Kuchabskyi S. M., Hudyma A. A.

THE EFFECT OF SOFT TISSUE PLASTIC SURGERY PERFORMED DURING THE COURSE OF A COMBINED TRAUMA ON THE MANIFESTATIONS OF CYTOLYSIS, ENDOGENOUS INTOXICATION, AND INFLAMMATORY REACTIONS IN AN EXPERIMENTAL STUDY

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About the author:

Kuchabskyi S. M., Hudyma A. A.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

In the context of modern military conflicts, the proportion of mine and explosive injuries in the overall pattern of combat trauma has increased significantly. Due to the high kinetic energy of munitions, such injuries are often accompanied by combined trauma involving significant blood loss and massive soft tissue damage. One of the key therapeutic measures aimed at preventing complications is the timely plastic reconstruction of soft tissue defects. Up to now, the effect of soft tissue reconstruction (STR) performed at various time points following com- bined trauma on the systemic manifestations of traumatic disease remains insufficiently studied, which necessitated specialized research and became the aim of this work. The experiments involved 199 mature male Wistar line rats weighing 200–220 g. All experiments involving the infliction of trauma were performed under thiopental sodium anesthesia (40 mg‧kg-1). In the first series of experiments, STR was simulated separately by excising a 4 × 8 cm skin flap on a pedicle from the rat’s back. In experimental group 2, cranio-skeletal trauma (CST) was simulated by sequentially applying a measured force to the skull and the left thigh. In experimental group 3, rats with CST were additionally exposed to acute blood loss (combined trauma). The rats were euthanized 14 days after the post-traumatic period by total bloodletting from the heart. Blood serum was taken for the study, in which alanine aminotransferase activity, the content of medium-molecular-mass fractions of 238 and 280 nm, and C-reactive protein were determined. In the second series of experiments on rats with combined trauma, STR was performed 1, 3, 7, and 14 days after the post-traumatic period. The rats were taken out of the experiment in the same way 14 days after STR, which corresponded to 15, 17, 21, and 28 days from the time of combined injury modeling, and similar studies were conducted. It was found that simulation of only STR after 14 days of the experiment was accompanied by a significant increase in serum levels markers of cytolysis, endogenous intoxication, and inflammation. A similar result, but with a greater amplitude, was observed after modeling CST, and especially after CST complicated by acute blood loss. Thus, STR can be considered a serious injury to the body, accompanied by pronounced systemic responses to the damage. In cases of combined trauma, the peak increase in serum AlAT activity and the levels of MMM238, MMM280, and CRP occurred on the 14-th day of the post-traumatic period, followed by a gradual decrease by the 28-th day, which did not reach control levels. The additional performance of STR in the context of combined trauma, regardless of the timing of its administration, resulted in a statistically significant increase in the values of the studied parameters compared to the experimental groups in which only combined trauma was simulated. The most significant violations were observed following STR performed 1 day after simulating combined trauma, and the least significant – following STR performed 14 days into the post-traumatic period. Thus, STR performed in the context of combined trauma contributes to the intensification of systemic reactions in the body, which plays a leading role in the development of secondary damage to internal organs. The intensity of surgical intervention’s impact on soft tissues under these conditions depends on the timing of the procedure and is lowest when STR is performed 14 days after simulating the main injury, which identifies this timeframe as optimal for performing STR with minimal systemic disturbances.

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Publication of the article:

«Bulletin of problems biology and medicine», 2026 Issue 3, 182, 293-300 pages, index UDC 616.74-089.844:616-001.3-031.81:616-008.6/.9-097.3

DOI:

10.29254/2077-4214-2026-3-182-293-300