The effect of mechanical skin damage on manifestations of endotoxicosis
and immune response under the influence of skeletal trauma complicated by
acute blood loss and PRP-therapy effectiveness
Authors: Smahlii Zoryana V. 
Published: March 2024

Summary. The frequency of emergencies in both peacetime and wartime
conditions has significantly increased in recent years. Under those
circumstances, severe multiple and combined traumas, caused by skeletal
trauma, acute blood loss and massive soft-tissue and skin damage,
predominate among the various kinds of injuries. The role of mechanical skin
damage in the course of severe trauma is insufficiently presented in the
existing studies and literature. There are no data on the effectiveness of
platelet-rich plasma grafts (PRP-therapy) under those conditions, which can
greatly accelerate the regeneration of damaged soft tissues and skin, and
thus inhibit the manifestations of systemic disorders, in particular
endotoxicosis and immune responses. The aim of the study – to establish the
effect of mechanical skin damage on the dynamics of indicators of endogenous
intoxication and immune responses under the influence of skeletal trauma
complicated by acute blood loss and evaluate the PRP-therapy effectiveness.
Materials and Methods. The experimental studies were performed on 186
nonlinear white male rats weighing 180–200 g. In the first experimental
group, the animals were simulated a mechanical damage of skin (a skin flap
of 2×2 cm on the back of the animal was cut). The animals of the second
experimental group were subjected to a skeletal trauma complicated by acute
blood loss. In the third experimental group, these lesions were combined. In
the fourth experimental group, the animals with combined trauma were
administered an intradermal injection of 0.1 ml of platelet-rich plasma in
wound edges. After 3, 7, 14, 21 and 28 days of trauma infliction, the
animals were removed from the experiment. Contents of middle molecular
weight (MMW280) fraction and circulation immune complexes (CICs) were
measured in serum. The control group consisted of intact animals. Results.
The research findings have shown that the infliction of isolated damage to
skin is accompanied by the accumulation of the MMW280fraction and CICs in
serum, the contents were higher than control values at all experimental
periods reaching their maximum after 7 days and starting to increase again
after 21 days. The pattern of the dynamics of the studied indicators in
conditions of skeletal trauma complicated by acute blood loss was similar,
but with greater amplitude. A combined trauma model resulted in an even
greater increase in the intensity of endogenous intoxication and immune
responses at all experimental time points. The administration of the
PRP-therapy led to the decrease in the contents of MMW280 fraction and CICs
in serum of rats with the combined trauma model starting from 7thday and
21st day of the experiment, respectively, as compared to the animals with
the trauma model without correction. Conclusions. The infliction of damage
to skin provokes the significant increase in the contents of MMW280 fraction
and CICs in serum and can enhance the endogenous intoxication and immune
responses in the presence of skeletal trauma complicated by acute blood
loss. Intradermal administration of allogeneic platelet-rich plasma
injection under these conditions leads to the decrease in the contents of
MMW280 fraction and CICs as compared to the untreated animals with trauma
model