The experience of using “ChitoPran” wound coating for treating a patient with combined injury

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Abstract

Background. Resolution of problems related to burn injuries remains relevant and extremely complex in the modern medicine. Biological wound coatings are actively used in the treatment of patients with burn injury. Researchers at the Scientific Research Institute at the Ochapovsky Regional Clinical Hospital No. 1 have been using the biological wound coating “ChitoPran” since 2017. This coating creates a dry environment in the wound for borderline depth burns and after autoplasty, which contributes to the acceleration of epithelization. For deeper burns after necrectomy, the “ChitoPran” accelerates the growth of granulation tissues.

Clinical case. This article presents the clinical case of the successful treatment of a 17-year-old burn patient with a combined injury. The patient presented with a blunt abdominal injury on the background of a deep burn of the anterior abdominal wall. The patient underwent a median laparotomy on the first day and an early necrectomy with primary cutaneous autoplasty with the “ChitoPran” closing of the wounds on a day later.

Discussion. The use of the “ChitoPran” wound coating in combination with skin autoplasty for the early surgical treatment of burns contributes to the acceleration of epithelization of wounds in comparison with stage-based surgical treatment. This coating is hence comparable in terms of cellular epithelization with the use of fibroblasts.

Conclusions. Creating optimal conditions for epithelization in the wound can prevent the development of purulent complications (such as the failure of skin sutures of the anterior abdominal wall). The use of “ChitoPran” wound coating showed improved outcomes in the treatment of patients with burn injuries through accelerated restoration of the skin and reduced suppuration in the wound.

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About the authors

Sergey B. Bogdanov

Scientific Research Institute — Ochapovsky Regional Clinic Hospital of Krasnodar Region Public Health Ministry; Kuban State Medical University

Author for correspondence.
Email: bogdanovsb@mail.ru
ORCID iD: 0000-0001-9573-4776

MD, PhD, D.Sc., Head of the Burn Department; Professor of the Department of Orthopedics, Traumatology and VPH

Russian Federation, Krasnodar

Anton V. Karakulev

Scientific Research Institute — Ochapovsky Regional Clinic Hospital of Krasnodar Region Public Health Ministry; Kuban State Medical University

Email: karakulev797@gmail.com
ORCID iD: 0000-0002-5477-5755

MD, Orthopedic and Trauma Surgeon of the Burn Department; post-graduate student of the Department of Orthopedics, Traumatology and VPH

Russian Federation, Krasnodar

Irina V. Gilevich

Scientific Research Institute — Ochapovsky Regional Clinic Hospital of Krasnodar Region Public Health Ministry; Kuban State Medical University

Email: giliV@list.ru
ORCID iD: 0000-0002-9766-1811

Head of the Laboratory

Russian Federation, Krasnodar

Karina I. Melkonyan

Kuban State Medical University

Email: kimelkonian@gmail.com
ORCID iD: 0000-0003-2451-6813

MD, PhD, Head of the Central Research Center, Associate Professor of the Department of Fundamental and Clinical Biochemistry

Russian Federation, Krasnodar

Andrey V. Polyakov

Scientific Research Institute — Ochapovsky Regional Clinic Hospital of Krasnodar Region Public Health Ministry; Kuban State Medical University

Email: 350000@mail.ru
ORCID iD: 0000-0003-1065-1352

MD, PhD, Associate Professor; Assistant Professor of General surgery

Russian Federation, Krasnodar

Alexander S. Sotnichenko

Kuban State Medical University

Email: alex24.88@mail.ru
ORCID iD: 0000-0001-7322-0459

MD, PhD, Head of the Central Research Center, Laboratory of Basic Research in the Field of Regenerative Medicine, Assistant Professor of the Department of Pathological Anatomy

Russian Federation, Krasnodar

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Supplementary files

Supplementary Files
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2. Fig. 1. Blunt abdominal trauma and burns on day 2 after combined injury due to a road traffic accident

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3. Fig. 2. Tangential surgical debridement up to 18% of the body surface (performed by a necrotome close to the laparotomy sutures)

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4. Fig. 3. After primary autografting with 1:4 perforation

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5. Fig. 4. Autografting sites covered with “ChitoPran”

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6. Fig. 5. Wound after 1 week of epithelialization under “ChitoPran”

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7. Fig. 6. Epithelized wound after 2.5 weeks

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Copyright (c) 2020 Bogdanov S.B., Karakulev A.V., Gilevich I.V., Melkonyan K.I., Polyakov A.V., Sotnichenko A.S.

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