Here - EWMA 2013

ORAL PRESENTATIONS
176
Russian Speaking Symposium: Free Paper Session
Appropriate different WBP methods at chronic wounds discrepant
on ethyology and expressiveness of inflammation
Leonid Rubanov 1 , Yulia Yarets 2
1 Gomel City Hospital No1, The regional centre of thermal injury, wound,wounds infection
and reconstruc (Gomel, Belarus);
2 Gomel State Medical University (Gomel, Belarus).
Aim: To estimate the results of different WBP methods taking into consideration wound
origin and the sings of inflammatory reaction.
Methods: 63 patients with chronic wounds were involved in the study. The wounds of
the patients with inflammatory ulcers (IU) (n=15) have the most expressed symptoms of
local inflammation. The sings of inflammatory reaction at the patients with traumatic
ulcers (TU) (n=23) were the smallest. The symptoms of inflammation at venous trophic
ulcers (VTU) (n=25) were not also expressed but these wounds had problems with
venous circulation. Pre-procedural treatment protocol of all types of wounds included
conventional treatment or apparatus methods – ultrasound debridement (UD), topical
negative pressure (TNP) or their combination (UD+TNP).
Results: Clinical effectiveness of UD+TNP in IU and VTU treatment was higher than
during standard treatment and isolated using of UD or TNP. The duration of treatment
with UD+TNP was longer (up to 17 (14;20) vs. 7 (2;10) days, p=0.026), but complete
healing was hastened (up to 10 (8;10) vs. 15 (11,5;20) days, p=0.04). After UD+TNP
treatment all the patients had successful results in grafting, whereas graft failure was
revealed at 20% of patients after using other methods. The results of different methods
of treatment at the patients with TU didn’t differ.
Conclusion: Using for WBP UD+TNP at the patients with IU, VTU with expressed
clinical symptoms of local inflammation promotes hasty wound healing and improves the
result of surgical closure.
RUSSIAN SPEAKING SYMPOSIUM: FREE PAPER SESSION (POSTER)
177
Russian Speaking Symposium: Free Paper Session (Poster)
Chronic wounds and wounds bed preparation methods
– tests of laboratory support
Yuliya Yarets 1 , Leonid Rubanov 2 , Natallia Shauchenka 3
1 Gomel State Medical University (Gomel, Belarus);
2 Gomel Clinical City Hospital No1 (Gomel, Belarus);
3 Republic Centre of radiation medicine and human ecology (Gomel, Belarus).
Aim: To define the list of the pathogenicity proved laboratory tests suitable for the control
of the whole and local reaction of the organism within the chronic wound process.
Methods: The object of the study were the patients (n=40) with chronic wounds.
Laboratory examination included dynamic wound bacteriological and cytological tests,
estimation of the wound bacteria biofilm forming activity, evaluation of blood neutrophils
function and calculation of leukocytes indices.
Results: Dynamic bacteriological examination allows to establish the completeness of
WBP, to define the list of antibiotics. The terms of biofilm formation by the bacteria from
chronic wounds can be used for choosing the way of treatment during WBP prior to skin
grafting. Cytological tests can be used for evaluation the stage of wound healing,
validation the choice of treatment methods, confirmation of the wound readiness for
surgical closure and prognosis the result of the surgery. Laboratory tests of the
evaluation of blood neutrophils function (NBT-tests, NET-forming activity, phagocytosis of
S.aureus) are informative for the monitoring of chronic wound transition into acute
wound. Leukocytes indices can be used for the evaluation of the patients’ immune
reactivity with the sings of inflammation.
Conclusion: We deveeloped the program of complex laboratory support for the patients
with chronic wounds. It can be used for the estimation of the wounds condition, validation
and selection of the methods of treatment, monitoring of the WBP, definition of the wound
readiness for the surgical closure and prognosis of the result of the surgery.
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