Possibilities of using innovative technologies for treating a victim with thermal injury (case report)

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

BACKGROUND: Victims with severe burn injuries require specialized and high-tech care. The treatment results of such patients, as a rule, depend on the timing of the transfer and the volume of surgical treatment aimed at removing necrotic tissues and restoring the skin in conditions of a shortage of donor resources. In this regard, the development and implementation into clinical practice of innovative techniques for the temporary closure of burn wounds with synthetic coatings and the creation of optimal conditions in the wound for engraftment of skin grafts with a high perforation index.

СLINICAL CASE: This paper demonstrates a clinical case of successfully treating a child with a critical area of deep burn injury by flame (“carriage trauma”) using early surgical treatment, innovative wound dressings, and cellular technologies.

DISCUSSION: We consider the transfer to a specialized department of a multidisciplinary hospital essential in successfully treating a patient with a large burn area. Under burn center conditions, surgical treatment was performed to remove the necrotic tissues in the largest part of the deep lesion before inflammatory reactions developed. Subsequently, active surgical techniques were used to prepare the wounds for delayed plastic closure. The use of wound dressings and the introduction of cell technologies into clinical practice ensured successful patient treatment due to the early adaptation of skin autografts and risk minimization of their regression, and acceleration of epithelialization in the cells.

CONCLUSIONS: The early transfer of a severely burned child to a specialized burn center, active surgical techniques, the use of innovative wound dressings and cellular technologies in the treatment of a patient with a critical area of deep burn lesions made it possible to save a life, successfully restore damaged skin, and create optimal conditions for starting early rehabilitation measures.

Full Text

Restricted Access

About the authors

Sergey B. Bogdanov

Scientific Research Institution — S.V. Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University

Author for correspondence.
Email: bogdanovsb@mail.ru
ORCID iD: 0000-0001-9573-4776
SPIN-code: 2465-5462
Scopus Author ID: 57202018252

MD, PhD, Dr. Sci. (Med.)

Russian Federation, Krasnodar; Krasnodar

Anton V. Karakulev

Scientific Research Institution — S.V. Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University

Email: karakulev797@gmail.com
ORCID iD: 0000-0002-5477-5755
SPIN-code: 9687-7717

MD, PhD student

Russian Federation, Krasnodar; Krasnodar

Andrey V. Polyakov

Scientific Research Institution — S.V. Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University

Email: 350000@mail.ru
ORCID iD: 0000-0003-1065-1352
SPIN-code: 5317-8105

MD, PhD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Krasnodar; Krasnodar

Irina V. Gilevich

Scientific Research Institution — S.V. Ochapovsky Regional Clinical Hospital No. 1; Kuban State Medical University

Email: giliv@mail.ru
ORCID iD: 0000-0002-9766-1811
SPIN-code: 3911-1488
Scopus Author ID: 55614951400

MD, PhD, Cand. Sci. (Med.)

Russian Federation, Krasnodar; Krasnodar

Anatoly A. Petrov

Scientific Research Institution — S.V. Ochapovsky Regional Clinical Hospital No. 1

Email: napetrovaa@gmail.com
ORCID iD: 0000-0002-1234-3399

MD, Surgeon

Russian Federation, Krasnodar

Yuriy V. Ivaschenko

Scientific Research Institution — S.V. Ochapovsky Regional Clinical Hospital No. 1

Email: yvi85@bk.ru
ORCID iD: 0000-0001-8242-2626

MD, Orthopedic and trauma surgeon

Russian Federation, Krasnodar

Alesya M. Karakuleva

City Polyclinic Number 12 of the City of Krasnodar

Email: nazarenkova93@mail.ru
ORCID iD: 0000-0002-2258-206X

MD, Pediatrician

Russian Federation, Krasnodar

Natalia A. Filipchenko

Scientific Research Institution — S.V. Ochapovsky Regional Clinical Hospital No. 1

