PECULIARITIES OF THE WOUND PROCESS DEVELOPMENT IN PATIENTS WITH THERMAL INJURY WHEN USED SILVER PREPARATIONS IN BURN WOUNDS SURGICAL TREATMENT
Authors: Tuzyuk N. V. 
Published: October 2021

Fundamental research in the field of burn wound development process highlights new pathogenetic mechanisms that underlie the improvement of medical practice, the main purpose of which is to create optimal conditions for early regeneration of the affected skin, as well as to eliminate the development of local and general complications. Irrational general and local treatment of wounds contribute to the slowing down of regenerative processes, thereby worsening the prognosis and consequences of thermal injury.

It was found out that in patients of both study groups in the first period of the study the characteristics of the cellular composition of the wound impressions of the wound bottom of the area of thermal damage correspond to the degenerative type.

In patients of the main group in the second term of the study in the area of thermal damage cells with high levels of functional and metabolic activity begin to appear, which increase antimicrobial resistance and reduce the risk of generalization of the infectious process which is the main source of burns.

In patients of the main group, an increase in the activity of neutrophilic granulocytes in the induced test was found in the second term of the study, which, in our opinion, indicates the involvement of neutrophilic granulocytes with high functional and metabolic activity. Under conditions of significant activation of resident monocytes in response to injury in patients of the main group in the second and third term, the area of thermal damage migrates functionally effective monocytes. In patients of the main group the preservation of the activity of myeloperoxidase - the main enzyme of the oxygen-dependent phase of phagocytosis at the minimum subcompensated level, which leads to the preservation of the oxygen-dependent metabolic reaction of neutrophilic granulocytes in the subsequent study, Increases in the content of PAS-positive substances in neutrophilic granulocytes indicate the preservation of the functional reserve for activation and completion of the oxygen-independent phase of phagocytosis.

The use of the developed treatment promotes the involvement of functionally active phagocytic cells in the burn wound, reduces the toxic load on monocytes and neutrophils, which helps to maintain their functional activity at the subcompensated level. These trends in patients of the main group reduce the risk of both local and general infectious complications of burn disease.

It was found that the level of spontaneous functional activity in the HCT test is associated with the activity of resident monocytes. They form the primary barrier that protects the body from infection or harmful macromolecular complexes. Monocytes - "inflammatory", which constantly come from the free pool and their functional activity against microbial antigens is much higher than resident monocytes. An indicator of the activity of monocytes - "inflammatory" is an indicator of functional activity in the induced HCT test. The results of the study indicate that under conditions of significant activation of resident monocytes in response to injury in patients of the main group in the second and third terms of the area of thermal damage migrate functionally effective monocytes.