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Objective: To evaluate the possibility of improving the effectiveness of early postoperative healing in patients after surgical interventions on periodontal tissues due to the topical application of alginate plates with a complex of antimicrobial peptides and cytokines., Materials and Methods: 40 patients who underwent periodontal surgery were examined: operations aimed at bone tissue regeneration; mucogingival operations (elimination of gum recession), corticotomy with osteoplasty, apical surgery. The patients were randomly divided into 2 groups of 20 people (main and control). At the end of the operation, alginate plates with a complex of antimicrobial peptides and cytokines were applied to the surgical intervention area to the main group. Further, 2-3 times a day, it was recommended to apply them independently for 10-14 days, after antiseptic treatment. In the control group, they were limited to double treatment with 0.05% chlorhexidine bigluconate solution daily for two weeks. Follow-up examinations and evaluation of the index of early wound healing, as well as indicators of postoperative pain, bleeding and edema were carried out on day 3, 7, 14., Results: In all patients in the early postoperative period, positive dynamics of healing were observed, however, in the main group, pain indicators, as well as bleeding and swelling, according to a patient survey, were less pronounced. The early wound healing index was also more positive in the main group - on days 3, 7 and 14 there was a more intense decrease. (1.9 points.,1.5 points., 1.2 points., respectively, and in the control group 2.3 points., 2.1 points., 1.9 points.)., Conclusion: Local application of alginate plates with a complex of antimicrobial peptides and cytokines in the early postoperative period allows to improve early wound healing after surgical interventions on periodontal tissues, and can be recommended for use at a dental appointment, as well as for use at home.

Aim: The purpose of the study was to establish the effectiveness of Remaxol in restoring tissue reparative ability of laparotomy wound in acute severe pancreatitis., Material and Methods: The work is based on the results of experimental and clinical studies. Experiments were carried out using acute total pancreatic necrosis model under anesthesia on 30 dogs. Furthermore, 28 patients with acute severe pancreatitis were examined and underwent surgery on various purulent-necrotic complications. In the postoperative period, healing and metabolic processes were evaluated in the tissues along the sutures line of the laparotomy wound. Also, such parameters as endogenous intoxication, oxidative stress, and phospholipase activity were evaluated at the organism level. In the studied groups, Remaxol is included in the postoperative therapy., Results: It has been established that during acute severe pancreatitis reparative potential of tissues is significantly reduced, which is caused by a significant disruption of trophism, activation of phospholipases and peroxidation of membrane lipids. Disorders of homeokinesis at the organism level play a negative role in tissue reparative potential reduction. Inclusion of Remaxol in the complex therapy of acute pancreatitis leads to a decrease in duration of wound healing by reduction in the phase of inflammation. Optimization of the healing process occurs due to complex effect of the drug at organ and body level, which results in improvement of the trophism and, what's more, stabilizes membranes of regenerating cells., Conclusion: In case of acute severe pancreatitis, the use of Remaxol in early postoperative period in the complex therapy leads to a significant correction of factors that adversely affect regeneration and contributes to the restoration of tissue reparative potential.

A successful administration of NPWT-therapy combined with Reamberin infusion for gastroenterostomy failure after stomach resection is reported in the article. It was noted that antioxidant/antihypoxic drug Reamberin combined with NPWT-therapy has a positive metabolic effect and results more active and rapid healing of the wounds. The absence of adverse effects of the drug allows us to recommend its inclusion into complex treatment of patients with this pathology.

The aim of the study was to evaluate the wound healing properties of the recombinant human angiogenin drug in the gel form on the models of planar musculocutaneous wound and a linear wound. The rats were divided into 3 groups: 1st group - control animals, that did not get any treatment of wounds; 2nd group - experimental, where animals' wound surface was treated with recombinant human angiogenin in a gel medicinal form; and the 3rd group - a comparison group, where animals were treated with "Solcoseryl" drug. The resulted morphology data and the time of complete epithelialization of planar wounds suggest that the human angiogenin drug in gel form has a pronounced wound healing activity. The latter surpasses the studied parameters of the reference drug "Solcoseryl", by contributing to the acceleration of healing process of planar musculocutaneous and linear wounds in rats.

For 15 years, from 2001, we began to apply Heberprot-P®, an injectable Epidermal Growth Factor (0.75 μg) created in the Center of Biotechnology, in Havana, Cuba. More than 159,000 patients were treated around the world, from 25 countries, with, with only 9-11% high-level amputations. In this paper, we discuss our experience in the treatment of the most complex diabetic foot ulcers cases for the last 15 years.

Aim: To evaluate the efficacy and safety of collagen biomaterial application during the 4-week follow-up of patients with diabetic foot syndrome., Material and Methods: 75 patients with diabetic foot (Wagner II (69.3%) and III (30.7%)) aged 30-80 years were included in the multicenter study, among them were 50.7% with the wound unhealed for 1.5-6 months and 49.3% over 6-48 months. Patients were randomized into 2 groups: 1) standard therapy (n=37), 2) the additional use of the collagen material Collost (n=38). Observation period was at least 4 weeks for each patient. The size of ulcers, results of general and biochemical blood tests, oximetry, microbiological testing, ultrasound of lower extremities vessels as well as a detailed medical history, social and functional status, level of cardiovascular comorbidity and ongoing therapy were estimated., Results: Additional use of a collagen biomaterial has led to a significant reduction ulcers of all sizes from 13.5 to 2.1 cm 2 (in the comparison group - from 12.5 to 7 cm 2 ). The best dynamics have been registered in Wagner II (4.4-fold average wound area regress in Collost group, from 8.8 to 2.0 cm 2 ; average wound area regress by 1.8 times, from 10 to 5.6 cm 2 in the comparison group) than in Wagner III group (in the main group from 55 to 21.3 cm 2 ; in the control group from 36 to 32.4 cm 2 ) and in ulcers existing less than 6 months. Treatment with biological material Collost within standard therapy after 4 weeks led to increase of complete epithelialization by 2.6% (21.1% as compared to 14.7%), while decreasing the frequency of ineffective treatment by 4.1 (7.9% in primary and 32.4% in the comparison group)., Conclusion: We have proved the efficacy and safety of collagen biomaterial topical application in a diabetic foot syndrome treatment.

