H. Zhurakovska, V. Malanchuk

Bogomolets National Medical University

Introduction. Scar formation in the area of traumatic skin damage is a heterogeneous process and is characterized by the presence of certain biomechanical (elasticity, tensile strength, tensile strength) and morphological (healing by primary tension, secondary tension, under a scab, complicated wounds) features that may not simply affect the dynamics wound healing, and to determine the result of the skin recovery as a biological barrier.In the experimental section of the work, an attempt was made to assess the strength of the wound connection in various ways using the dynamometry method. Dynamometry makes it possible to assess the impact of physical load on the object under study. In the case of skin regeneration research, this method allows to determine the force that should be applied to break the regenerate or the suture connection.

The aim of thе study. Assess the strength of the wound connection in various ways using the dynamometry method.

Materials and methods. In the course of the experiment, linear skin wounds were simulated in 48 animals, which were divided into 4 groups with different methods of closing surgical wounds. In group 1 (12 animals), the wounds were closed with knotted sutures, polyamide 4.0. In group 2 (12 animals), the wounds were closed by suturing with an intradermal suture, polyamide 4.0. In group 3 (12 animals), the wounds were closed by gluing the wound edges with Dermabond skin glue. In group 4 (12 animals), wounds were closed by welding soft tissues with a PATONMED EKVZ-300 electrocoagulator (Ukraine). On the 7th and 14th day, 6 animals from each studied group were removed from the experiment. When working with laboratory animals, we were guided by the Law of Ukraine “On the Protection of Animals from Cruelty Treatment” (No. 3447-IV dated 21.02.2006), Methodical recommendations on the use of animals in biomedical research (Stefanov O.V., 2002), in compliance with ethical standards Directive No. 2010/63/EU on the protection of animals used for scientific purposes.

Results. Based on statistical calculations of dynamometry results, it can be concluded that not all surgical techniques showed the same effect in the early stages of skin regeneration. Thus, the biomechanical characteristics of the skin regenerate after the nodal suture were the most homogeneous, but on the 14th day of wound healing, the biomechanical features of the junction of the edges of the skin and scar tissue reach a similar level. Biomechanical differences of the wound, which were detected on the 7th day, are almost leveled off. Differences between the comparison groups with different methods of wound healing on the 14th day were not found: group 1 vs group 2 P=0.59, group 1 vs group 3 P=1.59, group 1 vs group 4 P=1.05, group 2 vs group 3 P=1.0, group 2 vs group 4 P=0.46, group 3 vs group 4 P=0.54.

Conclusions. Areas of mechanical stress need better fixation, and therefore knotted seams should be used rationally in these areas. Whereas intradermal suture, glue and electric welding can be considered as the method of choice in areas of the skin with less mechanical and muscle stress.

References

1. Avetikov DS. Peculiarities of the structure and biomechanical properties of connective tissue structures of the head. Herald of Morphology. 2010;16(3):721-726. Available from: https://www.vnmu.edu.ua/downloads/journal/v_morf/visn_morf_2010-3.pdf. (Ukrainian)
2. Petrenko OV, Hryhorash NV. A modern view of the diagnosis and treatment of post-traumatic cicatricial deformities of the periorbital area. Archive of Ukrainian Ophthalmology. 2021;9(2):58-63 (Ukrainian)
3. Skrypnyk VM, Avetikov DS, Yeroshenko HA. Morpho-functional rationale for the prevention of postoperative pathological scars of the face and neck. The World of Medicine and Biology. 2012;4(35):96-98. Available from: https://womab.com.ua/ua/smb-2012-04/1730. (Ukrainian)
4. Alster TS, Tanzi Hypertrophic scars and keloids: etiology and management. Am J Clin Dermat. 2003;4:235-243.
5. Bloom BS, Goldberg DJ. Suture material in cosmetic cutaneous Surgery. J Cosmet Laser Ther. 2007;9:41-45.
6. Gabrielli F, Potenza C, Puddu P, Sera F, Masini C, Abeni D. Suture materials and other factors associated with tissuereactivity, infection, and wound dehiscence among plastic surgery outpatients. Plast Reconstr Surg. 2001;107:38-45.
7. Polykandriotis E, Daenicke J, Bolat A, Grüner J, Schubert DW, Horch RE. Individualized Wound Closure – Mechanical Properties of Suture Materials. J Pers Med. 2022;12(7):1041.
8. Rath AM, Chevrel JP. The healing of laparotomies: review of the literature. Hernia. 1998;2:145-149.
9. Roca J, Nogués M, Villalobos R, Mías MC, Comellas M, Gas C, Olsina JJ. Surgical Dynamometer to Simultaneously Measure the Tension Forces and the Distance between Wound Edges during the Closure of a Laparotomy. Sensors (Basel). 2018;18(1):189.
10. Zoltan Ya. Operatsyonnaia tekhnyka y uslovyia optymalnoho zazhyvlenyia ran. Hungary, Budapest: CicatrixOptima; Publishing House of the Academy of Sciences of Hungary; 1974. 219 p.