HYALURONIDASE OINTMENT IN TREATMENT OF HYPERTROPHIC SCARS.

We have studied efficiency of hyaluronidase ointment created on the base of microbial hyaluronidase preparation "Bilidase" in treatment of postoperative hypertrophic scars. A total number of 14 patients with postoperative hypertrophic scars on different part of face were enrolled in the study. All patients were treated with hyaluronidase ointment by help of iontophoresis for 10 days -1 procedure per day and than retreated 1 time with the same regimen at 4-week interval. Scar conditions were assessed in terms of pigmentation, vascularity, pliability, height, pain and pruritis in accordance with the Vancouver Scar Scale (VSS). The data of this investigation indicate that treatment of postoperative scars with hyaluronidase ointment significantly improves the function as well as a cosmetic appearance of scar tissues. Each of the investigated parameters was improved significantly after hyaluronidase treatment. Total score after 1 cycle of treatment was 5.14±0.9 vs 10±1.5 before treatment and after 2 cycles of treatment. total score was 0.85±0.9 vs 10±1.5 before treatment (p<0.001). Hyaluronidase ointment could also be recommended for preventing the scar formation in plastic surgery.

Histological and histochemical investigations of nasal septum cartilage in nasal deformations.

AIM of the study is to identify histological and histochemical peculiarities of nasal septum cartilage reconstruction in patient with different remoteness of trauma. MATERIALS AND METHODS: Patients of both sexes at the age of 16-39 years have been operated on. Depending on remoteness of the period from the trauma, witch caused the deformation, till the surgery, the materials was divided into 2 group: I group (36 patients) 1-5 years from the trauma to the surgery, II group (23 patient) 10-20 years from the trauma to the surgery. Bioptats of the nasal septum cartilage were fixed in Carnoy mixture. Paraffin sections were stained with hematoxilin and eozin, after Van Ghison on collagen fibrils, toluidine blue on acid glycoaminglicans (GAG) and Brashe reaction on RNA. STUDY RESULTS AND CONCLUSION: Thus, the histological and histochemical investigation of nasal septum cartilage, received in rhinoplasty, has revealed dystrophic changes in cartilage. Basing on the analysis of the material, we can conclude that the degree of expression of these changes depends on three factors: - localization of examined area of the nasal septum (bioptat); - the period of time the deformation exist; - the degree of septum curvature. The structure of cartilage bioptates in the patients with relatively short (1-5 years) duration of traumatic deformation differs from the normal hyaline cartilage by moderate dystrophic changes of some chondrocytes (20-25% of all the cells) in the central zone of the cartilage as well as by irregular distribution of acid GAG in cartilage matrix. Cartilage tissue dystrophic changes are still more pronounced in the patients with a longer period of nose deformation including nasal septum curvature. This fact indicates that these changes are connected with deformation duration rather than with etiology of the process. The analysis of material also enable to find the dependence of cartilage dystrophic changes on the degree of nasal septum deformation: at the 3rd degree of curvature, chondropathy is more pronounced than at the 1st-2nd degree.