Analysed in the article are the results of a comprehensive approach to treatment of patients presenting with lower limb critical ischaemia and diabetes mellitus by means of gene-induced angiogenesis. The study comprised a total of 65 patients found to have an ill-suited for surgical reconstruction peripheral arterial bed and undergoing conservative therapy. The patients were divided into two groups. The Study Group patients additionally to the conventional conservative therapy received 2 intramuscular injections of therapeutic agent Neovasculgen at a course dose of 2.4 mg. The active period of follow up amounted to 6 months followed by evaluating limb salvage and lethal outcomes at a further 6 months thereafter. Efficacy of treatment was determined both by primary criteria (lethality rate, amputations, dynamics of necrosis healing, clinical relief of critical ischaemia) and secondary criteria (pain-free walking distance, ankle-brachial index, transcutaneous oxygen tension, linear velocity of blood flow, the Michigan Neuropathy Screening Instrument (MNSI) and Neurological Symptom Score (NSS) scale). After 6 months of follow up, the statistical significance in the intragroup and intergroup comparisons was reached for the pain-free walking distance (increment up to 72.9±9.2 m, p=0.032), transcutaneous oxygen tension (increment by 34.4%, p=0.028), linear velocity of blood flow (increment by 65.3%, p=0.047). Induction of angiogenesis also made it possible to statistically significantly decrease the manifestations of diabetic neuropathy, as was evidenced by the data of the MSNI (p=0.009) and the NSS scale (p=0.044). The findings of the study also demonstrated the best value of the limb salvage rate (p=0.049) and a lower number of lethal complications at 1 year of follow up.

Aim: The aim of this research was to study the effects of complex therapy with Remaxol inclusion on laparotomy wound tissue reparative process in patients with obstructive jaundice in early postoperative period., Material and Methods: Clinical and laboratory studies were carried out in 55 patients undergoing surgery of the biliary tract, including 35 patients with mechanical jaundice of non-tumor origin and 17 of them received Remaxol (for 5 days daily intravenous infusions of 400 ml each) in the early postoperative period., Results: It has been proved that mechanical jaundice is a significant complication in the reparative process of laparotomy wound tissue structures. A significant decrease in the reparative potential of tissues can occur due to a local deterioration of the tissue metabolism of regenerating structures, and on the organism level - endogenous intoxication syndrome, hypoxia, oxidative stress, hypoalbuminemia., Conclusion: Remaxol is a drug with hepatoprotective, antioxidant and antihypoxant effects and its use in patients with obstructive jaundice makes it possible to correct disease pathogenetic impact on organic and organism level, which leads to optimization of reparative regeneration. A noticeable decrease in the early postoperative period of wound complications has been established as well as a significant reduction in days patients spent in the hospital.

Objective: To reveal the effect of photodynamic therapy on the healing of experimental radiation skin ulcers infect ed with Pseudomonas aeruginosa., Materials and Methods: The infected radionuclide was modeled by local X ray irradiation of the rat's hip skin at a dose of 85.0 Gy, followed by the application of Pseudomonas aeruginosa bacterial suspension to the surface of the ulcer. Photodynamic therapy (CTD) was performed with the help of a photon apparatus «Barva LED/630» and a photosen sitizer of methylene blue. The effect of PDT on the rate and quality of healing of an infected radionuclide was deter mined by comparing the histological and morphometric study of skin from the region of ulcer in animals from the control and treated groups of PDT., Results and Conclusions: The presence of Pseudomonas aeruginosa in the radiation sickness caused an increase in the area of the wound cavity compared with the non infected radionuclide and to a significant inhibition of its healing processes. The addition of the infection factor reduced the activity of the reparative processes in the radiation sick ness by 20 % compared with the uninfected. The effect of photodynamic therapy contributed to complete healing on average one month earlier than in control groups., (N. V. Krasnoselskiy, L. I. Simonova, V. Z. Gertman, E. S. Pushkar.)

Aim: to compare the dynamics of epithelial wound healing under two different post-op treatments in patients after uncomplicated phacoemulsification., Material and Methods: This prospective randomized clinical trial included 40 eyes of 40 patients aged 66.4±8.2 years who underwent uncomplicated phacoemulsification with flexible intraocular lens implantation through a 2.2-mm corneal incision. Patients were randomized to receive either dexamethasone 0.1% and diclofenac 0.1% (n=20 eyes, Group I), or bromfenac 0.09% (n=20 eyes, Group II). Also, all patients instilled levofloxacin 0.5%. The dynamics of epithelial wound healing was assessed with the RTVue-100 spectral domain optical coherence tomograph with CAM-L corneal module in the 3D CORNEA mode 2 hours after surgery and on days 1, 3, 5, and 10., Results: The postoperative period was uneventful in all cases. Two hours after surgery, epithelial defects were found in all eyes and their length did not differ statistically p=0.47. On the first day after surgery, complete epithelization was observed in 30% of cases from Group I and 60% of cases from Group II. The average length of epithelial defects was reliably smaller in Group II than in Group I (p=0.04 respectively). On postoperative day 3, 20% eyes from Group I still had epithelial defects with the average length of 0.45±0.13 mm, while there was only one eye with a 0.2-mm epithelial defect in Group II. Finally, on postoperative day 5, there was a single 0.3-mm epithelial defect in one eye from Group I. On day 10, none of the patients had epithelial defects in either group., Conclusion: Epithelial wound healing at the site of corneal incision after non-complicated phacoemulsification was found to be faster in patients instilled with bromfenac twice daily than in patients receiving dexamethasone and diclofenac four times daily as anti-inflammatory therapy and given topical fluoroquinolones for antibacterial purpose.

