FEATURES OF THE INFLAMMATORY RESPONSE IN PATIENTS WITH ACUTE AND LONG-LASTING NON-HEALING BURN WOUNDS

Аннотация

The problem of treating chronic wounds remains relevant, but the topic of research on the inflammatory process in patients with long-term non- healing burn wounds has not been sufficiently covered in the literature. The article is devoted to the study of the peculiarities of changes in the content of inflammatory markers in patients during the acute period of burn disease and with a duration of the wound process of more than 35 days. The conducted studies indicate the severity of inflammation, which persists despite the age of the process and undoubtedly has an effect on wound healing. Everyone has patients showed a significant increase in the level of C-reactive protein, and a1 - antitrypsin. When assessing the content of α - 2 macroglobulin (α -MG) and haptoglobin (GG), individual variability of these 2 indicators was established. In patients with long-term non-healing wounds, a greater frequency of a decrease in the concentration of α -MG and an increase in GH was 2 found compared with similar indicators in patients during the acute period of burn disease. The level of ceruloplasmin turned out to be a more stable indicator than other acute-phase proteins and exceeded the limits of Normal values are found in only one patient during the acute period of burn disease, as well as in one patient with long- term non-healing wounds. There was no correlation between changes in the concentrations of the studied acute-phase proteins, except for the found relationship between the level of GH and α -MG, which indicates compensatory rearrangements 2 leading to increased synthesis of GH neutralizing lysosomal enzymes against the background of reduced α -MG activity. Analysis of changes in the content of acute- 2 phase blood proteins (a -antitrypsin, α -MG, GG) can it can be important in assessing 1 2 Выпуск журнала №-18 Часть–7_ Январь –2025 156 MODERN EDUCATION AND DEVELOPMENT the severity of the course and prognosis of the disease, which will make it possible to outline tactics for regulating the inflammatory process and thereby increase the effectiveness of treatment of chronic wounds in burned patients. Keywords: burn wounds; C-reactive protein; α -antitrypsin; - 1 α2 macroglobulin; haptoglobin; ceruloplasmin Introduction. In response to severe thermal injury, infection, which can join and complicate the course of the underlying disease, physiological reactions develop in the body of the burned patient aimed at localizing the lesion and restoring impaired functions. The resulting inflammatory reaction is accompanied by changes in the immune system, intensification of catabolic reactions, increased energy consumption, and impaired microcirculation and blood coagulation [1-4]. The classic acute phase lasts for several days, but this The process can be prolonged if the damaging factors continue to act or if the control and regulation mechanisms are disrupted, as a result of which the acute phase response can be converted into a chronic phase of inflammation [5-8]. During the development of the inflammatory reaction, an increase in the content of acute phase proteins (OFBS), which occupy an important place in the system of immunoregulation and nonspecific resistance, is noted in the blood serum and damaged tissues. The dependence of the course of the wound process is known It depends on the level of acute-phase proteins with antiproteolytic activity [9-12]. On the one hand, a decrease in the activity of proteolytic enzymes of wound secretions slows down the cleansing of wounds from necrotic tissues, but on the other hand, a significant increase in proteolytic activity can contribute to deep tissue alteration with increased invasion of microorganisms. Such changes, depending on the course of the wound process, must be taken into account in the treatment of wounds using bandages containing immobilized enzyme preparations [13-14]. Among the victims of thermal trauma, there are patients with long-term wounds, the treatment of which is quite lengthy. The healing time of chronic burn wounds is influenced by many factors, including infection, inflammation, and microcirculation disorders [15-16]. The topic of studying the features of the Выпуск журнала №-18 Часть–7_ Январь –2025 157 MODERN EDUCATION AND DEVELOPMENT inflammatory process in this category of patients has not been sufficiently covered in the literature and needs further study. The purpose of this work is to study changes in inflammatory process reactants in patients with acute period of burn disease and with long-term non-healing burn wounds. Material and methods. 17 patients with a burn area of more than 20% of the body surface and a duration of the wound process of more than 35 days were examined (group 2). The comparison group (group 1) included 16 patients with a similar lesion area who were examined during the first 12 days after injury. The control group consisted of 20 practically healthy people. The groups were comparable in gender and age. The severity of