THE CONCEPT OF USING PLATELET AUTOMESO-CONCENTRATE IN THE COMPLEX REHABILITATION OF SERVICEMEN AFTER GUNSHOT WOUNDS WITH DEFECTS OF INTEGUMENTARY TISSUES

Aim. To identify the reparative processes mediation and improvement by growth factors from platelets automesoconcentrate (AMC) in the treatment of gunshot wounds. An additional aim was to perform a comparative analysis of the AMC-therapy efficacy with and without the wound defect area autodermatoplastic closure. Materials and methods. The clinical case of the wounded V., who was admitted for rehabilitation treatment following gunshot wounds to both hands from a gas cylinder explosion, is presented. As a result of the explosion, there were objectively observed residual skin wounds on both hands in the regenerative period. Dynamic monitoring was carried out in the form of photo-fixation of the results of treatment of wound defects of the palmar and back surfaces of the left and right hands. Results. A wounded person entered rehabilitation treatment with wound defects in the regeneration phase and foci of weak marginal epithelisation. The wounded received classical treatment (in the form of staged debridement) of 2 wounds of the left hand (without the AMC), 1 wound of the left hand was treated only with AMC, the thenar wound on the right hand was decided to be closed by the autodermatoplastic method according to Thirsch with the use of AMC. Complete epithelisation of all wound defects was achieved within 21 days. The use of AMС therapy made it possible to avoid rejection and necrosis of transplanted skin grafts, to achieve rapid epithelisation of wounds without the formation of a pathological scar at the edge of the wound defect, to restore skin sensitivity in the affected area, to achieve regression of interstitial edema and contractures in the phalanges of the fingers. Conclusions. AMC-therapy improves the results of treatment, allows to shorten significantly both treatment and rehabilitation duration, improves the quality of life by wound healing acceleration which is also an economically important when the need for further treatment, long-term dressings and work capacity restoration disappears. We consider the use of automesoconcentrate of platelets to be justified and expedient from a fundamental, scientific, clinical and economic point of view within the framework of our proved multimodal approach to the soft tissues’ gunshot defects reconstruction in the aspect of majority of military personnel suffering from gunshot wounds comprehensive recovery.