The objective of the present study was to elucidate the influence of retinoid-based pharmaceutical products on the process of regeneration of the tissues surrounding an open osteal wound under the experimental conditions. The experiments were carried out using 20 'Sovetskaya shinshilla' rabbits (12 males and 8 females). The animals with the modelled open osteal wound underwent daily treatment by the placement of the dressings impregnated with a mixture of dioxo-methyltetrahydropyrimidine and chloramphenicol ointments supplemented by 0.05% retinoic acid (1:1:1). The rabbits of the control group were treated using the dressings impregnated only with a mixture of dioxo-methyltetrahydropyrimidine and chloramphenicol ointments containing no retinoic acid. The study has demonstrated that the application of the retinoid-based medications for the treatment of the open osteal wound resulted in the well apparent positive dynamics of the wound process in comparison with that in the control animals. It is concluded that the data obtained give evidence that retinoid-based preparations can be used as an adjuvant treatment for the acceleration and promotion of the wound healing process in the trepanation cavity following sanation surgery on the middle ear.

Aim: To investigate the impact of various wound dressings on wound bed neoangiogenesis in patients with different forms of diabetic foot syndrome (DFS)., Subjects and Methods: The clinical (local tissue oxygenation) and immunohistochemical (CD31) markers of foot soft tissue neoangiogenesis were evaluated in patients with DFS receiving negative pressure (NP) therapy and collagen-containing dressings (CCDs) versus standard treatment. 63 patients with neuropathic and neuroischemic (without critical ischemia) forms of DFS were examined after wound debridement. In the postoperative period, 21 patients received NP treatment, CCDs were applied to 21 patients, and 21 patients had standard treatment., Results: During NP therapy, there was statistically significantly intensified local microhemodynamics, as evidenced by transcutaneous oximetry (p < 0.05); the remaining two groups showed no statistically significant differences in transcutaneous oxygen tension during the treatment. Immunohistochemical examination revealed a significant increase in the number of newly formed vessels, as shown by anti-CD31 antibody staining (p < 0.05), in patients who had NP therapy and CCDs (p < 0.05)., Conclusion: Vacuum (NP) therapy versus standard therapy most effectively affects wound bed neoangiogenesis. This is reflected in the increased local tissue microhemodynamics, as confirmed by immunohistochemical examination.

Aim: To the outcomes of lower extremities burn wounds management by using of controlled moist environment., Material and Methods: Burn wounds management by using of controlled moist environment in 23 patients is presented in the article. Physiological moist conditions on the surface of wounds were created with isotonic sodium chloride solution and sterile polyethylene diaphanous containers. Сontrol group included 12 patients who were treated with hydrocolloid patch., Results: It was shown that burn wounds management with moist environment allows to use and improve this method further. This technique gives good analgesic effect within the first days after burn trauma, allows to implement permanent clinical monitoring of the wound and preserve functional activity of the limbs.

Pterygium is widely distributed in regions with hot and dry climate. Frequent relapses of the disease are due to delayed epithelialization of postoperative corneal erosion, associated inflammation and formation of dry areas of the cornea. Effective stimulation of corneal epithelium regeneration in the postoperative period could reduce the frequency of relapses., Aim: to compare the effectiveness, safety and tolerability of different keratoprotectors in patients after surgical treatment of pterygium., Material and Methods: A total of 60 patients (73 eyes) with pterygium were operated on using classic McReynolds technique. Depending on the keratoprotector used postoperatively (Korneregel, Balarpan, or Stillavit), the patients were divided into three groups of 20 persons. In each group, the clinical picture during the postoperative period was evaluated at days 1, 3, and 7., Results: As to the subjective symptoms relief and stimulation of epithelization, Stillavit capability was comparable to that of Korneregel, but Stillavit was free of the common side effect of Korneregel - blurred vision after instillation. Epithelialization rate under Stillavit therapy was higher than that under Balarpan., Conclusion: Stillavit can be recommended as the drug of choice for patients after surgical treatment of pterygium. Components of the preparation (0.16% sodium hyaluronate, 0.05% sodium chondroitin sulfate, and 1% dexapanthenolum) act on each of the links in the pathogenesis of recurrent pterygium - slow epithelialization of the cornea, associated inflammation and formation of dry areas of the cornea.

Aim: Studying influence of remaxol on reparative process of tissue reparation in a laparotomy wound., Material and Methods: 90 patients with the acute appendicitis complicated by local peritonitis in the early postoperative period are examined. 50 patients received traditional therapy. Therapy of other 40 patients included Remaxol (intravenous introduction, daily within 5 days, of 400 ml)., Results and Conclusion: It is established that Remaxol optimizes the course of reparative process in laparotomy wound that was confirmed with data of tenziomety and wound exudate cytological research. Efficiency of a Remaxol is based on its capability to improve microcirculation, antiedematous action and its capability to reduce excessive intensity peroxide oxidation of membrane lipids, phospholipase activity and the phenomena of a hypoxia.

