One of the modern methods for tissue regeneration optimization in the treatment of the wounds in the maxillo-facial region
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StatusThe thesis was presented on the 15 October, 2008Approved by NCAA on the 22 January, 2009 Abstract – 0.29 Mb / in romanianThesisCZU 617. 52-001. 4-08+615. 26
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Keywords
Wounds in the maxillo-facial region, tissue regeneration optimization, the vitamin B12, the folic acid, the collagen pellicle, the local d’arsonvalisation.Summary
The wound treatment is one of the oldest problems in surgery which is relevant in the present time. In medical practice were offered a lot of methods and measures. The manipulation of the regeneration processes in the treatment of the wound in the maxilla-facial region remains the relevant problem, special for wounds in face region, where the presence of the cicatrices have specific role (as the face can not be covered by nothing and the cicatrices presence give the aesthetic discomfort).
For the formation of the aesthetic cicatrix in the face area it is very important that every regeneration stage proceeds consecutively one by one without delay.
According to the literature data, the mechanism of the tissue regeneration is not completely studied, but we can suppose that in the regeneration bases is the correlation between monocyte and collagen. It is considered that more measures can improve reparatory process, but fast these facilities can lead the regenerative process to optimal level rather than speed it.
Taking into consideration these data we used some modern methods with the aim of optimization of the regeneration processes. For this we used the following treatment mechanism:
- It was stimulated the hematopoes and metabolism of connective tissue having used the vitamin B12 and folic acid;
- It was applied the collagen pellicle on the wound surface with the aim of monocytes accumulation in the wound and the moisture retention.
- It was used the local d`arsonvalisation in the face and cervix area with aim of irritation of the skin receptors and elevation of the vessels tonus.
There were studied wounds of the traumatic origin at 60 patients (59,4%) and surgical origin wounds at 41 patients (40,6%). From the traumatic origin wounds were studied incised wounds at 8 patients (7,9%), tear - contused wounds at 42 patients (41,6%), bite wounds at 10 patients (9,9%).
The studied patients were subdivided into 5 groups:
- 21 patient (control group), to which was used the classical method of wound treatment;
- 20 patients were treated by combined treatment offered by us with the aim of the protein synthesis and normal hematopoes improvement. The patients received the vitamin B12 and folic acid for moisture retention in the wound and monocytes accumulation. On the wound was applied the collagen pellicle with aim of skin receptors irritation and elevation of the vessels tonus was used the local d`arsonvalisation;
- 20 received from the offered methods vitamin B12 and folic acid;
- At 20 patients from the offered methods was used only collagen pellicle;
- At 20 patients from the offered methods was used only local d`arsonvalisation.
To all patients was used the methods of wound cicatrisation:
- the clinical blood analysis on the 3d day after trauma or surgical interference;
- impression smear from the wound on the 3d day after trauma;
- the photography of the wound on the all stages of the cicatrization.
The obtained data was subjected by the statistical analysis in accordance with the generally accepted methods of the biological investigation, according to the Fisher Student criteria and „THI” (χ²) criteria.
The comparative data of the cytogram displayed that regeneration stages proceed more active at the patients to which is used combined treatment in comparison with patients which receive the traditional treatment.
The usage of the collagen pellicle on the wound surface has the obvious advantages in front of the usual gauze bandage or in front of the wound which are subjected to exsiccation without any protective bandage.
The collagen pellicle does not adhere to the healing wound in contradictions from gauze bandage and do not traumatize the new matured tissue during its delete. It also has the function of “artificial crust” and restrains the moisture in the wound region, and if the exudation from the wound is raised it absorbs it and transforms in gel mass. It was also observed that it is.the wound margins and in the dried state restrain it.
The local d`arsonvalization is extra effective in the treatment of bite wounds, firearm wounds, tear contused wounds, where the terms of cicatrisation of the wound are a good deal worse than in surgical wounds. The d`arsonvalisation renders the bactericidal effect, normalize the vessels tonus, irritates the epithelia receptors, as a result eliminates the proper skin hormones, which stimulates the regeneration. The treatment method is very simple in usage and does not demands special instrumentation.
Oficial Reviewers
- Valentin Topalo
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova - Gogălniceanu Dan
dr. în med., profesor universitar, UMF „Gr.T. Popa”, Iaşi, România
Theses
Under consideration [2] :
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