Peculiarities of the wound healing process in the acute period of burn disease depending on the antiseptic used

  • Vasyl Nahaichuk National Pirogov Memorial Medical University, Vinnytsia, Ukraine
  • Oleksandr Nazarchuk National Pirogov Memorial Medical University, Vinnytsia, Ukraine
  • Roman Chornopyshchuk National Pirogov Memorial Medical University, Vinnytsia, Ukraine
  • Pavlo Hormash Vinnytsia Regional Pathological and Anatomical Bureau, Vinnytsia, Ukraine
  • Yuliana Babina National Pirogov Memorial Medical University, Vinnytsia, Ukraine
Keywords: antiseptics, healing, infection, burns, wounds

Abstract

Background. Burn injury, as one of the most common types of trauma, requires a comprehensive approach to treatment, including surgical and conservative treatment with effective post-burn wound protection. One of the main obstacles to wound healing is purulent-infectious complications, for prevention of which antiseptics are widely used.

The aim is to study the microbiological, histological features of the wound healing course in the acute period of burn disease with the use of various antiseptics.

Materials and methods. In the research there were involved 44 patients with burns (burn area 10–20 % of the body surface), treated in the Clinical Center for Thermal Injury and Plastic Surgery of Communal Non-Commercial Enterprise “Vinnytsia Regional Clinical Hospital named after M. I. Pirogov” (2018–2019). Depending on the antiseptic therapy, these patients were divided into three observation groups. Patients in the 1st study group (n = 15; mean age 48.07 ± 12.05 years) were treated with 2.0 % povidone-iodine during dressing. In the 2nd group (n = 15; mean age – 48.53 ± 14.76 years) antiseptic based on 0.02 % decamethoxin was used. In patients of the comparison group (n = 14; mean age – 47.71 ± 12.39 years) a solution of 10.0 % NaCl was administrated for topical wound management. Microbiological assessment of the condition of the wound surface (on 3, 7, 14, 21 days) and histological examination of tissue samples from the bottom of the wound (on 3, 7, 14 days) were carried out by means of standard methods.

Results. Under the use of antiseptic agents based on 2.0 % povidone-iodine and 0.02 % decamethoxin during the treatment period in patients with burns up to 14 days, an effective reduction in the number of conditionally pathogenic microorganisms on the wound surface to lg (4.8 ± 0.4) and lg (3.06 ± 0.5) CFU/ml, respectively, was registered and it was significantly 1.5 times lower than that based on 10 % sodium chloride solution (p < 0.05). When applying decamethoxin for 14 days at the same time as the eradication of conditionally pathogenic microorganisms, moderate colonization of wounds was registered by representatives of normal skin microbiota (Corynebacterium spp., S. epidermidis). Histologically, there was found that with the use of 2.0 % povidone-iodine, the wound healing course was accompanied by a marked decrease in inflammation signs, as well as a pronounced inhibition of the formation of granulation tissue (10–14 days). The use of 0.02 % decamethoxin was accompanied by the formation of granulation tissue of sufficient maturity for atodermoplasty, in the presence of signs of inflammatory cellular reaction with the presence in the superficial parts of the bottom of the post-burn wounds of the fibrinoid layer, with signs of permanent formation of new hemocapillaries in it, surrounded by a thin argyrophilic mesh. When using a hypertonic sodium chloride solution before autodermoplasty, the granulation tissue had signs of uneven inflammatory cell infiltration. Signs of leukocyte-necrotic tissue changes, fibrinoid-leukocyte layers with fragments of tissue detritus, signs of resuscularization of granulation tissue were recorded.

Conclusion. Microbiological data strongly suggest the efficacy of 0.02 % decamethoxin and 2.0 % povidone-iodine in reducing microbial wound colonization infection compared to 10.0 % NaCl. The use of antiseptics and hypertonic sodium chloride solution in the acute period of burn disease provides a marked reduction in histological signs of inflammation in the wound with a noticeable positive effect of decamethoxin and 10.0 % NaCl on the formation of granulations and their revascularization compared with povidone-iodine (p < 0.001).

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References

Powar R, M. S, Prabhu M, Rajput D, Mallapur B. Epidemiological study of pediatric burns at a tertiary care centre in South India. International Journal of Community Medicine and Public Health [Internet]. Medip Academy; 2016;1242–6. Available from: https://doi.org/10.18203/2394-6040.ijcmph20161392

Brown M, Dalziel SR, Herd E, Johnson K, Wong She R, Shepherd M. A Randomized Controlled Study of Silver-Based Burns Dressing in a Pediatric Emergency Department. Journal of Burn Care & Research [Internet]. Oxford University Press (OUP); 2016;37(4):e340–e347. Available from: https://doi.org/10.1097/bcr.0000000000000273

Gee Kee EL, Kimble RM, Cuttle L, Khan A, Stockton KA. Randomized controlled trial of three burns dressings for partial thickness burns in children. Burns [Internet]. Elsevier BV; 2015 Aug;41(5):946–55. Available from: https://doi.org/10.1016/j.burns.2014.11.005