Major salivary glands play a role not only in digestion, but also in regulation of other functions in rodents. In this review, we analyzed and summarized the data about the rodents' parotid, submandibular and sublingual salivary glands functions, which is not limited to the production of saliva and action of its hydrolytic enzymes on food in the oral cavity. In recent decades significantly expanded understanding of major salivary glands nondigestive functions. They are involved in excretion of metabolic products, maintaining fluid and electrolyte balance. Special attention has been paid to the characteristics of specific (parotin, sialorphin, etc.) and nonspecific (epidermal growth factor, nerve growth factor, kallikrein, etc.) active substances of the major salivary glands and their involvement in wound healing, mineral metabolism, regulation of hematopoiesis and immunity system. Summarized and analyzed major salivary glands endocrine function in the organs and systems. Available literature data suggest: the structure of the major salivary glands, as well as the synthesis and secretion of a number of biologically active substances are controlled by sex hormones. In turn, these biologically active factors of the salivary glands, as epidermal growth factor, and parotin, sialorphin, whose expression is regulated by androgens, have an impact on the morphological and functional state of the gonads. Thus, major salivary glands operate a wide range of functions and involved in the regulation of sexual behavior of reproductive function and maintaining homeostasis in the body.

The objective of the present study was to evaluate the possibility of the application of the cyanoacrylate-based glue for the strengthening of the reconstructed elements of the middle ear and its influence on the regeneration of the cartilaginous tissue. We used the cartilaginous tissue from the auricles of the male California rabbits as a model. The cartilage was destroyed in a standard press. Half of the cartilage thus fragmented was implanted into the left auricle. The remaining part was mixed up with the cyanoacrylate glue and implanted into the right auricle of the same animal. The implanted material was used for the morphological study on day 10, within 1 and 2 months after the beginning of the experiment. The results of the study confirm the absence of the toxic action of the biologically compatible cyanoacrylate-based glue on the regeneration of the cartilaginous and connective tissues which suggests the possibility of its application for the surgical treatment of the diseases of the middle ear.

Aim: to study the effects of urokinase plasminogen activator (UPA) on the human retinal pigment epithelium (hRPE) cell culture., Material and Methods: The toxicity of 50 U/ml UPA was studied with the trypan blue exclusion test. Cell migration was assessed by the wound healing and modified Boyden chamber assays. Additionally, cell morphology, trypsin resistance, and Ki67 expression were investigated., Results: Trypan exclusion test did not reveal any cytotoxicity of 50 U/ml UPA against hRPE cells. The agent appeared able to induce cellular cluster formation and increase the number of spindle-shaped cells (6.4±2.4 cells/field and 67.3±3.2 cells/field in the controls and in the presence of 50 U/ml UPA, respectively, p<0.001). Cell migration in the Boyden chamber also showed a statistically significant increase (1.75-fold, p=0.012). Monolayer wounds were found to heal at an accelerated rate (p<0.05). This effect was dose-dependent, just like the increase in Ki67-positive cells (from 2.5 to 50 U/ml). Moreover, there was a reduction in trypsin resistance of the hRPE cells (the number of resistant cells in the control and 50 U/ml UPA cultures was 5.2±1.7 cells/field and 0.46±0.32 cells/field, respectively, p<0.001)., Conclusion: UPA, at concentrations of 50 U/ml or less, demonstrates no cytotoxicity against the hRPE cells. The effects of UPA on hRPE include stimulation of epithelial-mesenchymal transition, migration, proliferation, and intercellular interaction. At that, changes in migratory and proliferative activity are dose-dependent.

Aim: to evaluate the effectiveness of modern approaches to the treatment of purulent wounds with the use of foam-based wound coatings with the Hydrofiber technology in comparison with the traditional method of wounds., Material and Methods: An analysis of the results of treatment of 34 patients with purulent wounds of various etiologies was performed. Patients were divided into two groups: control and basic. In the main group, local treatment of wounds was carried out using a foam-based wound coating with Hydrofiber technology. In the control group, local treatment of wounds was carried out using traditional methods with the use of gauze bandages., Results: With the use of foam-based wound coatings with Hydrofiber® technology, the inflammation process in the wound and surrounding tissues is more rapidly eliminated, the periods of purification and microbial decontamination in the purulent focus are reduced.

Aim: The purpose of the study was to study the effectiveness of the domestic drug Remaxol in reparative processes of laparotomic wound tissues in acute surgical abdominal pathology in patients with diabetes mellitus., Material and Methods: Clinical and laboratory studies were performed in 86 patients with acute surgical pathology of the abdominal cavity, 56 patients with type 1 diabetes mellitus, including 26 patients who received Remaxol in the early postoperative period (daily intravenous infusions of 400.0 ml for 5 days)., Results: It was established that diabetes mellitus is an important aggravating factor in the reparative process of tissue structures of a laparotomic wound. Undoubtedly, a significant factor in reducing the reparative potential of tissues is a significant activation of factors leading to membrane-destabilizing phenomena - oxidative stress, activation of phospholipases, hypoxia. The inclusion of Remaxol, which has antioxidant and antihypoxic effects, allows to significantly correct these pathogenetic components, which is the basis for optimization of the reparative process against the background of diabetes mellitus. There was a significant decrease in wound complications in the early postoperative period, a significant reduction in the stay of patients in the hospital.

