[Wound-healing effect of carbopol hydrogels in rats with alloxan diabetes model].

The effects of 0.5% hydrogels of acrylic polymers (carbopol), antibiotic ointment based on polyethylene oxides (levomekol), silver-containing creams (dermazin and argosulfan), silver sulfadiazine ointment with epidermal growth factor (ebermin), and wound-covering fabric of antibacterial cellulose with poviargol and zero-valent silver (aquacell-Ag) on skin repair processes have been evaluated in comparative experiments on rats. The wound-healing effects were characterized by the time of cleansing and epithelization, rate of suppuration, index of healing, and skin impedance under conditions of necrotic skin lesions on the background of diabetes. It is established that local application of carbopol hydrogels modified by electric (frequency-modulated) signal with antiseptics (poviargol) and nanostructural components (natural fullerene complex) shortens the period of wound cleansing from detritus on the background of decompensated diabetes by 3.6 days (p > 0.05), accelerates healing by 8.4 days (p < 0.05), reduces the frequency of suppuration by 23.3% (p < 0.05), exhibits strong bactericidal effect against wound infections by pathogens, and restores tissue impedance. Thus, hydrogels based on low-crosslinked acrylic polymers are a promising basis of wound-healing formulations for the treatment of necrotic lesions on the background of diabetic foot syndrome.

[Experimental evaluation of reamberin and cytoflavin effects on the course and outcome of acute burn injury].

Survival rate, average life expectancy of victims, parameters of the acid - base balance, gas composition of blood, and morphological structure of internal organs have been studied in acute experiments on a group of 120 rats with burn injury of IIIB degree (20% of body surface) against early introduction of antihypoxants reamberin and cytoflavin. It is established that the introduction of antihypoxants reliably prevents the development of typical pathologic processes and hypoxemia, reduces expressiveness of organ dysfunction and extent of mophological changes in internal organs, and increases 1.5 - 2.5 times the survival rate of heavily damaged animals in the acute period of burn injury.

[Ways to improve medical help by deep massive burns in rural area].

Results of treatment were analyzed in 907 patients with extensive deep burns. It is shown that early large necrectomy and saving methods of skin plasty (microautodermoplasty) enables to improve significantly the results of surgical treatment in patients with deep burns. It is proved that introduced regional specialized hospitals with high-tech combustiology profile allow improving health care in such patients.

[Experience with surgical necrectomy for deep frostbitis using physical means to influence the tissue].

The efficiency of the methods of necrectomy for deep frostbite was analyzed according to the data of outcomes of surgical treatment of 272 patients with cold injury. It was shown that dissection of necrotic tissue in deep frostbite using modern physical techniques (electrosurgical, radiosurgical and argon-plasma dissector) improved immediate results of surgical treatment (due to decreased intraoperative blood loss, frequency of suppuration, cases of amputation, time of hospitalization) and optimized the wound process (by reducing the microbial contamination of the wounds) and accelerated the proliferative phase of regeneration.

[The modern approaches to the choice of infusion agents used in the treatment of severe injuries and burns].

The article presents an analytical review of modern possibilities of the complex pathogenic treatment for severe traumas and injuries at the expense of systemic use of infusion drugs with antihypoxic and antioxidant effects. It is shown that hypoxia and oxidative stress is the typical; pathologic process that accompanies the development of traumatic disease during severe surgical pathology. One of the effective ways to correct the developing disorders is to use the regulatory or substrate antihypoxants as well as the drugs with antioxidant effect.

[Combined and multifactorial burn injuries in military conflicts: tactical approaches to diagnosis and treatment].

The article reflects the experience of the treatment of the servicemen with combined burn injuries got in the Chechen Republic (1994-1996, 1999-2001). 266 causes of medical treatment for combined injuries where the burn was decisive were analyzed: 141 of which were got in the Chechen Republic in 1994-1996, 10 - in Daghestan in August-September of 199 and 125 - in the Chechen Republic in 1999-2001. In the structure of sanitary losses with surgical profile the burnt amounted to 4,1%, and 6,4%. The development of the medical treatment system made it possible to reduce lethality from 13,5% to 7,5% (P < 0,05). The optimal option of the medical evacuation organization in local military conflicts and wars is a two-stage scheme of evacuation, the first stage is premedical care ann the second is qualified (specialized) medical care.

