SYSTEMIC MANIFESTATIONS OF POLYTRAUMA FOLLOWING SOFT TISSUE RECONSTRUCTION PERFORMED AT VARIOUS STAGES OF THE POST-TRAUMATIC PERIOD
DOI:
https://doi.org/10.11603/mcch.2410-681X.2026.i2.16141Keywords:
craniocerebral trauma; skeletal trauma; soft tissue reconstruction; liver; kidneys; skin; lipid peroxidation.Abstract
Introduction. In the conditions of modern wartime, combined wounds most often occur, in which damage to the extremities involving soft tissue defects is the most common. Despite the implementation of modern treatment technologies, the functional outcomes of treating wounded patients with soft tissue defects remain unsatisfactory in nearly half of them. It is believed that one of the factors in selecting the optimal reconstruction method is the patient’s general condition, which is caused by systemic disorders associated with the primary injury. The aim of the study is to identify the characteristics of systemic manifestations of polytrauma following soft tissue reconstruction performed at different stages of the post-traumatic period. Research Methods. The experiments were conducted on mature male Wistar line white rats. In the first series of experiments, under thiopental-sodium anesthesia, rats underwent simulated cranioskeletal trauma (CST) and soft tissue reconstruction (STR), and were taken out of the experiment after 14 days. Intact rats served as the control group. In the second series of experiments, STR was performed on separate groups of rats with CST 1, 3, 7, and 14 days after the post-traumatic period. Rats with CST served as the control group. Rats were taken out of the experiment at a time corresponding to 14 days after modeling of STR. The intensity of systemic disturbances was assessed based on the determination of malondialdehyde (MDA) in extracts of liver, kidney, and skin homogenates. Results and Discussion. It was found that modeling STR 14 days after post-traumatic period, compared with the control group, led to an increase in MDA levels in the liver, kidneys, and skin. In rats in which only CST was induced, MDA levels in the examined organs reached their maximum 14 days after the post-traumatic period and gradually decreased by the 28th day without reaching control levels. In rats that underwent STR 1 day after CST, MDA levels in the liver, kidneys, and skin were higher compared to the group that underwent only CST. After STR performed 3 and 7 days after CST, the degree of MDA elevation in the liver, kidneys, and skin gradually decreased and was lowest after 7-day STR. However, performing STR 14 days after CST was accompanied by a repeated increase in MDA levels in the studied organs. Conclusion. The application of STR 7 days after the post-traumatic period is associated with fewer overall systemic complications, which may represent a new direction in the surgical reconstruction of soft tissue defects in the context of multi-trauma.
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