Integumentary Tissues Research Articles

A call to integrate non‐visual functions of pigments and their interactions with visual functions to understand global change impacts on visual systems

Abstract Animal coloration serves a variety of visually related functions in nature (e.g. mate choice, aposematism and camouflage) but the pigments in integumentary tissues such as skin, scales and feathers may also serve functions unrelated to the visual environment (e.g. temperature regulation, detoxification and pollutant protection). Our understanding of the significance of the non‐visual functions of animal integumentary pigments, as well as how they interact with the visually related functions to shape animal visual systems, remains limited. Furthermore, due to their important roles in shaping species interactions and mediating interactions in the environment, animal colour traits are likely to be impacted by global change (e.g. increased temperatures, altered habitat quality and quantity, increased environmental stochasticity, pollutants and novel species assemblages). Considering the effects of global change on both visual and non‐visual functions is important for understanding whether the selection is acting directly on the pigment or on coloration. Since changing the trait distributions can then lead to changes in visual systems, we advocate for studies to consider all potential functions of integumentary pigments, both visual and non‐visual functions and their interaction. Towards this goal, we first highlight common functions of pigments with a focus on non‐visual functions across animal systems. Then we synthesize our current understanding of how global change can impact pigmentation and discuss factors that can modify the interactions between climate change and pigment function. Lastly, we discuss how changes in colour traits can impact visual systems and provide an example using amphibians and their responses to climate change as a model. Read the free Plain Language Summary for this article on the Journal blog.

Prevention of the development of diastasis of the wound edges during two-stage breast reconstruction

The main problem of breast reconstruction after a mastectomy is the complete destruction of all structural elements of the breast and the lack of integumentary tissues that do not allow carrying out one-stage breast reconstruction. To solve this problem, usually performing a two-stage reconstruction, which today is the most commonly used method of breast reconstruction. The peculiarity of this method is that after removal of the expander, during the second stage of reconstruction, some retraction of the skin and a decrease in the area of the prepared skin cover are observed. Thus, after installing a permanent implant and suturing the surgical wound, the skin sheath is tightened around the installed endoprosthesis, while the greater the retraction of the skin, the more pronounced the tension appears and, accordingly, the load on the sutured wound increases. As a result, the risks of developing diastasis of the wound edges with the exposure of the endoprosthesis increase, which leads to the need to remove the implant. Therefore, when carrying out the second stage of breast reconstruction, a very important moment of the operation is the suturing of the postoperative wound, the competent implementation of which allows the prevention of implant extrusion.

CURRENT POSSIBILITIES AND PROSPECTS OF ALVEOLAR BONE DEFECT REPLACEMENT AND COVERING TISSUES: NARRATIVE LITERATURE REVIEW

BACKGROUND: The percentage of the need to increase the volume of supporting tissues remains high - from 43% to 77%, despite the fact that the currently used approaches for augmentation of tissue structures do not always show the expected results. A common cause of problems with the growth of new supporting tissues is the reduced activity of inducing factors of local and systemic levels in the human body. A critical deficiency of the integumentary structures significantly affects the result of reconstructive and reconstructive surgical interventions.Objective: to characterize the modern achievements of intraoral reconstruction of volumetric defects of supporting tissues, including bioengineering for the regeneration of the alveolar jaw bone and integumentary structures.Methods. The search strategy included an electronic search of literature sources performed in the PubMed database using keywords. The formats "Review", "Systematic Review" and "Clinical Trial" were requested. The search depth was 20 years.Results. Of the 378 articles found, 44 met the inclusion criteria set for this review. The prerequisites for the reconstruction of the alveolar ridge with an emphasis on early vascularization of de novo tissues are outlined, the advantages and disadvantages of bone and soft tissue grafts are characterized. The results of research efforts using mesenchymal stem cells, which play a crucial role in the regeneration of the alveolar bone and gum, are presented. The evolution of tissue engineering structures for integumentary tissues is presented – from thin layers of epithelial cells to 3D – epithelized equivalents of the oral mucosa.Conclusion. The rapidly increasing number of biomaterial studies involving stem cells, the active development of tissue engineering indicates the prospects for the development of biomaterials of the next generations, which will be able to work effectively together with their own mechanisms of tissue regeneration in their unique architecture.

