Reparative skin regeneration in case of thermal burn depending on the constitutional features

Abstract

Purpose: determination of morphological features of the course of regeneration of burn wounds depending on the type of Constitution. On the basis of the burn center of the regional children’s hospital in Voronezh, a study of the dynamics of healing of burn wounds was conducted, taking into account the somatotyping of patients according to the scheme of M. V. Chernorutsky (1949) in the modification of S. Yu. Zhukov (2005). Materials and methods: the study included 40 children of the children’s Department of thermal trauma aged 4 to 7 years, including 20 boys and 20 girls. The dynamics of reparative processes (the presence or absence of marginal epithelization, vascular reaction, signs of perifocal inflammation, the nature of the discharge, etc.) was determined macroscopically on bandages, and cytological examination of wound prints was also carried out using five typical characteristics of cytograms stained by May-Grunwald on the 5th and 14th days after the injury. Constitutional typing of children according to this scheme and its modification was based on determining the value of the Pinier index, followed by the allocation of three subgroups in each sex group: hypersthenics, normostenics and asthenics. Results: when somatotropine patients in each gender group we obtained the following data: among girls identified 50 % of hypersthenic type of Constitution, 40 % normosthenic, 10 % of the study noted asthenic type, and the average age in the group of girls was 5.2 years; among boys it was observed a smaller number of children with hypersthenic body type - 25 %, with normosthenic 60 % of patients and 15 % of asthenic type. The average age of boys was 5.8 years. At the macroscopic evaluation of the wounds at 5 days in groups of giperstenikov and normostenikov in comparison with asteniki both sexes was observed more pronounced symptoms of inflammation in the wound in the presence of seropurulent discharge, persistent perifocal inflammation, delay the beginning edge epithelialization. These observations were also confirmed cytologically, in smears prints from burn wounds, significant accumulations of neutrophil masses in various places of the drug were determined. At the same time, phagocytosis was incomplete and degenerative. Conclusion: the study reliably reflects the dependence of the course of the wound process and the timing of wound healing on the type of Constitution. For the first time, a feature of skin restoration in young patients with hypersthenic body type was revealed, which plays an important role in predicting the timing and methods of treatment.