Madhusudhan V. Efficacy of 1% acetic acid in the treatment of chronic wounds infected withPseudomonas aeruginosa: prospective randomised controlled clinical trial. International Wound Journal [Internet]. Wiley; 2015 Apr 8;13(6):1129–36. Available from: https://doi.org/10.1111/iwj.12428

Liu J, Liao ZJ, Zhang Q. [Phase clinical trial for external use of recombinant human granulocyte-macrophage colony-stimulating factor gel in treating deep partial-thickness burn wounds]. Zhonghua Shao Shang Za Zhi. 2016 Sep 20;32(9):542-8. Available from: https://doi.org/10.3760/cma.j.issn.1009-2587.2016.09.007

Borovnikov AE, Alekseev AA, Lagvilava MG. Novye vozmozhnosti i effektivnost antimikrobnogo lecheniya ozhogovyh ran [New opportunities and effectiveness of antimicrobial treatment of burn wounds]. Sovremennye aspekty lecheniya termicheskoj travmy. 2011:23-5. [In Russian].

Alhodzhaev SS, Bikonurov NO, Dzhaksybaev, et al. Kompleksnoe lechenie ozhogovyh ran s primeneniem sovremennyh antiseptikov [Complex treatment burn wounds with the use of modern antiseptics]. Vestnik kazahskogo nacionalnogo medicinskogo universiteta. 2015;2:283-5. [In Russian].

Nazarchuk OA, Nagajchuk VI, Nazarchuk GG, et al. Mikrobiologichne ta gistologichne doslidzhennya efektivnosti zastosuvannya antiseptichnih zasobiv prolongovanoyi diyi v likuvanni ran paciyentiv z opikami [Microbiological and histological efficacy of retention of antiseptic concerns prolonged in patients]. Art of medicine. 2018;4:129-135. {In Ukrainian].

Nagajchuk VI, Himich SD, Zheliba MD et al. Sovremennye tehnologii lecheniya bolnyh s kriticheskimi i sverhkriticheskimi ozhogami [Modern technologies for the treatment of patients with critical and supercritical burns]. Doklady Vinnickogo nacionalnogo medicinskogo universiteta. 2017;21(2):428-433. [In Russian].

Nahaychuk VІ, Paliy HК, Nazarchuk ОА, et al. Effektivnost mestnogo primeneniya protivomikrobnyh preparatov s programmiruemym dostupom antiseptika iz rany u pacientov s ozhogovoj travmoj [The effectiveness of topical application of antimicrobial drugs with programmed access to wound antiseptics in patients with burn injury]. Klinicheskaia khirurgiia [Internet]. Liga-Inform, Ltd.; 2018 Mar 3;85(3):52–6. Available from: https://doi.org/10.26779/2522-1396.2018.03.52

Burkot VM. Biologichni vlastivosti zbudnikiv uskladnen u hvorih z opikami [Biological authorities zbudnikіv acceleration in ill people with optics]. Visnik problem biologiyi i medicini. 2016;2(3):210-213. [In Ukrainian].

Palij DV, Nazarchuk OA, Bereza BM. Protimikrobni, fiziko-himichni vlastivosti likarskih antiseptichnih preparative [Protimicrobial, physical and chemical power of the antiseptic drugs]. Annali Mechnikovskogo institutu. 2014;4:61-6. [In Ukrainian].

Gonchar OO, Nazarchuk OA, Palij DV, et al. Vivchennya antimikrobnih vlastivostej likarskih antiseptichnih preparativ, sho mistyat dekametoksin [Study of antimicrobial properties of antiseptic drugs containing decamethoxin]. Ukrainian Biopharmaceutical Journal. 2016;1:74-7. [In Ukrainian].

Norman G, Christie J, Liu Z, Westby MJ, Jefferies JM, Hudson T, et al. Antiseptics for burns. Cochrane Database of Systematic Reviews [Internet]. Wiley; 2017 Jul 12; Available from: https://doi.org/10.1002/14651858.cd011821.pub2

Verstraelen H, Verhelst R, Roelens K, Temmerman M. Antiseptics and disinfectants for the treatment of bacterial vaginosis: A systematic review. BMC Infectious Diseases [Internet]. Springer Nature; 2012 Jun 28;12(1). Available from: https://doi.org/10.1186/1471-2334-12-148

Mofazzal Jahromi MA, Sahandi Zangabad P, Moosavi Basri SM, Sahandi Zangabad K, Ghamarypour A, Aref AR, et al. Nanomedicine and advanced technologies for burns: Preventing infection and facilitating wound healing. Advanced Drug Delivery Reviews [Internet]. Elsevier BV; 2018 Jan;123:33–64. Available from: https://doi.org/10.1016/j.addr.2017.08.001

Peculiarities of the wound healing process in the acute period of burn disease depending on the antiseptic used
Published
2019-11-01
How to Cite
1.
Nahaichuk V, Nazarchuk O, Chornopyshchuk R, Hormash P, Babina Y. Peculiarities of the wound healing process in the acute period of burn disease depending on the antiseptic used. prmd [Internet]. 2019Nov.1 [cited 2020Jul.12];2(2):14-2. Available from: https://perioperative.org.ua/index.php/prtmdc/article/view/31
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Original article

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