Enzymatic hydrolysis of integumentary tissues of pike perch

Enzymatic hydrolysis of integumentary tissues of pike perch

Efecto de la acupuntura sobre la fuerza de mordida en mujeres con cervicalgia crónico

Objetive: To investigate the maximum molar bite force in women with chronic neck pain after treatment with acupuncture. Materials and Methods: Twenty-three women with chronic neck pain participated. Dynamometer was used to measure the right and left maximum molar bite force. Dong Bang acupuncture needles - 0.25 mm x 30 mm was inserted into the integumentary tissue. Treatment was 10 sessions, each 30 minutes long and twice a week. Results: The right (p = 0.01) and left (p = 0.004) molar bite force was assessed after treatment with acupuncture, and showed increased occlusal strength. Conclusions: This study suggests a functional improvement in the stomatognathic system in women with chronic cervical pain after treatment with acupuncture. However, it is important to note that further research is needed to fully elucidate the long-term effects and potential clinical implications of these findings in the field of pain management and rehabilitation. Keywords: Acupuncture; Bite force; Neck pain; Women; Neck; Chronic pain

Intensification of the Grain Drying Process with an Ozone-Air Mixture

Background: The use of ozone allows not only to weaken the connection of moisture with the grain, but also, interacting with its internal components, the gas contributes to an increase in the temperature of the heap. Due to this, the grain must be heated for less time before reaching optimal parameters, which reduces the energy intensity of the drying process. At the same time, the separation of moisture from the grain occurs more intensively, since the gas in small concentrations improves the permeability of cell membranes, causes structural transformations of the integumentary tissues and promotes the orientation of water molecules around atomic oxygen. As a result, the drying time is significantly reduced. After treatment, the residual ozone decays to oxygen without polluting the environment. In addition, ozonation promotes deodorization, sanitation, sterilization of grain and equipment. However, the use of ozone-air mixture in grain drying in production is too insignificant due to the small experimental base and lack of practical recommendations. Purpose: Improving the efficiency of modern grain dryers through the use of the ozonation process. Materials and Мethods: The theoretical and methodological basis of the research was the work in the field of grain drying with an ozone-air mixture by leading Russian and foreign scientists, as well as their own research. The sources under study cover the first mentions of the use of ozone in grain drying and the subsequent development of this topic. The review included publications from various databases, among which are: e-library, Scopus, Web of Science, Agris, FIPS and others. Results: Hourly preliminary ozonation of grain with a humidity of 26.3% contributed to a decrease in the moisture content by 1.3% from the initial value. While in the control sample, which was not subjected to preliminary ozone treatment, the moisture content did not change over the same period. Subsequent drying of the exposed grain allowed for an hour of operation to remove 1.6% more moisture than that of the control sample. At the same time, the drying conditions of both batches of grain were identical. This indicates that the ventilation of grain with an ozone-air mixture is more effective than its presence in a buffer silo without processing. Conclusion: Pretreatment of a wet grain heap with an ozone-air mixture before feeding it to the grain dryer intensifies the process of subsequent grain drying. At the initial grain moisture content of 26.3%, hourly ozone treatment with an ozone concentration in an ozone-air mixture of 8 mg/m3 reduces the moisture content by 5.4% per hour of drying. Under the same conditions, in the experiment without processing for the same period, the decrease in grain moisture was 3.8%. Consequently, the proposed method of grain drying increases the efficiency of modern grain dryers.

In vitro Anthelmintic Activity of Croton tiglium Seeds Extract on Haemonchus contortus