[Urgent problems of experimental modelling of thermal skin burns]. / Aktual'nye voprosy éksperimental'nogo modelirovaniia termicheskikh ozhogov kozhi.

The review presents a critical analysis of principal benefits and shortcomings of standard experimental models of surface and deep thermal burns of the skin. Comparison of the results of experimental studies must rest on reproduction of identical traumas in series of experiments. It is important to choose animals species, burn model, exposition time and thermal agent depending on the study aim. An algorithm of simple and available methods of reproduction of superficial and deep thermal burns of the skin on a rodent model is described.

[Modern principles of the pathogenetic therapy of the burn shock]. / Sovremennye printsipy patogeneticheskoi terapii ozhogovogo shoka.

The article is devoted to the review of main directions of anti-shock therapy improvement for patients with severe burns. It is shown that the treatment efficiency can be considerably increased both by optimization of infusion volume and by the use of modern infusion drugs with anti-hypoxic and anti-oxidant effects. The use of anti-hypoxic and anti-oxidant drugs permits to change the burn shock course and to decrease its duration. Decrease in severity of tissue hypoxia, prevention of cellular membrane injury interrupt one of the circuits of burn disease pathogenesis and create the favorable conditions for realization of acute adaptation mechanisms in terms of traumatic disease conception. The modern schemes of anti-shock therapy approved at the department of thermal injuries were used in the treatment of casualties with combined burns after the armed conflict in the territory of Chechnia (1999-2001).

[Towards the problem of necessity to reduce the medical evacuation stages in conditions of local wars and armed conflicts]. / K voprosu o neobkhodimosti sokrashcheniia étapov meditsinskoi évakuatsii v usloviiakh lokal'nykh voin i vooruzhennykh konfliktov.

The article is devoted to the review of modern opinions concerning the experience of military operation medical support in conditions of local wars and military conflicts. On the base of analysis of medical assistance rendered to the wounded and casualties in Republic of Chechnya the advantages and defects of different approaches are discussed. The experience in rendering assistance to the casualties in the Armed Forces of NATO countries during the local wars for the last decades is discussed. It is shown that the optimal variant of organization of treatment-and-evacuation measures during the local armed conflicts and wars is the two-stage scheme of evacuation: the first medical aid--the qualified (specialized) medical aid.

Erysod, erythrocyte superoxide dismutase preparation: effects on LPO processes and morphological changes in the viscera of rats with burns under conditions of delayed antishock infusion therapy.

Biochemical and morphological changes in the kidneys, liver, heart, and lungs were studied in rats with deep burns of 20% body surface. Erysod (0.47 mg/kg/day) added to antishock therapy notably reduced the intensity of LPO processes in tissues both in cases when infusion therapy was started immediately (by 8-20% 12 h and by 5-24% 24 h after the injury) and when this therapy was 6 h delayed (by up about 36% after 12 h). This prevented injuries to visceral organs during the acute period of thermal injury and prevented the development of burn disease.

Effect of Erysod (erythrocyte superoxide dismutase) on blood concentration of reactive oxygen species in patients with severe burns and burn shock.

The dynamics of blood concentrations of reactive oxygen species and LPO products in patients with thermal injuries of different severity was studied. Monitoring of these parameters by chemiluminescent and spectrophotometric techniques helps to predict the course of burn shock and prevent complications. Erysod (0.004% solution, 33-66 microg/min, daily dose 24-32 mg) added to antishock infusion therapy during the early periods after injury suppressed generation of free radicals (by 20% after 15 min and by 30-40% after 24 h), promoted normalization of their contents, and reduced damage to visceral organs during acute period of thermal injury.

Effects of new wound dressings on healing of thermal burns of the skin in acute radiation disease.

Effects of new wound dressing bacterial cellulose impregnated with SOD and poviargol (Procel-Super and Procel-PA) and Inerpan hydrogel dressing on the reparative processes in deep dermal burns (IIIa-IIIb degree) in rats exposed to total even irradiation in a dose of 4 Gy were studied. Inerpan and Procel-Super dressings proved to be the most effective under these conditions: they accelerated healing of burn wounds by 17.0 and 5.5%, respectively.