии; 3Салахиддинов Зухриддин - доктор медицинских наук, профессор, кафедра терапии, Андижанский государственный медицинский институт, г. Андижан, Республика Узбекистан
Аннотация: эта статья посвящена профилактике и лечению осложнений ожоговой раны. Изучен ход раневого процесса, микробное обсеменение.
В статье обсуждаются события, связанные с заживлением ожоговых ран, и рассматриваются современные комплексные методы лечения, которые применялись при ожоговых ранах. Обсуждена эффективность раневых повязок и клеточных технологий при заживлении ожоговых ран. Ключевые слова: ожоги, восстановление кожи, осложнения, реконструктивная хирургия, комплексное лечение, лимфатическая терапия, раневые покровы
УДК 616-001.17
One of the widespread and having an obvious tendency to increase types of injuries is burns, representing a serious medical, social and economic problem.
The main danger at burns is constituted by a wound infection [1]. Besides direct threat for the patient's life, long existence of an infection of burn wounds leads to a delay of process of healing, formation of granulyatsionny fabric at deep burns, to lysis of again formed epithelium, deepening of burns of II - IIIA of degree also promotes excess scarring which continues as a result of chronic inflammatory reaction [2,3,5,6]. Actual are infection questions when carrying out an early ekstsiziya of a burn wound and its timely autodermoplastic closing [2,4], at application of such modern methods of treatment, as transplantation of the cultivated allofibroblast. Any infectious complication of a burn disease, whether it be sepsis, pneumonia, uroinfektion or arthritis, pathogenetic are connected with a burn wound. Due to these development of a complex of methods of prevention of an infection and infectious complications is one of the main problematic issues of modern Combustiology.
We have offered and improved a technique of treatment of burn wounds where much attention was paid to prevention of wound complications. As a subject of discussions in our opinion serves not the question of need of preventive prescription of antibiotics, but a problem of the choice of an effective technique of his carrying out. All know that at a burn trauma there is an expressed violation micro-lymphocirculation, shown existence of refocal hypostasis, destruction of integrity of walls of vessels, thrombosing his gleam that in turn worsens receipt of necessary medical concentration of medicines in a pathology zone.
The offered technique consisted in complex treatment - carrying out an early nekrektomiya with one-stage autodermoplastik (depending on a condition of a wound), transplantation of the cultivated autofibroblast distributed in the gel mass of "Biokol", use of biosynthetic wound coverings and regional lymphatic therapy
(RLAT) which began with the receipt moment. The venue of RLAT was made according to a segmental of a structure of lymphatic system.
The analysis of inspections of 46 patients with superficial and deep burns of 8 - 25% of a surface of a body has shown that for the 1-4th days after a trauma at the examined patients Staphylococcus aureus (41%), Pseudomonas aeruginosa (16,9%) or associations of these microorganisms (23,9%) were defined. at 8 - in the top layers separate cocci are revealed. For the 6-8th days only at 4,2% from the examined patients existence of streptococcal association of a microorganism is noted. In group of comparison these days associations of microorganisms with prevalence of strains of S. aureus and P. Aeruginosa, are noted at 26,1% of patients. On 1014 days after a trauma in the main group of patients histologic signs of a microbic invasion haven't been noted.
Doing the conclusion, it would be desirable to note that regional lymphatic therapy has a number of considerable advantages in comparison with traditional methods of antibiotic treatment, this aim direct introduction of preparations to a pathology zone, improvement local micro- lymphocirculation, long deposition of high concentration of an antibiotic in places of defeat, ease of a technique of application.
Use of integrated medical approach and prevention of wound infections in Combustiology, promoted decrease in level of infectious complications by 2,4 times, terms of hospitalization and material inputs.
References / Список литературы
1. Alekseev A.A., Salakhiddinov K.Z., Gavrilyuk B.K. Complex treatment of deep burns based on the use of surgical necrectomy and modern biotechnological methods // Annals of Surgery, 2012. № 6.
2. Salakhiddinov K.Z., Alekseev A.A. The role of biosynthetic coatings in the treatment of superficial burns of II-IIIA degree // Kazan medical journal, 2013. T. 94. № 4.
3. Liu H.F., Zhang F. Toilet Lineaweaver. History and development of burn treatment methods. Operation Ann Plast. 2017 February; 78 (2 Appendix 1): S2-S8. DOI: 10.1097 / SAP.0000000000000896. PMID: 28079548.
4. El Khatib A., Eshke M.G. Aspects of modern treatment of burns. Medicine (Kaunas). 2021 April 16; 57 (4): 386. DOI: 10.3390 / medicine 57040386. PMID: 33923571; PMCID: PMC8073568.
5. Yong E.K., Shen V.H., Xue P.R., Xue C.M., Huang H.F., Ko A.T., Tai H.S., Lai H.S., Chang S.K. Microbiology of wounds and the results of systemic antibiotic prophylaxis for massive burns. J Burn Care Decision, 2020 January 30; 41 (1): 95-103. DOI: 10.1093 / jbcr / irz077. PMID: 31999335.
6. Puca V., Marulli R.Z., Grande R., Vitale I., Niro A., Molinaro G., Presioso S., Muraro R., Di Giovanni P. Species of microorganisms isolated from infected wounds and analysis of resistance to Antimicrobials: Evidence from a 3-year retrospective study. Antibiotics (Basel), 2021. September 24; 10 (10): 1162. doi: 10.3390 / antibiotics 10101162. PMID: 34680743; PMCID: PMC8532735.
