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One of the modern methods for tissue regeneration optimization in the treatment of the wounds in the maxillo-facial region


Author: Rusu Natalia
Degree:doctor of medicine
Speciality: 14.00.21 - Stomatology
Year:2009
Scientific consultant: Dumitru Scerbatiuc
doctor habilitat, professor, State University of Medicine and Pharmacy "Nicolae Testemitanu"
Institution:
Scientific council:

Status

The thesis was presented on the 15 October, 2008
Approved by NCAA on the 22 January, 2009

Abstract

Adobe PDF document0.29 Mb / in romanian

Thesis

CZU 617. 52-001. 4-08+615. 26

Adobe PDF document 1.48 Mb / in romanian
120 pages


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:

There were studied 101 of patients with wounds in the maxilla-facial region, which had been under treatment in the republican center of the maxilla-facial surgery of the National Scientific and Practical Emergency Medical Centre of Republic of Moldova during the 2004-2007 years.

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:


To all patients was used the methods of wound cicatrisation:
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.