Background: Haemonchus contortus is a blood sucking parasite whose habitat is the abomasum of ruminants, which poses a significant threat to the health and production of sheep and goats in warm temperate and tropical regions. H. contortus leads to anemia, hypoproteinemia, reduced exercise tolerance and edema subcutaneous tissue that can result in the death of animals. In acute infection, animals suddenly become anemic and many are found dead. Even in the chronic phase, the condition is accompanied by a mild but persistent parasitic burden and is characterized by weight loss, widespread malaise and, in some individuals, anemia. The objective of this study was to identify the anthelmintic activity of Croton tiglium seeds extract against Haemonchus contortus and comparison with some drugs used against internal and external parasites. Methods: A study was performed to evaluate the anthelmintic activity of the methanolic extract of Croton tiglium seeds against Haemonchus contortus using an adult worm motility test. Six graduated concentrations of extract (25, 50, 75, 100, 125 and 150 mg/ml), were tested at different periods and changes over time in the viability of worms were registered for 2, 4 and 6 hr. Normal RPMI-1640 medium and ivermectin 0.1% were used as negative and positive control, respectively. Also, a histological study was conducted on the the integumentary tissue of the H. contortus and the changes that occur in it were observed. Result: At 2 and 4 h post treatment, the concentrations of C. tiglium seeds extract (100, 125, and 150 mg/ml) have caused significantly higher mortality compared to the other concentrations, while, similar to ivermectin that caused death for nematodes within 6 h. The lower concentration (25 mg/ml) was significantly more lethal than the negative control (RPMI-1640 medium) at 2, 4 and 6 h of exposure. Each concentrations damages the cuticle and muscles of H. contortus. The increase in concentration is proportional to the increase in damage to the integumentary. The present study indicated that all concentrations of methanolic extract of C. tiglium seeds produced anthelmintic activity.

A brief overview on the methods for extraction and identification of flavonoids

Flavonoids are active metabolites of plant cells. The significant biological role of these compounds is evidenced by the nature of their distribution in the plant. Flavonoids play an important role in plant reproduction, development and accumulation of pollen, and their content also determines the color of flowers, fruits, and plant seeds. Most flavonoids are found in actively functioning organs: leaves, flowers, fruits (color, aroma), seedlings, as well as in integumentary tissues that perform protective functions. Different organs and tissues differ in the quantity and qualitative composition of flavonoids. Relatively recently, it was found that flavonoids also influence signaling processes occurring in living systems due to specific interactions with proteins that perform regulatory functions. Numerous data have been accumulated on the influence of these compounds on other protein and non-protein structures, which can lead to changes in the functional state of cells and the entire organism as a whole. Despite the fact that currently the redox properties of phenolic compounds are not given so much importance, their comprehensive study still remains an important task. In addition, numerous studies confirm that flavonoids act as effective phytoalexins, exhibiting a wide range of antibacterial and antifungal activities. After all, a significant role of flavonoids is their function of protecting against various unfavorable factors for plants, such as temperature fluctuations, the influence of ultraviolet rays, attacks by viruses, bacteria, and parasites. A correlation has been established between their content in plants and plant resistance to fungal diseases and some pests. The appearance of these compounds in plants in response to the action of parasitic fungi of cultivated plants and inhibition of the growth of fungal mycelium is considered a protective reaction. Flavonoids with antimicrobial activity are found in large quantities in the seed coat. This review paper highlights the basic technologies for extraction and identification of flavonoids from different type of plants.

РАЗРАБОТКА ТЕХНОЛОГИИ ШОКОЛАДА С ПИЩЕВЫМИ ОБОГАТИТЕЛЯМИ ИЗ МОРЕПРОДУКТОВ

In recent years, growth in the production and consumption of chocolate dictates the need to correct composition of the popular product by enriching it with proteins, minerals and vitamins and replacing sugar with a non-carbohydrate sweetener. The article presents the results of the development of technology of chocolate with enriching ingredients based on seafood: with cucumaria powder and with the food fortifier ‟Kalmaks” based on the integumentary tissues of squid. The optimal amount of introduced concentrators is 5%, the optimal sequence of processing of the raw materials is determined. The nutritional value of the finished product and its energy value are determined. The degree of satisfaction of the daily protein requirement when consuming 100 g of chocolate is 15%, in fat 29%, in carbohydrates 11.8%, in energy 15.4%. As a result of the work, the shelf life of 50 days and the storage conditions of chocolate are set at a storage temperature not higher than 18º.

Heterologue Skin Microbiota Transplantation for Treatment of Sarcoptic Manges in Two Dogs with Zoonotic Transmission

