[Peculiarities of changes in circulatory parameters of microcirculation in local freezing injury of the upper limbs].

The condition of the microcirculatory bed in frostbitten tissues has the decisive importance in the course of the injury. The objective of the work was to investigate the dynamics of the parameters of microcirculation in patients with an endured local frostbite injury of the upper extremities. Evaluated were oscillations of the bloodstream by means of laser Doppler flowmetry. The study was carried out in a total of sixty 18-to-45-year-old patients presenting with a degree II-IV local frostbite injury of the upper extremities at various periods of the injury. In the prereactive period, when there are no significant deviations of the blood-flow oscillation parameters, using the occlusion test makes it possible to reveal alterations in the condition of the microcirculatory bed. The early and late reactive periods of a localfrostbite injury of the upper limbs are characterized by an increase in the neurogenic and myogenic components of vascular tonicity, as well as the by-pass index, thus suggesting a vascular spasm and increased by-pass blood flow. Degree II-IV frostbites of the upper extremities in the early and late reactive periods of the injury are accompanied by decreased reactivity of the vascular wall in response to occlusion, decreased potential of the active mechanisms of regulation of vascular tonicity, and maintenance of an adequate tissue blood circulation, with a 1.5-2-fold decrease in the blood flow reserve. The revealed alterations in the parameters of microcirculation and regulation of vascular tonicity explain a lingering course of the wound process in frostbites. Using the method of laser Doppler flowmetry makes it possible to determine the condition of microcirculation and vascular tonicity, to evaluate efficiency of the methods of treatment, and to predict the course of frostbite.

[Cold injury as a cause of stable changes in microcirculation].

Using laser Doppler flowmetry comparative evaluation of microcirculatory condition and regulatory components of vascular tone in lower limbs was carried out in 40 patients with local cold injuries in late reactive period and 12 reconvalescents with trophic disturbances. Microcirculation index decreased in all patients while neurogenous and myogenous vascular tone increased. Peak oscillation amplitude decreased in the endothelial range. At the same time in reconvalescents changes in passive regulatory components of vascular tone increase and frequency of peak amplitude neurogenous variation decrease. Thus, cold impact results in stable changes of microcirculation and therefore in dysthrophic changes in affected tissues.

[Changes in components of the vascular tone and microcirculation indices in frostbites of lower extremities].

The state of the microcirculation bed was assessed by the method of laser Doppler flowmetry in 40 patients with frostbites of lower extremities of the II-IV stages. In the proximal zone segments there was less inflow of blood to the arterial bed, increased neurogenic and myogenic components of vascular tone, decreased nutritive and, in a less degree, shunt blood flow. In aggravation of the injury severity the changes in question become more pronounced.

[Effects of thymalin on blood coagulation and contents of proinflammatory and anti-inflammatory cytokines in patients with burns]. / Vliianie timalina na svertyvaemost' krovi i soderzhanie provospalitel'nykh i protivovospalitel'nykh tsitokinov u bol'nykh s ozhogovoi bolezn'iu.

The authors share their experiences with treatment of 32 patients with burns of the III-IV degrees using an immunomodulator Thymalin which promoted liquidation of the syndrome of disseminated intravascular coagulation, normalization of fibrinolysis, influenced the content of pro-inflammatory and anti-inflammatory cytokins. It allowed to shorten the terms of the first autodermoplasty at an average by 5 days and to make staying of burned patients at the hospital 11 days shorter.

[Use of thymalin in the complex treatment of frostbite]. / Primenenie timalina v kompleksnom lechenii otmorozhenii.

The use of thymalin in the complex therapy of 19 patients with frostbites was shown by the authors to promote the stimulation of cell immunity, decrease the intensity of intravascular blood coagulation, to increase fibrinolysis, to improve the development of reparative processes in the wound and outcomes of autoplasty. It also decreased the percentage of infectious complications.