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2017 г. №4 Том 25

ОБЩАЯ И ЧАСТHАЯ ХИРУРГИЯ

DOI: https://dx.doi.org/10.18484/2305-0047.2017.4.373   |  

Y.I. YARETS 1, L.N. RUBANOV 1, Z.A. DUNDAROV 2

Indicators of neutrophiles functional activity as predictors of skin grafting results

SE “Republican Scientific and Practical Center for Radiation Medicine and Human Ecology” 1,
EE “Gomel State Medical University” 2, Gomel,
The Republic of Belarus

Objectives. To estimate the possibility of using the laboratory tests for evaluating the functional activity of the blood polymorphonuclear leukocytes (PNL) to predict skin grafting (SG) results in patients with chronic wounds (CW).
Methods. The analysis of the functional activity of peripheral blood neutrophils was carried out in patients with chronic wounds (n=148) requiring skin grafting (SG). Ingestion capacity of neutrophils was determined in the phagocytosis reaction with the evaluation of phagocytic index (PhI) and phagocytic number (PhN). Oxygen-producing activity of neutrophils was estimated in response of the spontaneous NBT-test (NBTsp) and S. aureus-stimulated (NBTst) nitroblue tetrazolium restoration. Activity of neutrophil extracellular traps (NET) in the blood were quantified prior (spontaneous; NETsp) and after neutrophils incubation with the stimulator (stimulated; NETst). Taking into account the differences of autodermoplasty outcomes within the incisional period all the patients were divided into 2 groups: group 1 (n=126) – favorable results of skin grafting and group 2 (n=22) – SG was complicated by lysis of autodermograft.
Results. With the usage of logistic regression and ROC-curves methods the informativeness of NBTsp, NETsp, NETst for flap viability prognosis was established in patients with chronic wounds. The optimal cut-off value for NBTsp is 15% (86,5% sensitivity and 93% specificity), NETsp – 7% (97% sensitivity and 95,2% specificity), NETst – 15% (86,4% sensitivity and 90% specificity). At preoperative values of NBT, NETsp, NETst below cut-off, rejection of the autodermotransplant is considered to be predicted, and at NBT, NETsp, NETst above cut-off values, analysis demonstrates engraftment rates with a probability up to 92%.
Conclusion. The values of functional activity of neutrophils (NBTsp, NETsp, NETst) are considered to be the informative predictors of the final outcome in patients with chronic wounds and they are also recommended for monitoring the efficiency of additional preoperative preparation in SG planning.

Ключевые слова: chronic wound, skin grafting, NBT-test, neutrophils extracellular traps, skin grafting prognosis, efficiency, logical regression
с. 373-381 оригинального издания
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Адрес для корреспонденции:
246040, Republic of Belarus,
Gomel, Ilyich str., 290,
SE «Republican Scientific
and Practical Center for Radiation
Medicine and Human Ecology».
Clinical Laboratory Medicine Department,
tel.: 37529 335-34-72,
e-mail: artyut@mail.ru
Yuliya I. Yarets
Cведения об авторах:
Yarets Y.I. PhD, Ass. Professor, Head of clinical-laboratory medicine department, SE «Republican Scientific and Practical Center for Radiation Medicine and Human Ecology».
Rubanov L.N. Head of department of esthetic medicine, SE «Republican Scientific and Practical Center for Radiation Medicine and Human Ecology» .
Dundarov Z.A. MD, Professor, Head of department of surgical diseases №2 with the course of pediatric surgery of EE “Gomel State Medical University”.
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