In the present case report, the authors inspected the feasibility of transferring unenriched (however moistured and pre-biotic treated) skin microbiota communities between two heterologous hosts, namely heterologue skin microbiota transplantation (hSmT), [from apparently healthy donor to other relevant and diseased dogs, with scabies, separately]. Two cross-bred, client-owned dogs (belonging to the same owners) with a diagnosis of scabies and intense pruritus were enrolled. Nivea Clear Up Strips were attached in a total of 3 various apparently healthy integumentary tissue of another donor dog and allowed to dry for 10-12 minutes. This was followed by peeling off, all 3 strips were then transferred to diseased skin tissue (laterolateral area in 2 dogs with scabies, separately) which were also irrigated with isotonic and allowed to attach for at least 12-15 minutes. Finally, all 3 strips were removed. Both in case I and II, Vas pruritus scores were decreased significantly beginning on day 0 (initial hSmT day) to days 21. Vas pruritus score ranged between 8-10 and 7-9, in case I and II, respectively, prior to hSmT [days -14 to day 0]. Prior to hSmT all skin scrape positivity were deemed available on days -14 to 0, whereas after day 2 of hSmT, all 2 dogs gave negative skin scraping results till the end of the study. It should not be unwise to draw preliminary conclusion that transfer of unenriched skin microbiota from a healthy donor to the diseased dogs with scabies, should have helped hastening clinical and parasitological recovery by manipulation of cutaneous microenvironment

The Anterolateral Thigh Perforator Flap is a Versatile Resource for Reconstructive Surgery

The Aim of Work: The aim of this study was to increase the efficiency of reconstruction of extensive soft-tissue defects of various localizations by differentiated use of the anterolateral thigh (ALT) perforator flap. Methods: We have retrospectively reviewed 39 patients, who had undergone soft-tissue reconstruction using pedicled and free transposition of ALT flaps. Results: In this series, all cases ended with a complete recovery of patients with adequate restoration of integumentary tissues. In the postoperative course, we encountered complications during free flap transplantation in nine cases (23%), two of which were associated with arterial insufficiency (5.1%) and seven – with venous thrombosis (17.9%). Most of these complications were not critical, and the problem was resolved by conservative treatment; in two cases, partial tissue death required a secondary suture. In three cases (7.7%), the complications were critical and led to the loss of the flap. Conclusions: The unprecedented versatility and the minimal trauma of the donor area make the ALT perforator flap one of the most demanded skin flaps. Despite the variable vascular anatomy, the ALT flap is the most adaptable plastic resource for extensive soft-tissue coverage of abdominal, perineal, and hip joints as a transposition flap on the vascular leg and for closing distant defects in any area of the body using it as a free microsurgical transplant. Other advantages include its variability in size and the ability to harvest multiple tissue components in different combinations depending on the desired outcome.

ПАТОГЕННЫЙ ПОТЕНЦИАЛ БАКТЕРИЙ ГРУППЫ ESKAPE, ВЫДЕЛЕННЫХ ИЗ РАН: ХАРАКТЕРИСТИКА ФЕНОИ ГЕНОТИПИЧЕСКИХ МАРКЕРОВ И ВОЗМОЖНОСТЬ ИХ ПРАКТИЧЕСКОГО ПРИМЕНЕНИЯ

Backgroud. Evaluation of the biological properties of isolates obtained from the clinical samples of patients will increase the informative value of the microbiological study and optimize the interpretation of the culture results in order to substantiate further wound treatment tactics. Aim. To analyze the phenotypic and genotypic properties of ESKAPE bacteria and to determine the possibility of practical use of the parameters characterizing the bioprofile of the isolate when interpreting the results of microbiological culture of the wound swabs. Material and methods. Pheno- and genotypic markers of the pathogenic potential of ESKAPE isolates were analyzed: Enterococcus faecalis (n=93), Staphylococcus aureus (n=177), Klebsiella pneumoniae (n=7), Acinetobacter baumannii (n=32), Pseudomonas aeruginosa (n=45), Enterobacterales (Proteus mirabilis, n=26). Microorganisms were isolated from the wound swabs of patients with acute and chronic wounds, who were admitted to the burn department of the Gomel City Clinical Hospital No. 1 for specialized medical care during the period 2012-2020. Integumentary tissue defects were represented by post-traumatic wounds (mechanical trauma, thermal burns), postnecrotic wounds (after purulent-inflammatory diseases of the skin and underlying tissues), trophic ulcers (on the stumps of the lower extremities after prolonged wearing of the prosthesis; neurotrophic ulcers after mechanical trauma to peripheral nerves); pressure ulcers stage III after prolonged tissue compression. When describing the isolates, the duration of the wounds and the presence of clinical signs of infectious inflammation were taken into account. Results. The relationship between the clinical state of the wound (no signs of inflammation, critical colonization, infection) and the bioprofile of the isolate obtained from the wound swabs was determined. Potentially pathogenic S. aureus, possessing colonization, invasive and cytotoxic properties, was found in wounds with a minimum duration of up to 4 days, but the absence of clinical manifestations of infection suggested contamination. Biofilm formation, persistent properties, genetic markers of pathogenicity in S. aureus and E. faecalis in combination with pathological changes in fine-grained granulations in the wound indicated colonization. The inflammatory status of the wounds (critical colonization and infection according to NERDS&STONEES criteria) from which P. aeruginosa and A. baumannii were isolated, the presence of genetic virulence markers, and antibiotic resistance indicated the clinical significance of these isolates as etiological agents of the infectious process. P. mirabilis isolated from critically colonized and infected wounds did not have the full range of virulence markers in all cases, especially in associations. K. pneumoniae was isolated only from the wounds showing signs of inflammation and demonstrated various combinations of genetic determinants of virulence, variability in capsular polysaccharide overproduction and biofilm formation. Conclusion. An algorithm has been developed for interpreting the results of microbiological culture of wound swabs with the use of pheno- and genotypic markers, which are recommended for determining the leading pathogen that colonizes the wound and disrupts the healing process. The algorithm allows assessing the etiological significance of mixed cultures isolated from critically colonized and infected wounds, which will determine the further tactics of treating patients.

