Substantiation of the Combined Use of Negative Pressure Therapy and Meglumine Sodium Succinate in the Treatment of Wounds of Various Etiologies

Abstract

The review presents a theoretical rationale for the effectiveness of including topically NPWT therapy and meglumine sodium succinate intravenously in the complex therapy of wounds of various etiologies. The biochemical pathways accompanying the formation of normoxia and hypoxia of varying severity, the significance of succinate in their formation, including depending on the form of its intake into the body (exogenous and endogenous pathways), are given. Thus, when endogenous production of succinic acid is decompensated, the tricarboxylic acid cycle is inhibited and anaerobic glycolysis is activated. At this moment and before the onset of irreversible biochemical damage, the restoration of energy exchange processes begins to depend on succinate, including its exogenous intake. Additional, but no less important, antihypoxic effects of exogenous succinate include stimulation of succinate oxidase oxidation of succinic acid with the restoration of its consumption in the mitochondrial respiratory chain and an increase in the activity of the antioxidant function of glutathione, as well as stimulation of protein metabolism. Reamberin (meglumine sodium succinate) significantly accelerates tissue recovery during hypoxia due to its antihypoxic, cytoprotective and other effects due to the activation of HIF-1ɑ biologically active factors.