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The effectiveness of the treatment of borderline skin burns using a gel of rare-sewn acrylic polymers with natural antimicrobial peptides FLIP-7 was evaluated. A total of 60 burned patients hospitalized in the Burn Center of Saint Petersburg Scientific Research Institute for First Aid named after I.I. Janelidze were examined during the period from 20192021. The following were evaluated: the general condition of patients, planimetric indicators, as well as the results of microscopic examination of smears-prints from the wound surface. This drug was established to be effective in the treatment of borderline skin burns from the first day of use. The burn wound areas upon use of FLIP-7 gel compared to wet-drying dressings and water-soluble ointment levomekol decreased by 6.25% and 8.6%, respectively. A complete restoration of the integrity of the skin was noted by the 7th treatment day, against the background FLIP-7 gel use. A complete restoration of skin integrity was noted by the 7th day of treatment, against the background of FLIP-7 gel use. The application of a hydrogel with a complex of natural antimicrobial peptides was demonstrated to have a pronounced antibacterial effect against most pathogenic microorganisms. Hence, the number of burn wound infection decreased by 35% by the 4th day from the treatment initiation. There was a possibility of reducing the analyzed indicator to 10% by the end of the week of local treatment with FLIP-7 gel, which indicates almost complete elimination of pathogenic microflora from the burn wound. It was proven that the humid environment conditions formed by hydrogel can stimulate the reparative regeneration processes. This was confirmed by the results of microscopic examination of smear prints, indicating a statistically significant increase in the concentration of fibroblasts on the wound surface by the 4th day of observation compared with the results obtained before treatment initiation with FLIP-7 gel. Not a single case of side effect or undesirable phenomenon was recorded during course of the clinical study. The gel of rare-stitched acrylic polymers with natural antimicrobial peptides FLIP-7 is an effective means of local treatment of borderline skin burns, which provides not only optimal conditions for the course of reparative regeneration processes, but also actively eliminates pathogenic microflora, including polyresistant microorganisms strains.

The results of three-year research on the use of allogeneic mesenchymal stem cells of adipose tissue (AMSCs) in the treatment of skin burns of II-III degree are presented. in a complex with wounds dressing of nanofibers chitosan and copolyamide, hyaluronic acid. It was found that with surgical necrectomy, introduction of AMSCs and substitution of defects with natural polymer coatings, the healing time is reduced by 89% (p < 0.05). Isolated administration of MSC reduces the healing period by no more than 5% (p > 0.05). The combined use of wounds dressings of nanofibers chitosan and copo lyamide with MSC accelerates the regeneration process by 26% (p < 0.05), with the introduction of AMSCs accelerating the development of granulation tissue by the fifth day of observation by 83% (p < 0.01). Joint use of wound coverings on the basis of hyaluronic acid with AMSCs is accompanied by an increase in the number of vessels of the microcirculatory bed in the defect area by 185% (p < 0.01). Clinical evaluation of the effectiveness of drugs with stem cells – a gel for topical application and a suspension of MSC LC for injection administration demonstrate their ability to optimize regeneration in the burn zone. Application of gel with AMSCs reduces the duration of epithelialization of border (dermal) burns by 2.2-2.4 times, with the final healing period being reduced by 59% (p < 0.01) and the suppuration frequency by 30% (p < 0.05). The introduction of a suspension of AMSCs into the zone of deep burn increases the frequency of engraftment of autografts, stimulates angiogenesis and proliferation of fibroblasts in the superficial and deep layers of the dermis. In the area of MSC administration, the LC perfusion level and the amplitude of blood flow fluctuation are twice as high as the values in the zones without the introduction of cells.

Purpose. To evaluate the results of the application of allogenic fibroblasts in patients with extensive thermal burns. Methods. The study included 34 patients with burns over 20% TBSA, treated in the burn ICU. In accordance with the indications for transplantation of fibroblasts, all patients were divided into 4 groups: stimulation of regeneration of superficial burns (n = 10), stimulation of regeneration after meshed skin graft (n = 14), reduction of healing time for donor wounds (n = 6) and acceleration growth of granulations after the escharectomy (n = 4). Results. A positive effect of fibroblast transplantation was found in 7 (70%) patients of the first group, 13 (93%) of the patients in the second group, 2 (33%) of the third group and 2 (50%) in the fourth study group. Conclusion. The maximum positive effect of transplantation of human dermal fibroblasts can be observed when performing the meshed skin graft and treating the superficial burns.