Surgical treatment results in patients with defects of the integumentary tissues of the trunk and limbs of mechanical origin.

This study aimed to develop and implement a universal method for the quantitative assessment of treatment effectiveness in patients with skin and underlying soft tissue defects of the trunk and extremities. The study involved 242 patients, including 46 patients with upper extremity injuries, 179 with lesions of lower extremity tissues, and 17 patients with defects of the integumentary tissues of the trunk. The greatest treatment effectiveness was observed in patients with upper limb injury: excellent result - 60.0%, good - 33.3%, unsatisfactory - 6.7% of patients. In the group of patients with lower extremity injuries, an excellent result was recorded in 19.6% of cases, good (58.1%), satisfactory (15.1%), and unsatisfactory in 7.2% of patients. In patients with trunk injuries, an excellent treatment result was obtained in 23.5%, good - 35.5%, satisfactory - 23.5%, and unsatisfactory - 17.6%. The universal quantitative method for evaluating treatment effectiveness in patients with various types of damage to the trunk and extremities tissues was proposed. This method makes it possible to objectively determine the level of medical service provided to each patient, which is of great importance in the context of medical service reorganization in the state.

A modern view of the processes of mechanotransduction in healthy and damaged skin: review

Questions concerning the study of mechanotransduction in the skin are currently of interest to many researchers, especially those engaged in the study of the problem of high-quality surgical treatment of soft tissue wounds. The possibility of developing new ways of treating various pathologies of the integumentary tissues, including wound defects, depends on understanding the processes of transmission and transformation of mechanical stimuli coming to skin cells into chains of biochemical reactions. The review presents the main historical stages of the development of scientific knowledge about mechanotransduction, describes the features of mechanotransduction in integumentary tissues, currently known mediators and signaling pathways that realize the transmission of mechanical influences from the cell surface to its nucleus, and also suggests possible directions for using this phenomenon in practice. The work also noted changes occurring at the cellular level during the recoding of mechanical signals in wounds prone to slowing down natural healing processes chronic wounds. We believe that one of the promising trends in the practical application of mechanotransduction is the possibility of using its effects when stretching the skin during the treatment of wound defects of soft tissues.

PREVENTION OF PULPITIS OF A VITAL TOOTH PREPARED FOR AN ORTHOPEDIC CONSTRUCTION

Abstract. The success of prosthetics in patients using fixed orthopedic structures on vital teeth is determined both by the high-quality preparation of teeth and by the antibacterial effect on the dentinal tubules exposed after preparation in order to reduce paresthesia and prevent bacteria from penetrating them. Orthopedic dentists are wary of certain potential problems that may arise when working with vital teeth. In this regard, the doctor should take care of the prevention of possible complications that arise after prosthetics with non-removable orthopedic structures, since the tooth after preparation has an unprotected dentin surface. During the preparation, a certain volume of hard tissues of the tooth is removed, which in functional terms is the integumentary tissue, and then comes the exposed peripheral dentin. Such an impact of various factors on the vital tooth can lead to damage to the dental pulp. This article discusses various ways to prevent tooth pulpitis, which can occur during tooth prosthetics with non-removable orthopedic structures due to the influence of physical and mechanical factors on the hard tissues of the tooth, or rather, due to the friction of the diamond bur against the hard tissues of the tooth during odontopreparation, as well as the penetration of bacteria along exposed dentinal tubules into the dental pulp. The purpose is to study and analyze data on various cements for temporary fixation of fixed orthopedic structures used to prevent pulpitis of vital abutment teeth. To analyze and identify what other modifications of temporary and permanent fixing cements for non-removable orthopedic structures are relevant to use in modern dentistry for prosthetics on vital teeth.

