TREATMENT OF BURNS USING XENOTRANSPLANTS, SATURATED WITH NANOCRYSTALS OF SILVER

Abstract

Summary. Today, the frequency of burns in the developed world reaches 1: 1 thousand people. Thus, according to the American Burn Association, nearly 200.000 people are burnt each year. Half of them need hospitalization, and approximately 5.000 patients end up in fatal burns. In case of burn, the problem of restoring the integrity of the skin in deep and large burns remains relevant. For a long time, combustiologists around the world have proposed various methods of autodermoplasty, and for the temporary closure of burns – synthetic skin substitutes, dermal equivalents, xenografts. However, despite the progress made in the treatment of burns, new approaches are being developed using xenografts with their saturation with silver nanocrystals.

The aim of the study – to analyze the effect of used xenografts saturated with silver nanocrystals on the course of the wound process in patients with burns of varying severity and area of the lesion.

Materials and Methods. The work is based on the analysis of treatment of 155 patients with burns who were hospitalized at the Center for Thermal Trauma and Plastic Surgery of the Municipal Non-profit Enterprise “ Lviv City Clinical Hospital No. 8” from 2017 to 2021. During the study, patients received adequate inpatient care. Surgical and conservative methods were used during treatment. After discharge of patients, dynamic observations were performed for 6 months. Laboratory clinical and biochemical, microbiological and morphological research methods were used in the examination of patients. To diagnose the depth of dermal burns remote non-contact method of thermography was used with a help of a medical thermal imager ULIRVIZION T1-120.

Results. Among patients with burns, there were 102 men (66 %), of whom 84 patients (54 %) aged 20–59, 53 women (34 %), of whom 118 patients aged 20–50 (76%). The oldest patient was in the group of women aged 90 (0.64 %).  Of those hospitalized in the Center for Thermal Trauma and Plastic Surgery, 41 patients (26 %) were referred from the surgical departments of the Central Distric Hospital, 19 patients (12 %) from the surgical departments of other medical institutions, 58 patients (38 %) were hospitalized by ambulance, and 37 people (24 %) applied to the admission department on their own. By localization, burns were diagnosed on the feet of 5 patients (3.72 %), on the torso – in 12 (7.7%), on the shoulder girdle, upper limb (limbs) – in 14 (9.0 3 %), on wrists, hands – in 15 (9.7 %), on the head (neck) – in 20 patients (12.9 %), on the hips, thighs and legs – in 37 (23.9 %), on several parts of the body – in 52 (33.55 %).  In terms of the depth of burns, most patients with grade IIAB were observed in 57 people (36.8 %), among whom men aged 20–59 prevailed – 40 (25.8 %). In 40 patients (25.8 %) degrees I-IIA of lesion were observed, among whom persons of working age aged 20–59 prevailed – 33 (21.3 %), 36 (23.2%) with degrees IIB-III of lesion, and in 22 patients (14.2 %) – severe lesions. The area of ​​the burn surface was more often observed by small (up to 10 %) – in 111 patients (71.6 %), among whom there were 83 patients (53.6 %) aged 20–59, moderate (11–39 %) – in 33 (21.3 %), common (40 % or more lesions) – in 11 (7.1 %).

Conclusions. Most often, men and women aged 20–59 with working burns and 118 patients (76 %) of working age were hospitalized. In the complex treatment of dermal burns of severity degrees I-IIA, II-III with lesion areas up to 10; 10–29; 30–49 % recommend the use of xenograft flaps saturated with silver nanocrystals, which significantly reduces the average duration of inpatient treatment.