Email: ozhogovycentr@mail.ru
ORCID iD: 0000-0002-0272-4606

MD, Pediatrician

Russian Federation, Krasnodar

Elena A. Titarenko

Scientific Research Institution — S.V. Ochapovsky Regional Clinical Hospital No. 1

Email: evenasoroka77@gmail.com
ORCID iD: 0000-0003-1425-1698

MD, Pediatrician

Russian Federation, Krasnodar

References

  1. Griban PA, Sotnichenko SA, Terekhov SM, et al. Evacuation of heavily burned cases as a stage of active tactics of rendering specialized combustiological aid. Experience of the Federal State Budget Healthcare Institution “The Far Eastern Regional Medical Center” of the Federal Medical and Biological Agency of Russia. Extreme Medicine. 2018;20(2):31–37. (In Russ.)
  2. Unizhayeva AYu, Martynchik SA. Medical economic evaluation of hospital costs linked to quality of inpatient care for burning injury. Social aspects of population health. 2012;28(6). (In Russ.). [cited 2022 March 3]. Available from: http://vestnik.mednet.ru/content/view/447/30
  3. Sacharov SP, Ivanov VV, Zoroastrov OM, Zoroastrov MO. Analysis of lethal outcomes in children with burn dieases. Journal of Experimental and Clinical Surgery. 2010;3(3):256–259. (In Russ.). doi: 10.18499/2070-478X-2010-3-3-256-259
  4. Bagin VA, Rudnov VA, Savitsky AA, et al. Risk factors and prognosis for sepsis in patients with burn injury. Vestnik anesteziologii i reanimatologii. 2013;10(5):21–26. (In Russ.)
  5. Zhylinski EV, Chasnoits AC, Alekseev SA, Doroshenko GV. Analisys of lethality, main prognostic factors and complications in burn patients. Meditsinskie novosti. 2014;11:87–91. (In Russ.)
  6. Sakharov SP, Axelrov MA, Frolova OI. Analysis of microorganism types composition in children with thermal injury. Medical Almanac. 2019;61(5–6):94–97. (In Russ.)
  7. Shakirov BM, Aminov UH, Hakimov EA, et al. Letal’nost’ pri ozhogovoj bolezni i puti eyo snizheniya. Vestnik ekstrennoj mediciny. 2013;3:180–181. (In Russ.)
  8. Baindurashvili AG, Kolbin AS, Brazol MA, Aristov AM. The effect of features of surgical treatment of children with the extensive thermal injuries on the frequency of invasive candidosis. Travmatologiya i ortopediya Rossii. 2009;52(2):76–80. (In Russ.)
  9. Lekmanov AU, Azovskiy DK, Pilyutik SF. Survival analysis in the children with severe thermal injury transferred to the hospital within the first 72 hours after the injury. Vestnik anesteziologii i reanimatologii. 2018;15(5):30–38. (In Russ.). doi: 10.21292/2078-5658-2018-15-5-30-38
  10. Gardien KL, Middelkoop E, Ulrich MM. Progress towards cell-based burn wound treatments. Regenerative Medicine. 2014;9(2):201–218. doi: 10.2217/rme.13.97
  11. Bogdanov SB, Babichev RG, Marchenko DN, et al. Plastic full thickness skingrafts wounds of various etiologies. Innovacionnaya medicina Kubani. 2016;1:30–37. (In Russ.)
  12. Bogdanov SB. Vidy kozhnyh autoplastik. Atlas. Krasnodar; 2018.
  13. Patent RUS No. 2618166 / 2017 May 2. Bul. No. 13. Bogdanov SB, Babichev RG. Sposob zabora kozhnogo autotransplantata. Izobreteniya. (In Russ.). [cited 2022 March 3]. Available from: https://www1.fips.ru/ofpstorage/Doc/IZPM/RUNWC1/000/000/002/618/166/%D0%98%D0%97-02618166-00001/document.pdf
  14. Brusselaers N, Pirayesh A, Hoeksema H, et al. Skin replacement in burn wounds. J Trauma. 2010;68(2):490–501. doi: 10.1097/TA.0b013e3181c9c074
  15. Groeber F, Holeiter M, Hampel M. et al. Skin tissue engineering – in vivo and in vitro applications. Adv Drug Deliv Rev. 2011;63(4):352–366.
  16. Patent RUS No. 2295924C1 / 2005 Jul 21. Bul. No. 9. Bogdanov SB, Kurinny NA, Polyakov AV, Afaunova ON. Method of skin plasty after early necrectomy. Inventions. (In Russ.). [cited 2022 March 3]. Available from: https://www1.fips.ru/registers-doc-view/fips_servlet?DB=RUPAT&DocNumber=2295924&TypeFile=html
  17. Rasulov MF. Application of bone marrow mesenchimal stem cells and embryonal fibroblasts during burn wounds treatment. Pacific Medical Journal. 2004;(1):7–9. (In Russ.)
  18. Leclerc T, Thepenier C, Jault P, et al. Cell therapy of burns. Cell Prolif. 2011;44(Suppl 1):48–54. doi: 10.1111/j.1365-2184.2010.00727.x
  19. Dimitropoulos G, Jafari P, de Buys Roessingh A, et al. Burn patient care lost in good manufacturing practices? Ann Burns Fire Disasters. 2016;29(2):111–115.
  20. Panov AV, Shapovalov SG, Pleshkov AS, et al. Pervyj opyt primeneniya cellyulyarno-matrichnogo kompleksa (CMC Complex) v lechenii ozhogov. Sbornik nauchnyh trudov IV s”ezda kombustiologov. 2013. P. 110–111. (In Russ.). [cited 2022 March 3]. Available from: http://combustiolog.ru/wp-content/uploads/2013/07/Sbornik-4-s-ezda-kombustiologov-2013.pdf
  21. Emelyanova AM, Styazhkina SN, Shepeleva VM, Tugbaeva OG. Treatment of victims wih extensive burns: a severe clinical case. Medicine in Kyzbass. 2020;(2):52–56. (In Russ.). doi: 10.24411/2687-0053-2020-10018
  22. Award to the best doctors of Russia “Vocation” [Internet]. Nomination “Channel One Special Award”. Alexey Georgievich Baindurashvili, Alexander Leonidovich Egorov. 2008. (In Russ.). [cited 2022 March 3]. Available from: http://www.prizvanie.ru/luchshie-vrachi-rossii/laureaty/457

