Study of the dosing tissue distraction clinical efficacy in the soft tissue defects treatment of various etiologies in the lower extremities

Justification. The most methods of extensive skin and soft tissue defects are aimed at accelerating wound healing  and preventing infectious complications. To improve the effectiveness of such defects treatment, a method of dosed tissue distraction (MDTD) is used, consisting in the application of a continuously acting load to the area of healthy soft tissue in close proximity to the wound defect.Purpose. It performed the evaluation of the medico-social  effectiveness of the introduction into clinical practice of developed methods and devices for implementing MDTD in  the treatment of skin and soft tissue defects of the extremities.Methods. 407 patients were treated with wound defects of  the extremities, which were divided into two groups: the main group – 198 patients in whose treatment MDTD was applied using original methods and devices; comparison group – 209 patients, in whose treatment standard treatment methods were applied. Comparison of the long-term results of treatment according to the frequency of repeated operations, complications, indicators of quality of life, frequency of disability.Results. The use of MDTD is characterized by better performance compared with the use of standard approaches. There is a decrease in the frequency of performing reconstructive plastic surgery after inpatient treatment (9–10 times), remote complications by 2.6 times, a reduced value of the Vancouver scale (by 28.8%), quality of life indicators higher levels. The use of the proposed approach is characterized by a shorter duration of treatment (by 26.0%), duration of disability (1.4 times), cases of disability (2.2 times).Conclusion. The use of MDTD is characterized by high medical and social efficiency, allows to reduce the cost of treating extensive skin and soft tissue defects by reducing the length of hospitalization, the frequency of repeated rehabilitation and reconstructive operations, accelerated recovery of patients, improving the quality of life and reducing the incidence of disability

Effectiveness of Autologous Platelet-Rich Plasma and Stromal Vascular Fraction in Autologous Skin Grafting

Introduction: Despite the medical advances, burns remain a serious challenge and require new and promising treatment options, such as biomedical technologies with a high potential for burn wound treatment. However, high cost and complexity of biotechnologies limit their routine use, but autologous tissues, such as stromal vascular fraction (SVF) and autologous platelet-rich plasma (PRP), overcome these shortcomings.   Objective: To demonstrate a successful case of using a combination of adipose-derived SVF and autologous PRP during autologous skin grafting in a severely burned patient.   Material and methods: We present a successful case of 84-year-old Patient B. treated at Saint Petersburg I. I. Dzhanelidze Research Institute of Emergency Medicine in September-October 2022. He was diagnosed with a 11% (6%) / II-III degree flame burn of the head, neck, trunk, and upper extremities and first-degree inhalation injury. At the first stage, the general condition of the patient was stabilized, and he was prepared for surgery. At the second stage, on day 25 of treatment we performed skin grafting using split-thickness autografts with rare perforations and application of SVF and autologous PRP on a burn wound. We evaluated the treatment effectiveness using planimetry, cytology, and histology.   Results: We observed complete engraftment of the autograft with no lysis or rejection during the first dressing change on day 3 after surgery and complete skin restoration on day 11. Cytologic findings over time showed an active decrease in inflammatory cells and an increase in regenerative cells, indicating successful wound healing. Histology demonstrated formation of normal stratified squamous epithelium with areas of hyperkeratosis and young granulation tissue in the superficial layers of the dermis on day 6.   Conclusions: Our case demonstrated that the combination of SVF and autologous PRP facilitates split-thickness skin autograft engraftment

Two-phonon coupling to the antiferromagnetic phase transition in multiferroic BiFeO3

A prominent band centered at around 1000-1300 cm-1 and associated with resonant enhancement of two-phonon Raman scattering is reported in multiferroic BiFeO3 thin films and single crystals. A strong anomaly in this band occurs at the antiferromagnetic Neel temperature. This band is composed of three peaks, assigned to 2A4, 2E8, and 2E9 Raman modes. While all three peaks were found to be sensitive to the antiferromagnetic phase transition, the 2E8 mode, in particular, nearly disappears at TN on heating, indicating a strong spin-two phonon coupling in BiFeO3.Comment: 12 pages with figure

Spin-order-induced multiferroicity in LiCuFe2(VO4)3 and disorder effects in NaCuFe2(VO4)3

