EFFECT OF INTEGRATED TREATMENT ON REPARATIVE REGENERATION OF WOUNDS AND BONE DEFECTS IN CHILDREN WITH ODONTOGENEOUS PHLEGMONS
Authors: Tkachenko P.I. , Bilokon S.O. , Lokhmatova N.M. , Dolenko O.B. , Popelo Y.V. , Korotych N.M. , Shvets A.I. 
Published: March 2024

The achievements of modern septic surgery are associated with the implementation of the latest technologies and new generations of pharmacological drugs, the action of which is aimed at correcting existing disorders. Recently, special literature has presented encouraging data regarding the effectiveness of placenta cryoextract in treating inflammatory processes of the maxillofacial area. However, little attention has been given to its application in children.

Objective of this study is to investigate the effectiveness of comprehensive treatment on the processes of reparative regeneration in wound and bone tissue in children with odontogenic phlegmons.

Subjects and methods. In order to assess the course of the wound process, 29 children with phlegmons localized directly in the submandibular area were selected; the length of the incision was 5 cm. In the first group, involving 16 people, a set of measures was carried out in accordance with the medical care protocol, and in the second group, consisting of 13 patients, on the second day after the operation, an aseptic bandage with "Levomekol" ointment was applied to the wound surface with the addition of cryoextract of the placenta in ratios of 5:1. In order to objectify the results, pH-metry of the wound exudate was performed, a planimetric study was performed to establish the speed of retraction of the wound edges, and the cellular composition of the wound exudate was analyzed for 1, 3, and 8 days. On the first day after surgery, changes in these parameters in both groups were of the same type. On the third day, in the second group of children, the pH level improved by 9.5%, and the speed of retraction of the wound edges increased by 9.0% compared to the first group. On the 8th day, the concentration of hydrogen ions in this group increased by 9.4%, and the average area of the wound surface became smaller by 8.2% compared to the previous values. The cellular composition of the cytograms also indicated the advantages of wound healing in this group of patients. In the first group, comprising 16 individuals, a standard set of measures was implemented following the medical care protocol. In the second group, consisting of 13 patients, an aseptic bandage with "Levomekol" ointment, supplemented with cryoextract of placenta at a ratio of 5:1, was applied to the wound surface on the second post-operation day. To objectively assess the outcomes, pH-metry of the wound exudate was conducted, alongside planimetric studies to determine the rate of wound edge retraction. Additionally, the cellular composition of the wound exudate was analyzed at 1, 3, and 8 days post-operation. On the first day after the operation, both groups exhibited similar changes in these parameters. However, by the third day, the second group demonstrated a 9.5% improvement in pH levels and a 9.0% increase in the speed of wound edge retraction compared to the first group. By the eighth day, the second group displayed a 9.4% rise in hydrogen ion concentration, and the average wound surface area decreased by 8.2% compared to previous measurements. Furthermore, cytogram analysis indicated superior wound healing advantages in this group of patients.

Conclusion. The comparison of clinical and laboratory indicators at the observation stages allowed us to determine that the combined application of topical "Levomekol" ointment with the additional incorporation of placenta cryoextract in its composition improves the conditions of the wound healing process. This improvement is evidenced by the dynamics of changes in the pH indicator, the results of planimetry, and the cellular composition of the exudate.