Simulation model of open penetrating wound of a spinal cord (SC) with its durable com- pression by biocompatible foreign body, was tasted. Experimental animals - mature male rats (inbred line, descendent from a Wistar breed); the trauma simulation model - a left- sided transsection of the SC half on the Txi level; experimental groups: the main (a SC trau- ma + homotopic implantation of microporous hydrogel fragment - foreign body [n=10]), groups of comparison (the SC trauma [n=16]; the SC trauma + homotopic implantation of chemically identical analogue of hydrogel - NeuroGelTM [n=20]). A SC compression by a foreign body worsens the regeneration process course essentially: during first 2 mo the function index of a hind ipsilateral extremity in experimental animals of the main group was the lowest in the experiment - (1.30 ? 0.94) points in accordance to BBB scale, during 3 - 4 mo - the function index had enhanced trustworthy - up to (2.35 ? 0.95) points in accor- dance to BBB scale, what is connected with lowering of a local pressure on a SC tissue due to change of the foreign body form and volume. In 24 weeks the function index of hind ipsi- lateral extremity had constituted (8.45 ? 0.92) points - while application of NeuroGeTM and (2.35 ? 0.95) points - of the foreign body; the tissue processes in the implants localization zone had differed essentially. The tasted simulation model reproduces satisfactory a mechanical component of the foreign body impact on a SC tissue. The SC compression reduction, even in a late follow-up period, had improved the conditions and results of recenerative process essentially.

The data on the experimental study of the efficacy of the gel wound dressings based on chitosan and calcium alginate containing bioactive substances from marine hydrobionts with complex therapeutic action (sulfated polysaccharides from brown algae, hydrolyzed bivalves, peptides from nerve ganglia of cephalopods) are described. The model of thermal burns complicated by Staphylococcus aureus infection was used. Planimetric and bacteriological investigations revealed pronounced wound healing and antibacterial effects of the gel coating. The gel containing sulfated polysaccharides from brown algae showed the highest wound healing activity.

Development, standardization and use of medicinal products of plant origin and various therapeutic value are described in the review. The literature data refer to the studies of some leading institutions of the Russian Federation and in particular to the Medical Institute of the Russian University of Peoples' Friendship, All-Russian Research Institute of Medicinal and Aromatic Plants, Pyatigorsk State Pharmaceutical Academy and some foreign laboratories. Possible use of the trichoderma extract and its prospects are shown.

Aim: To study an efficacy of Reamberine in complex therapy in early postoperative period after knee-joint surgery., Material and Methods: It was analyzed treatment of 108 patients (47 men and 61 women) with degenerative diseases of knee-joint in postoperative period. Periarticular osteotomy of tibia and knee-joint replacement were performed. Patients were divided into 2 groups. Main group consisted of 43 patients who received Reamberine 400-800 ml with infusion rate 4-5 ml/min during 1-1,5 hours for 4-8 days postoperatively. Control group (65 patients) had conventional therapy with daily volume 400-800 ml., Results: It was revealed that Reamberine increased efficacy of postoperative treatment. There were earlier (by 52.6% compared with control group) improvement of health including weakness disappearance, sleep and appetite recovery. Hemodynamic parameters were also improved (stabilization of blood pressure and pulse). It was observed earlier disappearance of pain and edematous syndrome (by 32.3%). There were also earlier postoperative wound healing (by 21.3%) and reducing of rehabilitation terms (by 72%, i.e. 2.1 ± 0.7 vs. 7.5 ± 0.9 days respectively).

The authors analysed the results of comprehensive examination and treatment of a total of 40 patients presenting with lower limb chronic venous insufficiency at the stage of trophic disorders (class C6), including 28 (70%) patients with varicose disease of lower extremities and 12 (30%) patients with post-thrombotic disease. Studying the microcirculatory blood flow by means of laser Doppler flowmetry showed a statistically significant (p<0.05) baseline decrease in the index of microcirculation in patients (12.2±2.4 perf. units for varicose disease and 10.8±1.8 perf. units for post-thrombotic disease) as compared with the control group of apparently healthy volunteers (20.4±1.5 perf. units). All stages of treatment included the program of stimulation of reparative processes and normalization of microcirculation by means of sulodexide. Conservative measures were independent therapeutic procedures in 31 patients. Of these, trophic ulcers completely epithelialized in 9 patients and decreased by half of its initial surface in 22 patients. The study of the microcirculatory blood flow in dynamics suggested improvement of microcirculation during treatment. Hence, comprehensive therapy using sulodexide in patients with venous trophic ulcers is accompanied by an endothelium-protecting effect and leads to improvement of the indices of microcirculation of the skin of the crus.

Relevance: Currently, there is increasing the number of diabetic foot patients with tissues defects. The local treatment of this pathology against the backdrop of diabetic angiopathy and polyneuropathy is a topical issue., Aim: Treatment of wound defects in patients with neuroischemic form of diabetic foot syndrome; study of the effectiveness of collagen implants and gene-therapy technologies in wound closure., Material and Methods: The comparative study was conducted for analyzing clinical effects of "Heberprot-P" and bioplastic material "Collost" on wound healing process in patients with verified diagnosis "diabetic foot syndrome" on the base of City Clinical Hospital №81(Moscow) and "Diabetic Foot" center (Kazan)., Results: The article shows the availability, methodology, results of combination treatment of wound defects of lower limbs in DFS patients with gen-therapy methods and bioplastic materials based on native type I collagen., Conclusion: The use of bioplastic materials based on native type I collagen for treatment of tissue defects in patients with diabetic foot is preferably than the use of epidermal growth factor.