Mixed spin chain compounds, ACuFe2(VO4)3 (A= Li,Na), reach magnetically ordered state at TN ~ 11 K (Li) or ~ 9 K (Na) and experience further transformation of magnetic order at T* ~ 7 K (Li) or ~ 5 K (Na), evidenced in magnetic susceptibility chi and specific heat Cp measurements. While no anomaly has been detected in dielectric property of NaCuFe2(VO4)3, the step-like feature precedes a sharp peak in permittivity epsilon at TN in LiCuFe2(VO4)3. These data suggest the spin-order-induced ferroelectricity in Li compound and no such thing in Na compound. On the contrary, the Moessbauer spectroscopy study suggests similarly wide distribution of hyperfine field in between T* and TN for both the compounds. The first principles calculations also provide similar values for magnetic exchange interaction parameters in both compounds. These observations lead us to conclude on the crucial role of alkali metals mobility within the channels of the crystal structure needed to be considered in explaining the improper multiferroicity in one compound and its absence in other.Comment: 9 pages, 5 figure

Femtosecond control of electric currents at the interfaces of metallic ferromagnetic heterostructures

The idea to utilize not only the charge but also the spin of electrons in the operation of electronic devices has led to the development of spintronics, causing a revolution in how information is stored and processed. A novel advancement would be to develop ultrafast spintronics using femtosecond laser pulses. Employing terahertz (10$^{12}$ Hz) emission spectroscopy, we demonstrate optical generation of spin-polarized electric currents at the interfaces of metallic ferromagnetic heterostructures at the femtosecond timescale. The direction of the photocurrent is controlled by the helicity of the circularly polarized light. These results open up new opportunities for realizing spintronics in the unprecedented terahertz regime and provide new insights in all-optical control of magnetism.Comment: 3 figures and 2 tables in the main tex

Прогноз результата кожной пластики по параметрам микроциркуляции в ожоговой ране

BACKGROUND Irregularity and mosaicity in the depth of the burn skin lesion limits the possibility of performing precision tangential necrectomy in the early stages after injury. Non-radical necrectomy leads to lysis of transplanted autodermal grafts. This problem is most relevant in the treatment of victims with extensive dermal and deep burns.AIM OF STUDY To study the relationship between microcirculation parameters in the burn wound and the outcomes of autodermal transplantation after tangential necrectomy.MATERIAL AND METHODS 74 patients with extensive skin burns included in the study underwent tangential necrectomy with simultaneous autodermal transplantation. All operations were performed early (up to 10 days) after injury before the formation of the demarcation line. Microcirculation parameters in the burn wound were studied by laser Doppler flowmetry before and after tangential necrectomy and in healthy skin of the same anatomical region.RESULTS Statistically significant differences (p≤0.001) were found between microcirculation parameters in the center of the burn wound after tangential necrectomy and in the control area of intact skin. In this case, the results of autodermal transplantation were characterized by a skin engraftment rate of up to 60–70%. In those areas of the body where there were no differences between microcirculation parameters , the engraftment exceeded 80%.CONCLUSION Assessment of microcirculation by laser Doppler flowmetry can be a reliable method for diagnosing the condition and viability of a burn wound after tangential excision of dead tissues in the early stages of treatment — before the formation of a demarcation line. The diagnostic technique is easy to use, but requires skills in working with a flowmeter, unification of such devices and methods for their use in the practice of surgical treatment of burns.Актуальность Неравномерность и мозаичность по глубине ожогового поражения кожи ограничивает возможности выполнения прецизионной тангенциальной некрэктомии в ранние сроки после травмы. Нерадикальная некрэктомия приводит к лизису пересаженных аутодермотрансплантатов. Наиболее актуальна данная проблема в лечении пострадавших с обширными дермальными и глубокими ожогами.Цель Изучить зависимость между параметрами микроциркуляции в ожоговой ране и результатами аутодермотрансплантации после выполнения тангенциальной некрэктомии.Материал и методы Хирургическое лечение 74 пациентов с обширными ожогами кожи, включенных в исследование, осуществляли путем тангенциальной некрэктомии с одновременной аутодермотрансплантацией. Все операции выполняли в ранние сроки (до 10 суток) после травмы до формирования линии демаркации. Параметры микроциркуляции в ожоговой ране изучали методом лазерной допплеровской флоуметрии до и после тангенциальной некрэктомии и в здоровой коже той же анатомической области.Результаты Выявлены статистически значимые различия (при p≤0,001) между параметрами микроциркуляции непосредственно в ожоговой ране после выполнения тангенциальной некрэктомии и на контрольном участке неповрежденной кожи. В этом случае результаты аутодермотрансплантации характеризовались частотой приживления кожи до 60–70%. В тех областях тела, где различий между показателями микроциркуляции не было, результаты приживления превысили 80%.Выводы Оценка микроциркуляции методом лазерной допплеровской флоуметрии может явиться достоверным методом диагностики состояния и жизнеспособности ожоговой раны после тангенциального иссечения погибших тканей в ранние сроки лечения – до формирования демаркационной линии. Методика диагностики проста в применении, однако требует навыков работы с флуометром, унификации таких приборов и методик их использования в практике хирургического лечения ожогов