EFFECT OF SILVER SULFATHIAZOLE ON THE HEALING OF SKIN WOUNDS FORMED DURING THE CUTTING OF EXTERNAL FIXATION APPARATUS NEEDLES

The study of the healing mechanisms of skin wounds resulting from damage to the skin by transosseous needles of external fixation devices in the treatment of osteoarticular pathology with the aim of further targeted correction of these processes is one of the urgent tasks of modern traumatology and orthopedics. The effect of silver sulfathiazole, recommended for the prevention of infectious complications, on the healing of this type of wound has not been studied previously. The aim of the study was to investigate the effect of silver sulfathiazole on the healing of skin wounds formed during the cutting of external fixation devices by pins. The experimental study was performed on 35 sexually mature male Wistar rats. Modeling of a skin wound formed during the cutting of external fixation devices by pins was carried out in sterile operating room conditions, under drug anesthesia of animals that underwent transosseous osteosynthesis of the femur using an original design of the external fixation device. By tractional movement of the proximal pin with a dosed stretching of the supports at a rate of 1 mm in 4 steps, tension and cutting of the skin were carried out for 10 days (the distraction period), then the device was in a static position for 15 days (the period of fixation of the limb in the device), after which the device was dismantled and observation was carried out for another 30 days. The animals were divided into 2 groups. In the control group, the simulated wound healed under natural healing conditions; in the experimental group, silver sulfathiazole applications were performed twice daily during the distraction period. Skin wounds were examined using light microscopy and morphometry after 10 days of distraction, 15 days of fixation, and 30 days after the apparatus was removed. The thickness of the epidermis, dermis, and the numerical density of the sebaceous glands and hair follicles were measured on digital images of histological preparations stained with hematoxylin and eosin. The volume density of elastic fibers was determined on preparations stained with orcein according to Tenzer-Unn. The obtained quantitative data were subjected to statistical analysis. The study showed that the formation of a skin wound with transosseous pins is accompanied by tissue tension. Healing of this type of wound occurs with a delay in epithelialization and an increase in the duration of the inflammatory phase. This affects the mechanisms of extracellular matrix synthesis and leads to the formation of scar tissue in the area of damage. The use of silver sulfathiazole applications promotes accelerated wound closure by epithelium, a reduction in the period of inflammation, normalization of elastin synthesis, and a decrease in cicatricial changes in the skin regenerate.