RESUMO
OBJECTIVE: To evaluate the effectiveness of preparing a wound for plastic closure of autoskin using a negative pressure apparatus and Reamberin. MATERIAL AND METHODS: . The results of preoperative preparation of 24 patients with chronic wounds of various etiologies were analyzed. Depending on the treatment regimen, the patients were divided into groups: the main one (n=18), the patients of which were divided into subgroups: in IA (n=9) they used NPWT therapy for 5 days, in IB (n=9) it was combined with Reamberin infusions (1.5% intravenously at a rate of 40-60 drops/min, 500 ml, once a day for 5 days). Patients of the comparison group (II, n=6) received standard preparation. In the dynamics of therapy, a morpho-histological study of wound biopsies was carried out with the determination of the area of fibroblasts, the area of the nucleus of fibroblasts, the number of vessels and the determination of their diameter. After autodermoplasty, the survival of the skin flap was determined. RESULTS: It was found that the combined use of NPWT therapy and Reamberin significantly increases the effectiveness of therapy: the greatest effect on fibroblastogenesis was exerted by the inclusion of NPWT therapy in the regimen - an increase of 1.5 times compared with the results of the traditional regimen. The vascularization of the wound surface (increase in the area and diameter of blood vessels) was best influenced by the combined preparation (NPWT-therapy and Reamberin) preparations - an increase of 3.4 times in comparison with the comparison group, which affected the dynamics of the survival of the skin flap: it was 1.3 times higher than in the comparison group (p<0.01). CONCLUSIONS: The results obtained, along with good tolerability of the drug, allows us to recommend the inclusion of Reamberin in the scheme of preoperative preparation of patients with this pathology.
Assuntos
Antioxidantes/administração & dosagem , Meglumina/análogos & derivados , Tratamento de Ferimentos com Pressão Negativa , Transplante de Pele , Succinatos/administração & dosagem , Ferimentos e Lesões/tratamento farmacológico , Ferimentos e Lesões/cirurgia , Doença Crônica , Humanos , Infusões Intravenosas , Meglumina/administração & dosagem , Cuidados Pré-Operatórios , Transplante Autólogo , Cicatrização , Ferimentos e Lesões/etiologia , Ferimentos e Lesões/terapiaRESUMO
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.
Assuntos
Antioxidantes/uso terapêutico , Gastrectomia/métodos , Gastroenterostomia/efeitos adversos , Fármacos Gastrointestinais/uso terapêutico , Meglumina/análogos & derivados , Tratamento de Ferimentos com Pressão Negativa , Estômago/cirurgia , Succinatos/uso terapêutico , Gastrectomia/efeitos adversos , Humanos , Meglumina/uso terapêutico , Cicatrização/efeitos dos fármacosRESUMO
A clinical case of successful combined use of NPWT-therapy and Reamberin infusion in the treatment of a non-healing (over 5 months) trophic ulcer of the lower limb in an elderly patient is presented. It was manifested that introduction of antioxidant/antihypoxant drug reamberin on the background of NPWT-therapy in patient with slow healing wounds has a positive effect on metabolic processes, resulting in more active and rapid cleansing of wound surface from opportunistic microflora by the 5th day of therapy. Absence of adverse effects to drug application allows to recommend its inclusion in the complex treatment scheme in patients with this pathology.