Complex biostimulation of intrapleural adhesiogenesis in thoracal surgery

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Abstract

The aim of the study is to determine the effectiveness of the use of platelet enriched plasma in the complex treatment of chest trauma and chronic pleural empyema.

Materials and methods. The work was performed on 450 male rats, simulated with chest trauma (n=180) and chronic pleural empyema (n=270). In the experimental groups, biostimulation of adhesiogenesis as an intrapleural injection of 1 ml of platelet-enriched plasma was carried out; in the comparison group; the animals with pleural empyema were injected with 1 ml of doxycycline solution; in the negative control groups, the treatment was not carried out at all. Withdrawal from the experiment took place on the 10th, 20th, 30th days. The samples of intrapleural adhesions were fixed in 10% formalin, followed by histological tracing and preparation of micropreparations, staining with hematoxylin and eosin. The morphometric study included determination of the volume fraction (VF) of collagen and reticular fibers; fibrin; inflammatory cells; blood-stream (%).

Results. An intrapleural administration of platelet-rich plasma is an effective way to stabilize the rib cage in chest injuries, and to eliminate residual cavities in chronic pleural empyema. When assessing the severity of the adhesions in chest trauma, it was found out that adhesions are most often visualized at the sites of rib fractures (from 13.3 to 40%). In pleural empyema, during the entire process of observation, the VF of collagen fibers forming adhesions was higher in the group with biological stimulation of adhesiogenesis than in the NCpe group and in the CG. In the PRP group, already at the initial stages of the experiment, this indicator was significantly lower than in the NC and CG (p<0.05).

Conclusion. Based on the data obtained, the effectiveness of the use of platelet-enriched plasma in thoracic surgery for the biological potentiation of adhesiogenesis has been proved in experimental chest injuries and chronic pleural empyema.

About the authors

Anton V. Kalashnikov

Pyatigorsk Medical and Pharmaceutical Institute – a branch of Volgograd State Medical University

Author for correspondence.
Email: cos@pmedpharm.ru

Candidate of Sciences (Medicine), the Head of the Department of Surgical Disciplines

Russian Federation, 11, Kalinin ave., Pyatigorsk, 357532

Alexander A. Vorobiev

Volgograd State Medical University

Email: cos@volgmed.ru
ORCID iD: 0000-0001-8378-0505

Honored Scientist of the Russian Federation, Doctor of Sciences (Medicine), Professor, the Head of the Department of Operative Surgery and Topographic Anatomy

Russian Federation, 1, pl. Fallen Fighters, Volgograd, 400131

Svetlana A. Kalashnikova

Pyatigorsk Medical and Pharmaceutical Institute – a branch of Volgograd State Medical University

Email: kalashnikova-sa@yandex.ru
ORCID iD: 0000-0002-7688-9366

Doctor of Sciences (Medicine), Associate Professor, the Head of the Department of Morphology

Russian Federation, 11, Kalinin ave., Pyatigorsk, 357532

Dmitry Sh. Salimov

Central Military Clinical Hospital named after P.V. Mandryka

Email: salimow.dmitry@yandex.ru
ORCID iD: 0000-0001-8647-1505

Candidate of Sciences (Medicine), the Head of the 2-nd Surgical Department

Russian Federation, 8A, Bolshaya Olenya street, Moscow, 107076

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Supplementary files

Supplementary Files
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1. JATS XML
2. Figure 1 – The design of the experiment

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3. Figure 2 – Pleural cavity on the 10th day of experimental chest injury

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4. Figure 3 – Pleural cavity on day 20 of experimental chest injury

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5. Figure 4 – Pleural cavity on day 30 of experimental chest injury

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6. Figure 5 – Experimental chest injury on day 10

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7. Figure 6 – Experimental chest injury on day 20

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8. Figure 7 – Experimental chest injury on day 30

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9. Figure 8 – Pleural cavity of experimental pleural empyema in the comparison group on day 10

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10. Figure 9 – Pleural cavity of experimental pleural empyema on day 20

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11. Figure 10 – Pleural cavity on the 30th day of experimental pleural empyema

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12. Figure 11 – Formation of immature connective tissue in pleural empyema on day 10 of the experiment against the background of chronic pleural empyema in rats

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13. Figure 12 – Experimental pleural empyema on day 20 of the experiment

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14. Figure 13 – Experimental pleural empyema on day 30 of the experiment

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Copyright (c) 2020 Kalashnikov A.V., Vorobiev A.A., Kalashnikova S.A., Salimov D.S.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 

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