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Vol. 25, Art. 37 (pp. 674-696)    |    2024       

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Possibilities and results of use of autologic cells of stromal-vascular fraction in local treatment of deep burns

Alekseev A.A., Kostyakov D.V., Zinoviev E.V., Manukovsky V.A., Filimonov K.A., Hromina S.S., Derii E.K.
1 Saint-Petersburg I.I. Dzhanelidze research institute of emergency medicine
2 A.V. Vishnevsky National Medical Research Center of Surgery
3 Russian Medical Academy of Continuous Professional Education

Brief summary

Introduction. Burn injuries occupy one of the first places in the overall structure of traumatism. The high frequency of complications of the wound process in burn injuries requires a constant search for new methods of their surgical and conservative treatment. Currently, more and more attention is paid to regenerative medicine. At the same time, important scientific and practical significance is given to the use of minimally manipulated cells based on the stromal-vascular fraction of adipose tissue (SVF AT), including in combination with platelet-rich plasma (PRP). Purpose of the study. To evaluate the effectiveness of the technology of local treatment of deep burns based on the application of autologous SVF AT cells, including in combination with PRP, in autodermoplasty with a split mesh graft. Materials and methods of research. The study is based on the results of surgical treatment of 54 patients with deep skin burns hospitalized in Saint-Petersburg I.I. Dzhanelidze research institute of emergency medicine and A.V. Vishnevsky National Medical Research Center of Surgery. All patients underwent autodermoplasty with a split, mesh transplant with perforation from 1:3 to 1:6 with application of autologous SVF ZH cells in combination with PRP. During the work, the timing of the onset of epithelialization of perforation cells and the final engraftment of autodermografts was assessed, the frequency of postoperative complications was analyzed, as well as the cytological picture of the wound surface, the intensity of microcirculation on the 5th day after skin grafting and the duration of surgical intervention. Statistical data processing was carried out using generally accepted methods of variation statistics. The alternative hypothesis was accepted at p<0,05. Research results. It was established that the application of SVF in combination with PRP allowed to reduce the time of the onset of epithelialization of perforation cells and the final engraftment of grafts compared to the traditional technique by 36.3% (p<0.05) and 26% (p<0.05), respectively, and also to reduce the frequency of postoperative complications by 2 times (p<0.05). When using grafts with perforation 1:6, a decrease in the epithelialization time by 7 days (by 39%) was also noted compared to the traditional method of restoring the integrity of the skin. Cys-examination of the wound surface allowed to testify to the anti-inflammatory and regenerative effect of SVF in combination with PRP. A decrease in neutrophils and macrophages by 34.1% and 32% and an increase in fibrocytes, fibroblasts by 1.7 (p<0,05) and 2.2 (p<0,05) times, respectively, were noted. The intensity of microcirculation in the transplantation zone is characterized by a twofold increase. The proposed technique does not increase the overall duration of surgical intervention. Conclusion. The application of autologous SVF HT cells, including in combination with PRP when performing autodermoplasty, improves the results of surgical treatment of patients with deep burns.


Key words

burns, stromal-vascular fraction, autodermoplasty, mesenchymal stem cells, PRP, platelet-rich plasma

Reference list

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Журнал основан 16 ноября 2000г.
Выдано Министерством РФ по делам печати, телерадиовещания и средств массовых коммуникаций

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