POSSIBILITIES OF IMMUNOLOGY STUDIES IN ESTIMATION OF VALIDITY OF BURN WOUNDS FOR SKIN PLASTICITY

Abstract

Immunological features of burn disease largely reflect the state of general and local changes caused by the action of thermal factors. They are fundamental in formation of physiological repair of damaged tissue and disorders of the local immune system, lead to disruption of protective mechanisms with increased risk of occurrence and progression of local and systemic complications. It is the period of burn shock that is one of the main ones in the course and consequences of burn disease. In patients, the burn septicemia period even starting from the third day is characterized by severe immune changes, frequent generalization of inflammation and infection. Since one of the main tasks in treatment of patients with thermal trauma is the earliest possible recovery of lost skin, which consists in early surgical treatment (excision of necrotized tissues followed by simultaneous or delayed autodermoplasty), it is necessary to take into account metabolic disorders and changes in immune reactivity, affecting reparation of damaged tissues. To study the main immunological parameters in treatment of skin burn defects and their impact on the results of skin grafting, 17 patients with deep burns were examined. The main indices of metabolic status and immune reactivity in t surgical treatment of skin lesions, namely, innate immunity, humoral and cell components of immunity, metabolism (phagocytic activity of neutrophils, oxygen−dependent metabolism of neutrophils, concentration of peptides) differentiation clusters CD22 +, CD25 +, HLA−DR +) were examined. It is established that the corresponding changes in the indices can be the markers to predict the results of skin grafting. In this research it was found that with an unfavorable result of autodermoplasty in the patients with deep burns significant changes in immune reactivity and metabolic disorders were revealed. Altered immune reactivity due to increased circulating immune complexes and medium molecular weight peptides that provide opsonization and elimination of cytotoxic antigens in patients with deep burns may affect the results of skin grafting in surgical treatment of skin defects. Key words: burns, immune reactivity, dermatoplasty, metabolic state, autological skin transplantation.