DYNAMICS OF CYTOLYTIC SYNDROME INDICES UNDER THE INFLUENCE OF SKELETAL TRAUMA IN COMBINATION WITH ACUTE BLOOD LOSS, SKIN DAMAGE AND PRP-THERAPY EFFECTIVENESS

Abstract

Introduction. Road injuries are among the topical issues of modern urban society. Road accidents often cause soft tissue damage, including skin damage, in addition to skeletal traumas. Improper diagnosis and treatment of these injuries often leads to an increase in mortality. One of the promising methods of regeneration of the damaged body tissues is platelet-based biological grafts (Platelet Rich Plasma (PRP) therapy), but in the case of multiple trauma, this method of correction is insufficiently studied.

The aim of the study – to determine the dynamics of cytolytic syndrome indices under the influence of multiple trauma and evaluate the PRP-therapy effectiveness.

Research Methods. The experiments were performed on 186 nonlinear white male rats weighing 180–200 g. In the first experimental group, the animals were simulated mechanical damage of skin (on the back of the animal a skin flap of 2×2 cm was cut). In the second experimental group, skeletal trauma complicated with acute blood loss was simulated. In the third experimental group, these lesions were combined. In the fourth experimental group, animals with multiple trauma were intradermally injected with 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. The serum values of alanine and aspartate aminotransferase activities (ALT, AST) were measured. The control groups consisted of intact animals.

Results and Discussion. The studies have shown that mechanical trauma of skin causes statistically significant increase in serum values of ALT and AST activities up to 21st day compared to the control. By the 28th day, the activity of cytolysis markers decreased. Serum AST reached the control level, while ALT activity continued to be elevated. The regularity of ALT and AST dynamics under conditions of skeletal trauma complicated with acute blood loss, but with greater amplitude, was similar. By the 28th day, both indicators did not reach the control level. The multiple trauma model was accompanied by an even greater intensification of cytolysis processes at all experimental periods. Due to use of PRP-therapy in the group with multiple trauma compared to injured animals without correction from the 14th day of the experiment, there was a decrease in serum ALT and AST activity.

Conclusions. Mechanical damage of skin considerably exacerbates the cytolytic syndrome caused by skeletal trauma complicated by acute blood loss. Intradermal administration of allogeneic platelet-rich plasma under these conditions leads to decrease in the intensity of cytolysis processes, starting from the 14th day of the experiment.