Dosed tissue stretching in the preparation of the donor site for chronic wounds split-skin grafting

Abstract

Objective. Development of a new method for preparing an skin graft to hypoxia conditions in a recipient wound by tissue stretching of the donor site.Materials and methods. Scientific hypothesis: dosed tissue stretching and localized circulatory compensated hypoxia resulting in this increase the concentration of cytokine HIF-1α in the area of distracted skin graft. The experiment was performed on 18 white outbred male rats. The level of local circulatory compensated hypoxia was monitored by using laser Doppler flowmetry. An enzyme immunoassay was used to determine the concentration of cytokine HIF-1α in tissue. In the clinical stage of the study, the results of treatment in 9 patients – main group (split-skin grafting developed by the original method) were compared with the results of treatment in 10 patients – control group, who underwent plastic closure according to the traditional method.Results.The experiment revealed a statistically significant difference between the concentration of cytokine HIF-1α in the intact and disractablegraft, which was confirmed by the results of a clinical study.In the group where split-skin grafting was performed according to the traditional method (control group), the graft engraftment area was (Me [Q1; Q3]) 71.0 [65; 78] %, in the main group – (Me [Q1; Q3]) 87.0 [79; 95] % (p = 0.0003).Conclusion. It is advisable to use a compensated reduction of microcirculation in a tissue subjected to dosed tissue stretching to train split-skin graft for hypoxia conditions.