The authors assessed efficacy of regional intraosseous administration of urokinase medac in comprehensive treatment of patients with complicated forms of diabetic foot syndrome by means of analysing therapeutic results in a total of 65 patients presenting with pyonecrotic complications of diabetic foot. The patients were subdivided into 2 groups. The control group was composed of 35 patients receiving basic therapy. The study group comprised 30 patients subjected to comprehensive treatment including regional intraosseous (into the heel bone of the affected limb) administration of urokinase medac at a dose of 100 thousand IU for 5 days. Efficacy of treatment was evaluated by the course of the wound process, indices of haemostasis, free radical oxidation, results of surgical treatment. In patients of the Study Group the terms of wound purification from pyonecrotic masses amounted to 9.8±0.3 days, which was by 4.7 days less than in the Control Group patients (p<0.01), marginal epithelialization of wounds also occurred averagely by 6.4 days faster. On day 22 of using the basic therapy alone, the haemostasis system preserved the condition of coagulation activity. The Study Group patients as early as on day 5 of treatment demonstrated shifts towards normocoagulation. In the Control Group by day 22 of treatment, the level of malonic dialdehyde decreased by 18.5%, the index of catalase activity increased by 24.6% (p<0.05); in the Study Group the level of malonic dialdehyde decreased by 42.6% and catalase activity increased by 69.4% (p<0.01). On the background of using urokinase the number of high amputations decreased by 18% and the number of operations with the supporting function preserved decreased by 12% as compared with basic therapy alone. A conclusion was made that additional use of regional intraosseous administration of urokinase medac as compared with basic therapy alone promoted a more significant decrease in the coagulation activity of blood and the level of free-radical lipid oxidation, stimulation of regenerative processes, as well as improvement of outcomes of surgical treatment.

Presented herein is a case report concerning successful treatment of a patient with the neuroischaemic form of diabetic foot syndrome using Neovasculgen(®) agent. This case by salvage of the supporting leg could have been considered unpromising without the use of the methods of therapeutic angiogenesis. The use of Neovasculgen(®) made it possible to obtain an optimal result with rehabilitation of the patient and preserving the initial level of his quality of life.

Aim: To evaluate the influence of different methods of local treatment on tissue repair in patients with diabetic foot ulcers., Materials and Methods: We evaluated such clinical characteristics as wound size and local perfusion after using negative pressure wound therapy (NPWT), local collagen, and standard care in patients with diabetic foot ulcers. We observed 63 patients with neuropathic and neuroischemic forms of diabetic foot (without critical ischemia) after surgical debridement. After that 21 patients received NPWT, 21 local collagen treatment and 21 ― standard care., Results: After using NPWT wound area and depth decreased in 19,8% and 42,8% (p<0.05), in group of collagen dressings in 26,4 and 30,4% (p<0.05). In control group those parameters were 17,0 и 16.6% respectively (p<0.05). There was found the significant increase of local perfusion according to oxygen monitoring in group of NPWT (p<0.05)., Conclusion: The received data showed that the intensity of lower limb tissue repair processes increases more significant after using NPWT and collagen dressings in comparison to standard care which is found according to wound size and tissue perfusion alterations.

Aim: Find out the condition of mucosal microflora in gastroduodenal ulcer patients in different phases of its recurrence, to determine changes in the value of dysbiotic changes in ulcerogenesis, develop and confirm new transendoscopic treatment of gastroduodenal ulcers., Materials and Methods: The study included 134 patients and 10 healthy volunteers, Results: At relapse of peptic ulcer and distant from the ulcer areas of the mucosa were allocated to 28 genera and species of microorganisms with a wide range of enzymatic activity and cytotoxicity, that corresponds to the 2-3 degree dysbacteriosis and shows microbiological parameters infected wound which required sanation., Conclusion: Application for transendoscopic sanation of gastroduodenal ulcers of new compounds iodine-lysozyme, dimexide-iodine-lysozyme and chitosan with bactericidal and sorption effects, can significantly reduce the time of ulcer healing and restore normobiocenosis of mucosal microflora of the gastroduodenal zone.

Treatment and prevention of infectious complications remain the actual problems of surgery. Purulent complications very often arise in operative interventions with an application of various fixing devices. A study of the adhesive surgical antiseptic (ASA) «ARGAKOL» (Registration certificate № FS 012б2005/1878-05) was completed. The results of the preliminary antimicrobial activity of the developed composition showed that ASA «ARGAKOL» had a broad spectrum of antimicrobial action. There was used the method of twofold serial dilutions in a liquid medium and Cup-suspension. The study of the influence of the ASA «ARGAKOL» on the wound healing was made in the experiment on white outbred rats. There were carried out two series of experiments with 10 rats in each group: on the model of just contaminated wound (the first series) and on the model of infected wound with delayed application of the glue (after 3 days) after trauma (the second series).

The influence of an original substance based on enzymatically destructed alginic acid on the reparative activity has been studied using an experimental model of planar aseptic wound. Toxicity of the test compound was evaluated and its effective dose was determined using curiozin as the reference drug. It is found that the test compounds is non-toxic. It is established that the pharmacological activity of the reference drug (curiozin) is lower on the average by 3.5% (δ = 0.021) than that of the original pharmaceutical substance based on destructed alginic acid

The effectiveness of a new complex preparation based on starch containing active copper (0.05 - 0.07 mass %) and silver 0.03 - 0.05 mass %) nanoparticles was studied in animals with experimental fill-flap septic wounds. Localized application of complex preparation (0.3 g per animal) by uniform layer on 5th, 7th, and 9th day upon wound induction led to significant reduction in wound surface (according to planimetric analysis) at all control periods, in contrast to reference group. There was statistically significant (p < 0.001) decrease in malondialdehyde (by 23%) and increase of serum enzymatic antioxidant ceruloplazmin activity (by 20.5%) in rat blood serum compared to the corresponding indexes in animals before therapy. These results are indicative of the suppression of peroxidation processes and stimulation of antioxidant system. The complex preparation exhibited positive influence on soft tissue repair processes, lipid peroxidation processes, and activity of the antioxidant system.

