Abstract
Objective – to study the morphology of wound process in diabetic patients. Materials and methods. The subjects treated in this study were 180 patients: 122 females (67.8 %) and 58 males (32.2 %). Traditional methods for evaluating the morphology of wound healing have been used: imprint smear of the edge of the wound according to the method of M.P. Pokrovskaya and M.S.Makarov (1942), staining of paraffin sections according to the histochemical methods proposed by D.D. Zerbino and L.L. Lukasevich (1984), study of epidermal thickness and its keratinization degree, measuring of the epidermal zone and dermoepidermal junction. All measurements in histological sections were carried out using the eyepiece-micrometer, the results presented in micrometers. Results. It is found that in patients with diabetes mellitus with increasing duration of the disease occurs thinning of epidermis and the signs of keratinization of the epidermis. In the zone of dermoepidermal junction and dermis in patients with diabetes mellitus there is emergence of adipose tissue. This incidence of adipose tissue correlates with the duration of the disease. The amount of regeneration-degeneration index correlates with the nature of the wound process. Conclusions. In the skin of patients with diabetes mellitus there appear symptoms of parenchymal proteinosis and adipose degeneration, which reflects metabolic imbalance in tissue. The wound process in patients suffering from diabetes mellitus is characterized by prolonged inflammatory phase and delayed regenerative processes.
Highlights
In the zone of dermoepidermal junction and dermis in patients with diabetes mellitus there is emergence of adipose tissue. This incidence of adipose tissue correlates with the duration of the disease
The amount of regeneration-degeneration index correlates with the nature of the wound process
The wound process in patients suffering from diabetes mellitus is characterized by prolonged inflammatory phase and delayed regenerative processes
Summary
Цель исследования – изучить особенности морфологии раневого процесса у больных сахарным диабетом. Использованы традиционные методы оценки морфологии раневого заживления: мазок-отпечаток с края раны по методу М.П. Все измерения в гистологических срезах проведены с помощью окуляр-микрометра, результаты представлены в микрометрах. Установлено, что у пациентов с сахарным диабетом при увеличении срока заболевания наблюдается уменьшение толщины эпидермиса и увеличивается частота встречаемости признаков роговой дистрофии в эпидермисе. В зоне дермоэпидермального контакта и в дерме у пациентов с сахарным диабетом отмечается появление участков жировой ткани. В коже больных сахарным диабетом имеются проявления паренхиматозного диспротеиноза и жировой дистрофии, что отражает нарушение тканевого метаболизма. Течение раневого процесса у пациентов, страдающих сахарным диабетом, характеризуется пролонгированностью фазы воспаления и задержкой регенеративных процессов. Ключевые слова: раны, раневой процесс, фазы раневого процесса, сахарный диабет, цитология раневых отпечатков, регенеративно-дегенеративный индекс
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