Authors
Kostyakov D.V., Zinoviev E.V., Krylov K.M., Krylov P.K., Orlova O.V., Soloshenko V.V.
Saint-Petersburg I.I. Dzhanelidze research institute of emergency medicine, Saint-Petersburg
Abstract
Introduction. Solving the problem of assisting victims with infected wounds and burns of various etiologies is one of the leading tasks of surgery. In light of the active use of systemic antibacterial therapy and topical antimicrobial agents for local treatment, specialists are increasingly faced with multiresistant strains. The evolutionarily formed mechanisms of defense / aggression of microorganisms, characterized by the formation of biological films, make it possible to level the effect of a number of well-known wound healing preparations. This necessitates the development of a new generation of antibacterial agents. One possible way to solve this problem is to use natural antimicrobial peptides that were discovered at the turn of the 20th century. Natural peptides are natural waste products of insects, amphibians, plants, including human (neutrophils). Modern developments have made it possible to isolate and combine several types of natural antimicrobial peptides in one preparation. One of them is the FLIP7 complex, which includes defensins, cecropins, diptericins, proline-rich peptides. Experimental studies have shown that FLIP7 peptides are highly effective against most microorganisms, including multiresistant strains, fungi, viruses and protozoa. This complex actively destroys and helps to slow down the formation of biological films. The introduction of a new group of wound healing drugs will increase the effectiveness of the treatment of patients with infected wounds and burns.
Objective. To evaluate the effectiveness of hydrogel coating based on a complex of natural antimicrobial peptides FLIP7 in the treatment of patients with skin burns of the II-IIIa degree.
Materials and methods. The work was performed as part of a clinical study involving 20 patients with borderline (dermal) burns. During the observation, the dynamics of the local status of the wounds, the general condition of the patients, laboratory and planimetric indicators were evaluated. A microscopic examination of smears from the surface of the wound was performed.
Results. It was found that the use of a hydrogel wound dressing based on a complex of peptides FLIP7 made it possible to reduce the burn wound area by 69.6% (p <0.05) by 4 days of the study, and by the end of the week to achieve the final epithelization of burn wounds in 80% of patients. By the fifth day of the study, on the background of the application of the coating, a complete regression of signs of inflammation in the wound area was achieved. It was demonstrated that by 7 days of observation in the analyzed group of patients, the absolute level of leukocytes and neutrophils decreased by 26.2% (p <0.05) and 19.1% (p <0.05), respectively, compared with the initial values. The results of microbiological studies indicate that by the end of the first week of observation, application of the coating with a complex of natural antimicrobial peptides FLIP7 ensured the complete elimination of pathogenic microflora from the surface of the wound. During the study, not a single case of a side effect or an adverse event was noted.
Conclusion. Hydrogel wound dressing based on a complex of natural antimicrobial peptides FLIP7 is an effective tool for topical treatment of skin burns of the II-IIIa degree. It allows you to optimize the course of the wound process, has a pronounced antibacterial effect.
Keywords: skin burn, dermal lesions, moist environment, natural antimicrobial peptides, FLIP7.
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