Wound healing activity of 20 different means of conservative treatment of radiation burns was studies in the experiments on the rats subjected to local β-radiation (at a dose of 60 Gy) and combined radiation damage (β-radiation at a dose of 60 Gy and the whole-body γ-irradiation at a dose of 4 Gy). It was found that reparative processes in the irradiated,skin in the case of the local radiation injuries are most effectively accelerated by ointments Biopin, Panthenol-Ratiopharm, IL-1β and Iruksol; Dimexidum solution; aerosols Olazol, Gipozol and Polkortolon; wound coverings Procell-super and Selenopol. Ointments containing IL-1β, Dimexidum solution, aerosols and wound coverings have a healing effect in the case of combined radiation injury.

The data on inhibition of the growth of microorganisms of a characteristic spectrum and antibiotic resistance isolated from long-term healing wounds by light of various wave ranges are presented. The growing cultures on blood agar were exposed to polarized light, red and infrared, ultraviolet of medium- and short-wave continuous modes accustomed in physiotherapy of wounds.The effect of light in some way induced inhibition of the growth, but complete recovery was stated only after the use of ultraviolet light when confirmed quantitatively in terms of the CFU.

Described in the literature properties of osteoplastic material "Cerabone®" have been obtained from studies in the maxilla and cancellous bone. The lack of data on the impact of «Cerabone®» on the dynamics of the healing of defects of compact substance of the long bones of the skeleton dictates the need for such studies. Implantation of osteoplastic material «Cerabone ®» was performed into the defect of rat femoral shaft followed by computer-tomographic analysis of its healing. Starting from the 30th day until the end of the experiment (120th day) there were found faint signs of rarefaction in the distal part adjacent to the defect of parent bone, with no signs of bone resorption in its proximal part. There was identified an extremely high density of the implantation site «Cerabone®», no visible radiographic evidence of resorption of osteoplastic material and ensuring by the latter the stability of volume of the defect in cortical bone at all stages of the experiment.

In the treatment of tissue wounds practically all the time there is necessary the establishment of aseptic conditions in the area of the damaged tissue. In modern medical practice quite a while the use of materials on the basis of collagen aroused widespread. The aim of the study was an assessment the bacteriostatic properties both of collagenic substance with the antibiotics immobilized on it, and ions of silver also. The presence on a surface of collagen of a large number of active functional groups allow to use it as a matrix for an immobilization of various biologically active and medicinal agents. Authors performed an assessment of possibility of an immobilization of antibiotics on the collagenic carrier. The purpose of an immobilization was in the prolongation of the impact of an active component--Polymyxin-M or Gentamycin. Besides aseptic effect, availability of specific amino acids of collagen will promote the acceleration of the reparative processes in a wound. There were performed investigations on determination of bacteriostatic effect of immobilized on the protein carrier (collagen of hydrobionts) antibiotics, and silver ions also. Bacteriostatic effect was estimated by the disco--a diffusive method with use of E. coli as test culture. Results of the studies showed that the delivered preparation had bacteriostatic effect on the test culture. At that the area of a zone of a growth inhibition in case of the of use--Polymyxin was 1.3 time more than, than in case of the use of a preparation of Gentamycin. The obtained collagenic substances of an origin with the immobilized bacteriostatic components and ions of silver have considerable prospects and real opportunity in the delivery of aseptic preparations of a domestic production. Taking into account the available data in further there is planned the development of aseptic preparations with the occluded biologically active agents and nanoparticles of metals for providing an aseptics and acceleration the reparative processes in the treatment of open wounds.

The authors studied efficacy of preventing wound infection of a sternotomic wound with and without conventional use of topical antibiotics, also determining predictors of the development of infectious complications after cardiosurgical interventions. Our retrospective study included a total of 1,593 patients subdivided into two groups. In Group One patients (n=951) sternal infection was prevented according to the P. Vogt technique; Group two patients (n=642) were also subjected to the same methodology, but with the exception of topical use of antibiotics. By the frequency of re-sternotomies performed, cases of superficial and deep wound infection, as well as by the average duration of operation, hospital and ICU stay there were no statistically significant differences between the groups (p<0.05). The average cost of antibacterial agents as calculated per one patient in Group One turned out substantially higher than in Group Two (amounting to 8.1±3.9 and 3.3±1.4 thousand roubles, respectively, p<0.001). Analysing possible predictors of the risk for the development of wound infection showed that the body mass index, duration of the operation, and performing re-sternotomy exerted a statistically significant influence on probability of infections complications. It was determined that using the methodology of preventing sternal infection with topical application of antibiotics led to predominance of Gram-negative flora in the wound discharge (p=0.02). Exclusion of topical use of antibiotics does not lead to an increase in the incidence rate of wound complications (p=0.78) and normalizes the ratio of Gram-negative and Gram-positive strains.

Unlabelled: The aim of this study was to define the possibility of using a collagen substance CollGARA as a protective barrier between the polypropylene mesh implant and abdominal organs. The drug is a sterile bioabsorbable membrane consisting of refolded equine collagen. Indications--use as barrier separating adjoining tissues and organs in the areas of the abdominal cavity, where the formation of adhesions., Materials and Methods: Were performed 10 operations in patients with ventral hernias with different localization. 8 patients had postoperative hernia in 2--linea alba hernia. 8 patients were operated open, 2--laparoscopically. After intra-abdominal hernia repair was performed plastic mesh implant, delimiting it from the abdominal cavity membrane CollGARA. Serious complications from the abdominal cavity and the surgical wound wasnt observed., Results: The first experience with intra-abdominal plastic polypropylene mesh implant coated with collagen plate indicates the possibility of applying this method in the future.

