Email this article Cosmetic results of wound treatment using the living skin equivalent in open tibial fractures
- Authors: Giandzhaliev R.A.1, Abdrakhmanov R.R.1, Ivashkin A.N.1, Abakirov M.D.1, Akhpashev A.A.1,2
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Affiliations:
- Peoples’ Friendship University of Russia named after Patrice Lumumba
- Academy of Continuous Medical Education of Federal Scientific Clinical Center
- Issue: Vol 29, No 5 (2023)
- Pages: 374-382
- Section: Original Research Articles
- URL: https://journals.rcsi.science/0869-2106/article/view/232004
- DOI: https://doi.org/10.17816/medjrf562880
- ID: 232004
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Abstract
BACKGROUND: Soft tissue wound treatment in open tibial fractures requires complex clinical approach. New cellular methods of wound treatment must be compared with the gold standard split-thickness skin grafting.
AIM: To compare the esthetic results of wound management with the living skin equivalent and skin grafting.
MATERIAL AND METHODS: A comparative study included 108 patients with open tibial fractures and soft tissue defects who underwent staged surgical treatment. In group 1 (n=51), the living skin equivalent was used, which is a bioengineered three-layer construction containing keratinocytes, fibroblasts, and collagen matrix. In group 2 (n=57), standard split-thickness skin grafting was used for wound repair. The surgery duration, complete epithelialization period, hospital stay, Vancouver Scar Scale (VSS) after 3, 6, and 12 months, and self-reported esthetic results 1 year after surgery were compared.
RESULTS: Living skin equivalent procedures were performed significantly faster than skin grafting (18.2±4.8 min vs. 35.5±14.8 min, р <0.001), and wound healing took longer (25.5±6.3 days vs. 19.6±4.7 days, р=0.035). The overall VSS score was significantly lower at all follow-up visits in group 1 than in group 2 (6.23±0.81 points vs. 8.12±0.98 points after 3 months, р <0.001; 5.17±1.18 points vs. 6.76±1.31 points after 6 months, р <0.001; 4.54±1.07 points vs. 5.09±0.65 points after 12 months, р=0.038). Moreover, 74.5 and 68.4% of the patients were satisfied with the appearance of the limb after treatment with living skin equivalent and skin grafting, respectively (р=0.023).
CONCLUSION: The cosmetic results of wound treatment in open tibial fractures with living skin equivalents are significantly better than those of split-thickness skin grafting.
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##article.viewOnOriginalSite##About the authors
Ramin A. Giandzhaliev
Peoples’ Friendship University of Russia named after Patrice Lumumba
Author for correspondence.
Email: dr_ramin@mail.ru
ORCID iD: 0000-0003-1427-1365
SPIN-code: 5634-3140
candidate of the department
Russian Federation, 6 Miklukho-Maklaya street, 117198 MoscowRinat R. Abdrakhmanov
Peoples’ Friendship University of Russia named after Patrice Lumumba
Email: rinat.abdr@gmail.com
ORCID iD: 0009-0009-4752-3531
SPIN-code: 4606-6819
MD, Cand. Sci. (Med.)
Russian Federation, 6 Miklukho-Maklaya street, 117198 MoscowAleksandr N. Ivashkin
Peoples’ Friendship University of Russia named after Patrice Lumumba
Email: doctor-alik@yandex.ru
ORCID iD: 0000-0001-5266-2418
SPIN-code: 1968-9218
MD, Dr. Sci. (Med.)
Russian Federation, 6 Miklukho-Maklaya street, 117198 MoscowMedetbek D. Abakirov
Peoples’ Friendship University of Russia named after Patrice Lumumba
Email: medetbek@mail.ru
ORCID iD: 0000-0002-5842-5904
SPIN-code: 5099-0493
MD, Dr. Sci. (Med.)
Russian Federation, 6 Miklukho-Maklaya street, 117198 MoscowAleksandr A. Akhpashev
Peoples’ Friendship University of Russia named after Patrice Lumumba; Academy of Continuous Medical Education of Federal Scientific Clinical Center
Email: akhpashev@yandex.ru
ORCID iD: 0000-0002-2938-5173
SPIN-code: 9965-1828
MD, Cand. Sci. (Med.)
Russian Federation, 6 Miklukho-Maklaya street, 117198 Moscow; MoscowReferences
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