The analysis of domestic and foreign literature sources showed that the problem of diagnosing and treating electrical injuries remained relevant as in the early 20th century. Over the past century, the mechanisms of the effects of electric current on organs and tissues have been well studied. However, the search for methods for diagnosing the volume of tissue damage has not been completed, and such methods are necessary, since they are designed to help determine the volume of surgical intervention. Many patients still require repeated surgical interventions to completely excise necrotic tissue. In most patients with severe electrical trauma, reconstructive surgery takes place in several stages. Today, most clinical data and practical recommendations are based on the opinions of individual experts and limited clinical studies.Authors declare lack of the conflicts of interests.

Этиология и патогенез ожоговой анемии. Роль гемотрансфузии в лечении обожженных

Introduction. The search for methods to reduce the time of treatment of burns and wounds of the donor sites currently remains relevant.Aim. Objective of this retrospective study was to evaluate the effectiveness of local treatment of II–IIIA degree burns and donor site wounds with dressings based on allogeneic type I collagen.Material and methods. The study included 434 patients hospitalized in 2018–2021. Collagen dressings were used in 280 patients (234 with II–IIIA degree burns and 46 with donor site wounds); 154 patients of the comparison group received traditional treatment in accordance with the standards of care for burns. Patients did not differ statistically significantly in age and the area of burns (general, superficial, deep). Lyophilized, sterile dressings based on type I collagen (RC No. FSR 2009/06370 December 8, 2014) were manufactured in accordance with TU No. 9393-002-01967081-2008 by the Department for Tissue Preservation and Graft Manufacturing of our Institute. We compared the timing of wound epithelialization when using collagen dressings versus the conventional treatment, and the pain intensity in the donor sites as assessed by the visual analogue scale for pain.Results. The terms of complete epithelialization of II–IIIA degree burn wounds made 10 (7;12) days when collagenbased dressings were used, and 18 (14;20) days without collagen, the difference being statistically significant (p<0.001). Epithelialization of the donor site wounds took 9 (8;10) days with using collagen dressings, and 11 (10;12) days with conventional treatment (p<0.001). The visual analogue scale assessed pain intensity in the donor site wounds after collagen application was statistically significantly lower on days 1, 4, and 7 than in patients on conventional treatment (p<0.001, p<0.001, p=0.003, respectively).Conclusion. The use of dressings based on type I allogeneic collagen for the treatment of superficial burns and the donor sites reduces the time of re-epithelialization, decreases the pain intensity in the donor site wounds, which proves the greater efficacy of this treatment method.

SUMMARY The index used in Russia to predict mortality in patients with burns, the Frank index, needs to be revised because it has a low prognostic value.TARGET Modify the Frank index to increase its predictive value for mortality.MATERIAL AND METHODS A retrospective study included 307 patients with skin burns. We added the age of the patient to the Frank index (FI) formula and changed the score for inhalation trauma (IT). We compared the discriminatory power and predictive value of FI and the Revised Frank Index (RFI) using statistical analysis methods.RESULTS Adding the absolute number of years of the patient and 30 points for IT to the FI formula improved the discriminatory power and predictive value of RFI, which is calculated by the formula ∑ = S_{surface burns} (% b.s. ) + 3*S_{surface burns} (% b.s. ) + age (full years) + 30 (points for IT).CONCLUSION The predictive power of the revised Frank index is higher than the Frank index currently used. The threshold value of the revised Frank index, dividing the forecast into favorable and unfavorable, is score 130.

The article has analyzed the world experience and main trends in the preparation of cadaveric skin for use in the treatment of patients with wounds of various etiologies. The history of the question is described from the first attempts of transplantation of the native skin to the creation of specialized banks of allogenic decellularized tissue grafts. Presented are the modern approaches of donor material conservation, specifically, to the principle and topical question: whether the viability of the cells should be preserved in the graft, or it is more efficient to transplant the skin devoid of cellular elements. The advantages and disadvantages of lyophilized grafts have been described, namely the possibility of longterm storage, but loss of elasticity, after rehydration. The methods of cryoconservation of cutaneous allografts, their properties, and acceptable methods of sterilization have been discussed. A perspective technology of graft decellularization has been assessed and the methodologies of their manufacturing have briefly been presented.