Novosti
Khirurgii
This journal is
indexed in Scopus









Year 2020 Vol. 28 No 3

SCIENTIFIC PUBLICATIONS
GENERAL & SPECIAL SURGE

DOI: https://dx.doi.org/10.18484/2305-0047.2020.3.249   |  

K.S. KOBELEV 1, D.D. DOLOTOVA 2, O.V. MIDLENKO 1, N.I. BELONOGOV 1, V.I. MIDLENKO 1

INVESTIGATION OF RISK FACTORS OF THE DERMAL BURN WOUND CONVERSION

Ulyanovsk State University 1 , Ulyanovsk,
"Gammamed-Soft", Ltd 2, Moscow,
The Russian Federation

Objective. The present study is focused on risk factors of burn wound conversion in the local treatment with DDBM (dressing, dressing, Breitman-Menzul) dressing material in comparison with routine treatment based on gauze bandages with iodophors.
Methods. During the research work, we used retrospective data of 281 patients with second-degree burn injuries. The group was divided into two: those who were treated with DDBM dressing (n=130), and those who were treated with gauze bandages with iodophors (n=151). Patients were included in this study if: 1) their age was over 18; 2) they had II degree burns without scab; 3) admission was not later than 3 days after trauma; 4) predominance of II degree burns in case of its combination with full-thickness skin burns (III degree). A predictive model of burn wound conversion was designed with logistic regression.
Results. The analysis showed that usage of DDBM dressing led to wound epithelialization on 15th [13; 17] day and to the reduction of burn conversion frequency by 28% in comparison with the treatment with gauze bandages with iodophors. Body mass index was found to be a highly significant predictor: risk of wound conversion tended to increase strongly for patients with body mass index over 29.5 kg/m2. A set of such variables as the location of burns on the back of the body and buttocks, body mass index, and treatment method allowed development of a binary regression model with high sensitivity and specificity (97.2% and 99.5%, respectively).
Conclusions. The study identified the advantages of local treatment with DDBM in comparison with iodophors gauze bandages. The developed predictive model allowed calculating the probability of burn wound conversion with high accuracy.