Повышение эффективности снятия покровной ткани с плодов томата импульсным электрическим полем

Electrophysical technologies are a global trend of sustainable agriculture and food industry. Peeling is an energy-intensive procedure of fruit and vegetable processing. The research featured the effect of pulsed electric field (PEF) treatment on tomato peeling effectiveness. The assessment included such factors as specific effort, energy costs, and product losses in comparison with thermal and electrophysical methods.
 Tomatoes of Aurora variety underwent a PEF treatment at 1 kV/cm. The expended specific energy was 1, 5, and 10 kJ/kg. The tomatoes were visually evaluated with optical microscopy before and after processing. The peeling effectiveness and mass loss were measured with a texture analyzer and digital scales.
 The PEF treatment decreased the specific force of mechanical peel removal by 10% (P < 0.05). The mass loss decreased by 4% (P < 0.05) at 1 kJ/kg. The PEF method resulted in cell electroporation, which activated the internal mass transfer of moisture from the endocarp region between the mesocarp and the integumentary tissue. The hydrostatic pressure produced a layer of liquid, which facilitated the peeling.
 In comparison with thermal treatment (blanching), ohmic heating, and ultrasonic processing, the PEF technology had the lowest production losses and energy costs. The research proves the prospects of the PEF treatment in commercial tomato processing.

Skin Micrograph Protector in a Burn Wound: Alloderm or Hydrogel Coating?

AIM OF STUDY Was to compare the dynamics of engraftment of skin micrographs in a burn wound when using protectors from an allodermal graft and from a hydrogel coating.MATERIAL AND METHODS The experimental study was conducted on 18 rats with a scab formed 3 days after modeling a deep burn with an area of 20% of the body surface. Partial fascial necrectomy was performed: two rounded sections of the sling with a diameter of 25 mm were excised. 6 automicrographs of skin 4x4 mm, 0.3 mm thick, were applied to each surface freed from the scab. In each animal, micrographs on one of the wounds were covered with a hydrogel protector, on the other with an allodermotransplant from another animal of the group. A secondary aseptic dressing was applied to the protectors. On the 5th and 20th days after the operation, the state of micrographs was studied: blood circulation — according to laser Doppler flowmetry, microstructure in vivo — using optical coherence tomography, microstructure ex vivo — according to histological examination of biopsies.ReSUlTS Differences in the rate of restoration of blood circulation of micrographs in the early stages of the postoperative period were found. In the first 5 days, the perfusion of micrographs under an allodermal protector exceeded the indicator in micrographs under a hydrogel coating by 44 [21; 51] % (p=0.031) due to the contribution of endothelial and neurogenic mechanisms of blood flow modulation. Starting from day 10, the differences in perfusion were levelled, but there were signs of more active endothelial regulation of blood flow under the skin (p=0.028). Histologically, the appearance of full-blooded capillaries was revealed earlier in micrographs under the alloderm than when using a hydrogel protector. By 20 days, under the condition of regular change of hydrogel coatings, the area of wound healing under the studied coatings did not significantly differ. However, the structure of the integumentary tissue under the alloderm according to the optical coherence tomography data was closer to normal skin than when using a hydrogel protector.CONClUSIONS From the point of view of the physiology of the wound process, alloderm is the preferred option of an autograft protector in comparison with a hydrogel coating, which is probably due to the paracrine biological activity of the alloderm. However, hydrogel coatings can provide a comparable level of efficiency, provided they are regularly changed and, potentially, given the properties of cytokine activity.

