[The role of EGF-stimulated epidermis in the regulation of wound healing]. / Rol' EGF-stimulirovannogo épidermisa v reguliatsii zazhivleniia ran.

Sluggish wounds are characterized by impaired proportions of proinflammatory cytokines, deficiency of fibrogenic growth factors, imbalance in the system of matrix metalloproteinases and their inhibitors this preventing reparation. The study was made of biopsies obtained from patients with sluggish wounds before the treatment, 5, 10 and 15 days after transplantation on the wound of allogenic EGF-stimulated cryopreserved epidermis. The wound closure with biologically active coat was followed by the reduction of expression of proinflammatory cytokines and return to their normal correlations, higher production of fibrogenic growth factors, restoration of balance in the expression of MMP-9 and TIMP-1/TIMP-2.

[Morphological and immunohistochemical characteristics of repair processes in nonhealing wounds]. / Morfologicheskaia i immunogistokhimicheskaia kharakteristika reparativnykh protsessov v dlitel'no ne zazhivaiushchikh ranakh.

Sluggish wounds (SW) are characterized by chronic inflammation, abnormal proportion of extracellular matrix (ECM) components, appearance of ECM components that do not occur under normal conditions, this preventing formation of basal membrane (BM) and reepithelization of the wound. 89 biopsies from 25 patients with SW were studied before treatment and in different intervals after transplantation of allogenic cryopreserved epithelium on the wound. Decreased collagen type III content and accumulation of tenastcin in combination with low number of myofibroblasts were observed in ECM before the transplantation. Normalization of quantitative and qualitative composition of ECM components, BM formation, wound reepithelization without scarring were noted after the transplantation; myofibroblast number remained very low. Wound healing without contraction and scarring is a distinctive feature of reparative process in SW when allogenic cryopreserved epidermis is used.

[Application of viable cryopreserved alloderm transplants in the treatment of wound defects of soft tissues]. / Ispol'zovanie zhiznesposobnykh kriokonservirovannykh allodermotransplantatov v lechenii ranevykh defektov miagkikh tkanei.

An original method is proposed for treatment of long-standing intractable wounds and trophic ulcers using viable cryopreserved allodermotransplants and a distant air-plasma treatment. The main source of the allodermotransplants is the cadaverous skin. It was shown that the cadaverous skin taken during 17 hours after the donor's death was viable. The maximum period for storage of the viable skin when the worked out preservative is used at the temperature regimen -18 degrees C is 10 days, and at -70 degrees C it can be as long as 45 days. The analysis performed included 101 patients with long-standing intractable wounds and trophic ulcers. In 51 of them the new worked out method was used. An analysis of clinical and histomorphological data has proved that the application of the viable cryopreserved allodermotransplants and distant air-plasma treatment favor the better course of reparative processes. By the end of the forth week the wounds were completely closed in 19.7% of patients, the wound areas were considerably less (more than by 50% of the initial size) in 43.1%, less reduction of the wound area (less than 50% of the initial size) in 27.4%, in 9.8% there was no effect. No negative results were noted. It should be noted that closure of the tissue defect can be achieved by stimulation of the physiological regeneration of the patient's tissues. This method of regeneration of the skin is effective in trophic ulcers, long-standing intractable wounds and is also recommended in case of deficit of donor resources or when the severe state of the patient does not allow active surgical treatment.