This work is an experimental study on 30 rabbits to determine the effect of antioxidants on the process of repair of the esophagus. Chemical agent was 46% acetic acid, a The antioxidant "Mexidol" were injected to core group of test animals in 2 weeks. Animals were taken from the experiment at 5, 14, 21, 30, 45 and 60 hours. We conducted morphometric study of histological exemplars, determining the number of inflammatory cells, epithelial thickness, the area of newformed blood vessels. In the study group we reported an improvement of reparative processes in the wall of the body: it was increased blood supply to the burn surface on 242% and more rapid relief of inflammatory processes on 117% (p < 0.05).

Activated protein C (APC) is serine protease hemostasis, independent of its anticoagulant activity, exhibits anti-inflammatory and anti-apoptotic properties that determine the possibility of the protective effects of APC in different diseases, including sepsis and chronic wound healing. APC, binding of endothelial protein C receptor (EPCR) and specifically cleaving PAR1 receptor and releasing peptide agonist PAR1 stabilizes not only endothelial cells, but also many others, including epidermal keratinocytes of the skin. We develop the hypothesis that the cytoprotective effect of APC on the cells, involved in wound healing, seem to imitate peptide - analogous of PAR1 "tethered ligand" that activate PAR1. In our work, we synthesized a peptide (AP9) - analogue of PAR1 tethered ligand, released by APC, and firstly showed that peptide AP9 (0.1-10 мM), like to APC (0.01-100 nM), stimulates the proliferative activity of human primary keratinocytes. Using a model of the formation of epithelial wounds in vitro we found that peptide AP9, as well as protease APC, accelerates wound healing. Using specific antibodies to the receptor PAR1 and EPCR was studied the receptor mechanism of AP9 action in wound healing compared with the action of APС. The necessity of both receptors - PAR1 and EPСR, for proliferative activity of agonists was revealed. Identified in our work imitation by peptide AP9 - PAR1 ligand, APC acts on keratinocytes suggests the possibility of using a peptide AP9 to stimulate tissue repair.

In this paper we compared the efficacy of proton pump inhibitors (PPIs) and H2 receptor antagonists on the morphogenesis of the marginal zone of gastric and duodenal ulcers in 56 patients withacute gastroduodenal bleeding. It is shown that the antisecretory drugs in the treatment of patients with acute ulcerative bleedingnot only affect on the secretory activity of the glands in gastroduodenal zone, but it also modulates inflammatory reparative process and the status of mucous and bicarbonate barrier. A greater anti-inflammatory effect of PPI in comparison with H2-receptor antagonists has been proved. Appointment of PPIs had more pronounced stimulation of angiogenesis and cell proliferation of the surface epithelium.

Evaluation of the efficacy of sekretolitičeskoj therapy with synthetic analogue of somatostatin, a short-acting oktreotid (group 1) and extended oktreotid-depo (group 2) in 24 patients with external pancreatic fistulas after destructive pancreatitis. Results of clinical studies have shown that against the backdrop of an analogue of somatostatin-depo true healing and purulent-necrotic pancreatic external fistula occurs in less time: average 19 ± 1.8, and 16.2 ± 1.2 day observations, respectively.

The original material of monitoring of 118 patients with chronic anal fissure is presented in the article. Patients' mean age was 48.9+-10.5 years. It was used injections of medicine of botulinum toxin of type A (Lantox) by its introduction in internal anal sphincter in all patients. There was granulating wound with signs of marginal epithelialization in 59.3% of cases on the 10th day after injection. It was detected complete epithelialization of dermis defect in 93.2% of cases on the 21st day, after six weeks - in 100% of cases. According to anorectal profilometry the index of maximal and average pressure in the anal canal at the level of the internal sphincter in patients at rest decreased to norm. Lantox introduction leads to rapid and persistent reduction of pain intensity. "Lantox" use in ambulatory practice permits to minimize the indications for surgical treatment.

Currently, there is an increase in the number of patients with infections of the skin and soft tissue. There is a question of closing tissue defects after the elimination period of acute inflammation. Application auto skin grafting free split-skin graft does not always lead to a positive outcome of primary closure of the defect and to the appearance of one more wound skin. The technique that avoids these drawbacks is proposed.

The main cause of long-term healing of ulcers in patients with diabetic foot is considered to be direct mechanical damage when walking due to reduced sensitivity to due to neuropathy, hyperglycemia, infection and peripheral artery disease. These factors determine the standard approaches to the treatment of diabeticfoot, which include: offloading, glycemic control, debridement of ulcers, antibiotic therapy and revascularization. Recently, however, disturbances in the healing process of the skin in diabetes recognized an additional factor affecting the timing of healing patients with diabetic foot. Improved understanding and correction of cellular, molecular and biochemical abnormalities in chronic wound in combination with standard of care for affords new ground for solving the problem of ulcer healing in diabetes.

The authors present the investigation of inpatient treatment of 137 patients with trophic ulcers of venous aethiology. All the patients were hospitalized in the "Road clinical hospital" on the Krasnoyarsk station. A comparative analysis of treatment results of the patients with trophic ulcers using different medical methods was made. The efficacy of combined use of low-frequency ultrasound and ozone therapy was proved.