CYTOLOGICAL CHARACTERISTICS OF REGENERATIVE PROCESSES IN PURULENT WOUND DEPENDING ON THE TIME OF SURGERY (MORNING EVENING) AND CHRONOTYPE OF PATIENTS (MORNING AND EVENING CHRONOTYPE)
Authors: Lychman V.O. , Skikevich M.G. , Voloshyna L.I. , Havryl’iev V.M. , Avetikov D.S. 
Published: April 2022

Healing of postoperative wounds is a staged process. At the early stage of the wound process is characterized by the presence of a large number of unchanged and altered erythrocytes, the latter are characterized by shrinkage, change in shape, the formation of clusters. Hemorrhages in a wound and the initial phenomena of an inflammation are defined. In the period of regeneration of wound healing, inflammatory phenomena gradually disappear, and regenerative processes are increasingly developed. n the study of the dynamics of healing of postoperative wounds, the most informative is the method of "superficial wound biopsy". For cytological material is taken by lightly scraping the surface layer of the wound with a special spatula. This method usually manages to obtain elements not only of the exudate and the superficial (granular-fibrinous) layer of the wound, but also newly formed cells. The cytograms obtained in this way provide significant information about the course of regenerative processes in the wound. [1]. Using the method of "surface biopsy" of wounds to determine the features of the regenerative processes in the wound depending on the time of surgery (morning evening) and the chronotype of patients (morning and evening).

Cytological examination was performed using the method of "surface biopsy" of the wound [2]. The material for the study was taken by lightly scraping the surface layer of the wound with a spatula on the 1st, 3rd, 5th and 7th day of the postoperative period. The resulting material was transferred to a glass slide, evenly distributed in a thin layer, fixed and stained by Romanowski-Gimza [3]. The obtained preparations were studied using a microscope Biorex-3 BM-500T with a digital photomultiplier DCM 900 with programs adapted for research data. Cytometric study was performed by the method of standard planes [4] at a magnification of x1000, determined the average number of erythrocytes, unaltered neutrophilic granulocytes, naked nuclear neutrophilic granulocytes, macrophages, lymphocytes, fibroblasts, fibrin threads and collagen fibers in 10. Microphotography of the selected areas for illustrations was performed using a microscope Biorex-3 BM-500T with digital photomultiplier DCM 900.

It is established that the time of surgery, depending on the patient's chronotype, affects the course of the postoperative period and the wound healing process. Carrying out of operation according to the maximum activity of the patient reduces terms of realization of reparative process in a wound. Acceleration of hemostasis is accelerated and microcirculation and, accordingly, oxygenation of damaged tissues is restored faster. The number of unchanged and altered erythrocytes is probably lower in the superficial biopsies of wounds of patients who were operated with the chronotype in the most active time. In them, the dynamics of changes in the number of neutrophilic granulocytes indicates an earlier transition from the inflammatory stage of the wound process to regenerative. The obtained cytological data indicate the implementation of the reparative process 2 days earlier.