Biochemical method for determining the readiness of burn wounds for autodermoplasty

The choice of tactics for surgical treatment of burn injury mainly depends on the course of the injury process, the presence of inflammatory changes in the wound, the addition of pathogenic microbial flora, the state of the body's immune system and the presence of concomitant pathology. Determining the optimal and early terms for autodermoplasty is of particular importance in severely burned patients with a large deficit of donor resources. Therefore, the issues of determining the readiness of the burn injury surface for skin graft transplants remain relevant at present, and the search for solutions to this problem continues. The purpose of the study is to study injury discharge from the surface of burn injuries with the determination of biochemical indicators of total protein and fibrinogen and the level of bacterial contamination to develop a method for determining the readiness of burn injuries for autodermoplasty. Materials and methods. To achieve the stated objective, 70 samples of biochemical analyses of total protein and fibrinogen of injury discharge, as well as bacterial cultures with determination of the level of bacterial contamination of injuries, taken from 19 patients with deep burns of III (IIIb-IV) degree were studied. Autodermoplasty was planned for all patients during treatment. Injury discharge sampling was collected for studying the concentrations of biochemical markers and determining bacterial contamination the day before plastic surgery. Results and discussion. The analysis of the data revealed statistically significant high levels of total protein and a decrease in fibrinogen levels in wound discharge with a degree of contamination of burn injuries ≤ 103 CFU/g, than with higher levels of bacterial contamination of the injury. Based on the results obtained, a method was developed for determining the readiness of the burn injury surface for autodermoplasty. Conclusion. Determining the degree of readiness of burn injuries for plastic surgery, according to the proposed method, allows you to quickly obtain and analyze data on the state of the injury process and simultaneously determine the tactics of surgical treatment in burn patients. Key words: burn injury, autodermoplasty, fibrinogen, total protein