Keywords: burn wound conversion, dermal burns, moist wound healing, film dressing, predictive model
p. 249-257 of the original issue
References
  1. Bogdanov SB, Afaunova ON, Babichev RG. Topical application of wound dressings in early surgical treatment of burns on border course children. Medical Herald of the South of Russia. 2016;(3):27-30. doi: 10.21886/2219-8075-2016-3-27-30 (In Russ.)
  2. Singh V, Devgan L, Bhat S, Milner SM. The pathogenesis of burn wound conversion. Ann Plast Surg. 2007 Jul;59(1):109-15. doi: 10.1097/01.sap.0000252065.90759.e6
  3. Glutkin AV, Kovalchuk VI Termicheskii ozhog kozhi u detei rannego vozrasta (opyt eksperimenta i kliniki): monografiia. Grodno, RB: GrGMU, 2016. 180 p. http://elib.grsmu.by/handle/files/861 (In Russ.)
  4. Lehnhardt M, Hartmann B, Reichert B, eds. Verbrennungschirurgie. Springer-Verlag Berlin Heidelberg; 2016. 501 . doi: 10.1007/978-3-642-54444-6
  5. Voinovskii EA, Menzul VA, Rudenko TG, Iusupov IE, Voinovskii AE, Shekhter AB, Kovalev AS, Guller AE. Sistema lecheniia ozhogovykh ran v sobstvennoi zhidkoi srede: monogr. Moscow, RF: Na boevom postu; 2015. 272 p. https://docplayer.ru/37857979-Sistema-lecheniya-ozhogovyh-ran-v-sobstvennoy-zhidkoy-srede-monografiya.html (In Russ.)
  6. Obshcherossiiskaia obshchestvennaia organizatsiia Obedinenie kombustiologov Mir bez ozhogov Ozhogi termicheskie i khimicheskie. Ozhogi solnechnye. Ozhogi dykhatelnykh putei. Klinicheskie rekomendatsii [Elektronnyi resurs]. Moscow, RF; 2017 [data obrashcheniia: 2019 Mart 18]. 118 p. Available from: http://combustiolog.ru/wp-content/uploads/2013/07/Natsional-ny-e-klinicheskie-rekomendatsii-po-ozhogam-2017.pdf (In Russ.)
  7. Barret-Nerin J, Herndon DN. Principles and practice of burn surgery. N.Y.: Marcel Dekker; 2005. 412 p. https://pdfs.semanticscholar.org/0636/8b2aeedd6c2db6a5ffcfa12a55241d8a64d1.pdf
  8. Sokolov VA, Efimenko NA. Admakin AL, Petrachkov SA, Stepanchenko AA. Piecetime burns. Sources of danger. Klin. Med. 2015; 93 (6): 30-35. https://cyberleninka.ru/article/n/ozhogi-mirnogo-vremeni-istochniki-opasnosti (In Russ.)
  9. Aksoy N, Arli S, Yigit O. A retrospective analysis of the burn injury patients records in the emergency department, an epidemiologic study. Emerg (Tehran). 2014 Summer;2(3):115-20. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4614574/
  10. Zinoviev EV, Alov NV, Apchel AV, Vasilieva AG, Yakimov DK. Effectiveness of antiseptic solutions in treating dermal burns. Vestn Ros Voen-Med Akad. 2014;(4):173-81. https://www.vmeda.org/wp-content/uploads/2016/pdf/173-181.pdf (In Russ.)
  11. Arev TIa. Termicheskie porazheniia. Leningrad: Meditsina; 1966. 702 p. (In Russ.)
  12. Singer AJ, Towery H, McClain SA. Effect of tadalafil on reduction of necrosis in the ischemic zone in a rat comb burn model. Burns. 2018 Sep;44(6):1427-32. doi: 10.1016/j.burns.2018.05.013
  13. Widgerow AD, King K, Tocco-Tussardi I, Banyard DA, Chiang R, Awad A, Afzel H, Bhatnager S, Melkumyan S, Wirth G, Evans GR. The burn wound exudate-an under-utilized resource. Burns. 2015 Feb;41(1):11-17. doi: 10.1016/j.burns.2014.06.002
  14. Bagnenko SF, Krylov KM. The real means of burn depth diagnostics. Skoraia Med Pomoshch. 2000;1(4):28-33. https://www.elibrary.ru/item.asp?id=36151251 (In Russ.)
Address for correspondence:
432071, Russian Federation,
Ulyanovsk, Ryleev str., 30/30,
Ulyanovsk State University,
Institute of Medicine, Ecology and Physical Culture, the Department of Hospital Surgery,
Anesthesiology, Resuscitation, Urology,
Traumatology and Orthopedics,
tel. mobile: +79603686624,
e-mail: kskobelev78@mail.ru,
Kobelev Konstantin S.
Information about the authors:
Kobelev Konstantin S., Post-Graduate Student of the Department of Hospital Surgery, Anesthesiology, Resuscitation, Urology, Traumatology and Orthopedics, Institute of Medicine, Ecology and Physical Culture, Ulyanovsk State University, Traumatologist-Orthopedist of the Highest Category, Burn Department Employee, Central City Clinical Hospital, Ulyanovsk, Russian Federation.
http://orcid.org/0000-0002-0817-8175
Dolotova Daria D., PhD, Leading Researcher, Gammamed-Soft, Ltd, Moscow, Russian Federation.
https://orcid.org/0000-0002-5538-1109
Midlenko Oleg V., MD, Professor of the Department of Hospital Surgery, Anesthesiology, Resuscitation, Urology, Traumatology and Orthopedics, Institute of Medicine, Ecology and Physical Culture, Ulyanovsk State University, Ulyanovsk, Russian Federation.
https://orcid.org/0000-0001-8076-7145
Belonogov Nikolaj I., MD, Professor of the Department of Hospital Surgery, Anesthesiology, Resuscitation, Urology, Traumatology and Orthopedics, Institute Of Medicine, Ecology and Physical Culture, Ulyanovsk State University, Ulyanovsk, Russian Federation.
https://orcid.org/0000-0002-6064-9384
Midlenko Vladimir I., MD, Professor, Head of the Department of Hospital Surgery, Anesthesiology, Resuscitation, Urology, Traumatology and Orthopedics, Institute of Medicine, Ecology and Physical Culture, Ulyanovsk State University, Ulyanovsk, Russian Federation.
http://orcid.org/0000-0003-4358-8484
Contacts | ©Vitebsk State Medical University, 2007