Kremen V. Improvement of the dermatological method in reconstructive surgery of skin defects of various origins (Experimental and clinical study)

The presented work includes the result of experimental studies and treatment patients with tissue deformations. The experimental part of the work consisted of two independent experiments. The first experiment (Development of a model of dermatensia in guinea pigs) was carried out by simulating dermatensia in 19 mature guinea pigs. It was shown that the introduction of 25 ml of 0.9% NaCl solution on days 1 and 3 to 50 ml in an expander allows to obtain an innervated, blood supply, full-layer autoplastic material in the shortest possible time and therefore can be used to accelerate the production of additional plastic material. The second experiment involved studies of the physiological and morphological features of skin grafts, taken with regard to the direction of the Langer lines, which were subjected to stretching. The material for the study was skin flaps, seized within 5 hours at an autopsy, in men aged 40–60 years without severe cardiovascular pathology. It has been experimentally proven that the maximum tissue growth without damage and fragmentation of collagen fibers is observed when the skin-subcutaneous flaps are taken perpendicular to the Langer lines. Clinical studies were conducted in 102 patients who underwent dermatensia to eliminate skin defects of various origins. An algorithm was developed for dermatensia to obtain additional plastic material using ultrasound and infrared control of stretchable flaps. In the long term, in the main group, it was possible to reduce the number of complications by 4.1 times, which made it possible to significantly improve the results of treatment of such patients.