NUTRITIONAL SUPPORT IN THE TREATMENT OF GUNSHOT WOUNDS: THE ROLE OF COLLAGEN HYDROLYSATES

Abstract

The aim of the work: to evaluate the effectiveness of collagen hydrolysates in the comprehensive treatment of gunshot limb wounds in military personnel.

Materials and Methods. The study included 80 servicemen aged 20–59 years with gunshot injuries of the limbs, who were divided into two groups: control (n=42; standard treatment) and main (n=38; standard treatment plus oral collagen hydrolysate for 45–60 days). The groups did not differ in age (33.4±1.2 vs. 34.1±1.4 years), body mass index (27.7±3.2 vs. 28.3±2.7 kg/m²; p>0.05), severity of injuries, or frequency of comorbidities. The most common were shrapnel wounds (72.5%), more often affecting the lower limbs (61.3%), reflecting the conditions of combat operations. Clinical and laboratory parameters were assessed: wound cleansing dynamics, granulation tissue formation, microbial contamination level, cytological smear characteristics, inflammation intensity, and markers of intoxication.

Results. In the control group, wound healing followed the typical course with marked leukocyte infiltration (130.5±7.5 cells per field of view on day 7), high levels of leukocyte destruction (96.5±2.0 %), and prolonged microbial contamination (3.5±0.8×100 microbial bodies per 100 leukocytes). In patients receiving collagen hydrolysate, the leukocyte count on day 7 was significantly lower (101.5±6.8; p<0.05), while the proportion of destroyed cells decreased nearly 1.5-fold (63.5±4.2 % vs. 92.4±3.1%; p<0.01). By day 14, microbial contamination decreased to 0.4±0.1 (vs. 1.3±0.4 in the control group; p<0.05). Cytological analysis showed a faster transition from degenerative-inflammatory to regenerative cytograms: the number of macrophages and fibroblasts in the experimental group on day 14 was nearly twice as high as in controls (18.5±1.4 % and 12.8±0.9 % vs. 8.5±0.7 % and 5.9±0.6 %; p<0.01). By day 21, the cytogram of the main group corresponded to the stage of mature granulation, while in control patients signs of delayed inflammation persisted.

Conclusions. The inclusion of collagen hydrolysates in the comprehensive therapy of gunshot wounds provides a protective effect: it reduces the severity of inflammatory destruction, accelerates wound sanitation from pathogenic flora, and stimulates early formation of the macrophage–fibroblast component necessary for effective regeneration. The method has prospects for wide use in military medicine, as it shortens healing time, lowers the risk of infectious complications, and increases recovery efficiency in wounded servicemen.