Therapeutic Treatment of 2A Grade Burns with Decellularized Bovine Peritoneum as a Xenograft: Multicenter Randomized Clinical Trial.

Background and Objectives: Homogeneous and xenogenic bioengineering structures are actively used as wound coatings in treatment of burns and have already shown their effectiveness. Nevertheless, the disadvantage of such dressings is their high cost. This issue is particularly challenging for developing countries in which the incidence of burns is the highest one. With such needs taken into account, the research team developed and clinically tested a new wound coating based on decellularized bovine peritoneum (DBP). Materials and Methods: A multicenter randomized clinical trial was conducted to evaluate DBP. The following variables were considered in the research study: the number of inpatient days, the number of dressing changes, the level of pain experienced during dressing changes, and the condition of wounds at the time of the follow-up examination. Results: The research involved 68 participants. It was found that the patients who were treated with a DBP experienced less pain with less changes of dressings. However, the number of inpatient days and wound healing failed to demonstrate statistically significant difference compared to the control group. Conclusions: In the given research, DBP showed efficacy in improving patients' quality of life by reducing pain and the number of dressings' changes. However, when comparing this research study with the studies of other animal-derived wound coverings, there were a number of differences and limitations in the parameters. Thus, the results requires further study for a greater comparability of data. Given the above, we expect that DBP will become an inexpensive and effective treatment for burns in developing countries.

Successful Treatment Outcomes for Partial Thickness Burns by Innovative Bovine Peritoneum Dressing.

In the world practice of treating burns, acellular matrices have been used for quite a long time. However, the budget for treating one burn patient in Kazakhstan does not exceed $1000. This amount does not cover the costs for procurement of foreign-made xenograft dressings. Because the cattle breeding sector is very well-developed in the country, a domestic xenograft is produced by decellularization and sterilization of the cattle peritoneum, which costs only $10. This case report outlines how we used this matrix in a patient with partial thickness burns. A 45-year-old woman was admitted to the burn department with second stage burns on her back and right shoulder. The burn area comprised 10%, according to the Lund Browder chart. Once formal consent was obtained from the patient, an occlusive dressing was applied from the decellularized cattle peritoneum. Good adhesion of the dressing to the wound bed was noted. The patient was discharged from the hospital on the tenth day. It took 23 days to reach complete epithelialization. No adverse effects were noted. We believe that further studies conducted by our research team will allow this innovative, low-cost, easy-to-apply biologic dressing to be widely used in the therapeutic treatment of burns.

Composite Reparative Surgery of a Postoperative Through-and-through Facial Defect: Case Report.

We report our positive experience on the treatment of a patient with a composite facial maxillary defect. The stoma was formed following the removal of the adenoid cystic carcinoma of the maxillary sinus. We propose reconstruction repair of the postoperative facial maxillary defect using an inverted cutaneous flap and a split-thickness skin graft.

Transplantation of Cultivated Fibroblasts on a Backing of Xenogenic Tissue in the Treatment of Wounds.

INTRODUCTION: Trophic ulcers are a common health problem, and there are numerous treatment methods. Irreversible damage in the skin, subcutaneous tissue, and fascia with long-term ulcer existence make standard autotransplantation inneffective. Skin grafts are often complicated by partial or complete rejection of skin flaps. The aim of this study was to examine the feasibility of using transplanted cultivated allogenic fibroblasts on the backing of a cellularless xenogenic fabric for wound healing. METHODS: Transplantation of cultured embryonic fibroblasts on a backing of xenogenic tissue was used in the complex treatment of trophic ulcers for stimulation of regenerative processes. Decellularization xenogenic film was previously held. Then allogenic fibroblasts were cultivated on the surface of collagen-elastin matrix. Since 2013, we treated 12 patients with giant ulcers caused by the following: lymphedema (2 patients), vascular disease (3 patients), diabetes (2 patients), after injury (4 patients), and radiation ulcer (1 patient). Dimensions of ulcers were from 150 to 600 cm2. Duration of the lower limb ulcers ranged from 8 months to 10 years. For a number of years, all patients were on a complex therapy, which had not resulted in healing wounds. During the operation when excision of granulation tissue was performed, plastic wounds perforated with the ratio 1:2 autoskin. Xenogenic fabric with cultured fibroblasts was applied on top. In this case, xenogenic film protected the skin from drying, created optimal microclimate, and cultured fibroblasts stimulating regeneration and improving engraftment. RESULTS: The first redress was held on the fifth day. In all cases, the results of engraftment skin grafts achieved maximum possible (100%) and optimal (90%). Complete epithelialization of the cell perforation was seen in five patients on the fifth day and three on seventh day after skin plastics. Average period of inpatient treatment was 20.7 days. All patients were discharged with healed wounds. CONCLUSION: Thus, the treatment of trophic ulcers can be successfully solved using advances in biotechnology. Transplantation of cultivated allogenic fibroblasts on a backing of cellularless xenogenic fabric shows good clinical results due to the stimulation of regenerative processes and creates the optimum environment for autotransplants.