The thesis work focuses on theoretical generalization and new solution to the actual scientific task, which deals with establishing the role of mechanical damage to the skin in the exacerbation of hepatic metabolic, functional and structural impairments, aggravation of cytolysis, enhancement of endotoxemia and immune responses caused by skeletal trauma complicated by acute blood loss, and highlighting the efficacy of the PRP-therapy in the correction of identified impairments. The role of mechanical damage to the skin in the manifestations of systemic disorders, provoked by skeletal trauma complicated by acute blood loss, has been established in the thesis work. The dynamics of the abnormalities in indicators of the liver’s functional state, activities of the lipid peroxidation and liver antioxidant defense system, cytolysis processes, endogenous intoxication, immune responses as well as the hepatic morphological alterations under the influence of isolated mechanical damage to the skin, skeletal trauma complicated by acute blood loss and the combined trauma model has been fist-time indicated. For the first time, the efficacy of the PRP-therapy in the correction of identified impairments in the presence of combined trauma has been demonstrated. The infliction of mechanical damage to the skin, skeletal trauma complicated by acute blood loss and combined trauma results in the enhancement of lipid peroxidation processes in the liver, which is evidenced by an increased thiobarbituric acid reactive substances (TBARS) values and elevated content of diene conjugates as compared to the control. It has been first-time evidenced that mechanical damage to the skin in the background of skeletal trauma complicated by acute blood loss leads to more intense lipid peroxidation (LPO) in the liver, which is accompanied by statistically significant increased values of the studied parameters starting from the 14th day of the experiment. A substantial inhibition of enzymatic and non-enzymatic (glutathione) antioxidant defense mechanisms in the liver of rats is observed under trauma models. It has been evidenced that an additional infliction of mechanical damage to the skin in the presence of skeletal trauma complicated by blood loss contributes to a significant reduction in superoxide dismutase (SOD) activity after 3, 14 and 38 days of the experiment, decrease in pro-oxidant/antioxidant ratio value, catalase activity (CAT) and the level of reduced glutathione (GSH) starting from the 7th day of the experiment as well as a decline in glutathione peroxidase (GP) activity after 7, 21 and 28 days. It has been substantiated that the combined trauma model is accompanied by more pronounced cytolysis processes, enhanced endotoxemia, and augmentation of immune responses compared to the animals subjected to skeletal trauma complicated by acute blood loss. A significant increase in aspartateaminotransferase (AST) and alanine aminotransferase (ALT) activities starting from the 3rd day of the experiment, as well as accumulation of the middle molecular weight fractions in the blood after 7-14 days and elevated incidence of circulating immune complexes (CICs) within 3-21 days of the experiment in serum have been observed. It has been established that an additional infliction of mechanical damage to the skin in the background of skeletal trauma complicated by acute blood loss is followed by a significant exacerbation of hepatic functional and morphological impairments, which is manifested by a decrease in the content of total bile acids and the cholate-cholesterol ratio starting from the 7th day of the experiment as well as decrease in rate of bile and its studied constituents excretion starting from the 3rd day of the experiment as compared to the animals exposed to isolated traumas. Hepatic structural abnormalities are considerably aggravated under conditions of combined trauma compared to the animals subjected to skeletal trauma complicated by acute blood loss. The administration of the PRP-therapy injections to rats exposed to combined trauma results in an improvement in hepatic metabolic, functional and structural state of the liver as well as decrease in the intensity of cytolysis, endotoxemia and immune responses starting from the 14-21 days of the experiment.