Supplementary files

Supplementary Files
Action
1. Fig. 1. Patient P., 9 years old: a — 3 months. after injury, the result of necrectomy with primary and delayed autoplasty; b — formation of a granulation wound on the back (3.5 months after injury)

Download (245KB)
2. Fig. 2. Delayed autodermoplasty: a — irrigation with a suspension in isotonic sodium chloride solution of autofibroblasts into cells after autoplasty with a perforation ratio of 1 : 6; b - the use of wound dressing "KhitoPran"

Download (272KB)
3. Fig. 3. Results of treatment: a — restored skin before discharge; b — view after 7 months. after injury

Download (172KB)
4. Fig. 1. Patient P. (9 years old): a, 3 months after injury, the result of necrectomy with primary and delayed autoplasty; b, formation of a granulation wound on the back (3.5 months after injury)

Download (245KB)
5. Fig. 2. Delayed autodermoplasty: a, irrigation with a suspension in isotonic sodium chloride solution of autofibroblasts into cells after autografting with a perforation ratio of 1:6; b, use of the wound dressing ChitoPran

Download (272KB)
6. Fig. 3. Treatment results: a, restored skin before discharge; b, appearance 7 months after the injury

Download (172KB)

Copyright (c) 2022 Bogdanov S.B., Karakulev A.V., Polyakov A.V., Gilevich I.V., Petrov A.A., Ivaschenko Y.V., Karakuleva A.M., Filipchenko N.A., Titarenko E.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС77-54261 от 24 мая 2013 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies