THE ROLE OF SKIN DAMAGE IN THE DEVELOPMENT OF OXIDATIVE STRESS IN THE KIDNEYS UNDER THE CONDITIONS OF COMBINED TRAUMA AND THE EFFECTIVENESS OF THE APPLICATION OF PRP THERAPY
DOI:
https://doi.org/10.11603/mcch.2410-681X.2024.i2.14767Keywords:
mechanical skin damage, skeletal injury, blood loss, oxidative stress, kidney, PRP therapyAbstract
Introduction. In the conditions of wartime and peacetime trauma, limb injuries dominate, which are often accompanied by soft tissue damage with the separation of a significant part of the skin and subcutaneous tissue from the underlying fascia, muscles, or bone surface. Additional damage of the skin under conditions of combined trauma can deepen the development of systemic disorders, including oxidative stress.
The aim of the study – to find out the role of skin damage in the development of oxidative stress in the kidneys under conditions of combined trauma and to evaluate the effectiveness of PRP therapy.
Research Methods. Experiments were performed on 156 sexually mature white Wistar line rats weighing 200-220 g. In experimental group 1, a skeletal injury was simulated by a fracture of the femur and blood loss in the amount of 20 % of the circulating blood volume, in experimental group 2, skin damage with a size of 2×2 cm was additionally induced. In experimental group 3 animals with combined trauma were intradermally injected with platelet-enriched allogeneic plasma. After 3, 7, 14, 21, and 28 days post-injuries, a marker of oxidative stress – antioxidant-prooxidant index (API) was determined in the tissues of the cortical and medullary layers of the kidneys.
Results and Discussion. Simulated skeletal injury contributes to the development of oxidative stress in the cortical and medullary layers of the kidney, evidenced by a shift in the antioxidant-prooxidant balance toward the dominance of prooxidant mechanisms. Violations have a phase nature with the first increase – after 3 days of the experiment and the second increase, but smaller in amplitude – after 21 days. The value of API decreased in proportion to the severity of injuries. The application of PRP therapy to the rats with a combined injury compared to rats without correction led to an increase in the value of API in the cortical layer of the kidney after 21 and 28 days of the experiment, in the medullary – starting from the 14th day.
Conclusion. The infliction of a skeletal injury complicated by mechanical damage to the skin, is accompanied by a wave-like increase in oxidative stress in the cortical and medullary layers of the kidney, which are revealed by a greater decrease in the value of API with two periods of maximum violations – after the 3rd and 21st day of the experiment.The use of PRP therapy contributes to smaller violations of the API value in the cortical layer of the kidney, starting from the 21st day of the experiment, in the medullary – starting from the 14th day of the experiment.
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