CHARACTERISTICS OF SKIN DIELECTRIC PROPERTIES IN PREGNANCY (EXPERIMENTAL STUDY

The purpose of our study was to evaluate the dielectric characteristics of the skin that occur during pregnancy in an experiment. The study included 60 Wistar rats, 30 of which were pregnant (in the 3rd trimester; parturition took place 2–3 days after the study). Once, on a pre-epilated area of the skin of the back, the dielectric properties were studied using the method of near-field resonant microwave sensing. The diagnostic software and hardware complex for microwave sensing allows calculating the level of dielectric permittivity of the medium and conductivity based on the shift of the resonant frequency. Based on the conducted studies, it was found that the integumentary tissues of pregnant rats have a significantly higher level of dielectric permittivity and conductivity compared to non-pregnant animals. Such shifts are caused by the formation of edematous syndrome associated with pregnancy, and predispose to the development of postpartum skin changes.

Fournier’s gangrene: the current state of the problem and our treatment experience

The OBJECTIVE of the study was to analyze the results of treatment of patients with lightning scrotal gangrene (Fournier’s gangrene).METHODS AND MATERIAL. The work is based on the analysis of the results of treatment of 31 patients with Fournier’s gangrene aged 32 to 82 years. In 19 (61.3 %) patients, the most probable nosological causes of Fournier’s gangrene were diseases of the anorectal zone, in 10 – pathology of the urogenital sphere. In 2 patients, Fournier’s gangrene developed as a result of a closed injury (1) and a gunshot wound (1) of the perineum and scrotum. A limited (slowly progressing) form of the disease was observed in 18 (58.1 %) patients, a common form with a lightning (9) and rapidly progressing (4) course – in 13 (41.9 %). 6 (19.3 %) patients suffered from diabetes mellitus of varying severity. In all patients, the clinical manifestations of the disease and laboratory parameters were characterized by the phenomena of generalized surgical infection with signs of systemic inflammatory response syndrome and endotoxicosis. In 93.5 % of patients, causative microflora was represented by various associations of both facultative-anaerobic and obligateaerobic gram-negative and obligate-facultative anaerobic gram-positive microorganisms. The growth of anaerobic gramnegative non-clostridial flora was also obtained.RESULTS. Out of 31 patients, 6 (19.3 %) patients died who had a common form of FG with a lightning and rapidly progressing clinical course in the format of systemic inflammatory response syndrome and systemic endotoxicosis with an outcome in organ-system dysfunction. The causes of death were: septic shock (in 1), progressive systemic endotoxicosis (sepsis) with the outcome of multiple organ failure (in 3) and pulmonary embolism (in 2).CONCLUSION. Multidisciplinary approach to solving organizational and therapeutic and tactical tasks with the participation of doctors of related specialties, active surgical tactics in the format of «aggressive surgery», providing for the widest possible excision of necrotic and non-viable tissues, performed in combination with programmed (stage-by-stage) sanitation necrectomy, pathogenetically justified correction of violations of the homeostasis system, rational antibacterial therapy, a comprehensive system of local wound treatment and plastic replacement of lost integumentary tissues are priority ways to optimize the results of treatment of patients with Fournier’s gangrene.

Ошибки и осложнения при лечении больных с отслойками покровных тканей

The complexity of the condition, lack of clear routes for patients with degloving injury of integumentary tissues, inadequate and untimely diagnosis, lack of clinical guidelines and a paucity of literature lead to a great number of failures and complications in treatment of the cohort of patients. The objective of the study was to analyze failures and complications encountered in treatment of patients with degloving injury of integumentary tissues, and identify ways for the prevention. Material and methods Medical records of 40 patients with degloving injury of integumentary tissues were retrospectively reviewed. The patients treated in trauma departments and the Burn Center in Chelyabinsk between 2008 and 2014 were divided into two groups according to the time of admission to the burn center. The first group of patients was hospitalized within 6 days of injury and over. The second group of patients was admitted to the combustiology department in the first 5 days of injury. Results Failures in diagnosis and treatment were mostly observed in patients who were admitted for treatment after 5 days of injury. Most common complications included necrosis of integumentary tissues, infected wounds, necrosis of skin autografts. Discussion Most of the complications seen in patients with extensive degloving injury of integumentary tissues resulted from organizational, diagnostic, therapeutic, strategical and technical failures, and several adverse events were associated with the severity and extent of the involved tissues. Conclusion A number of recommendations have been offered for prevention of failures and complications in treatment of the cohort of patients.