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EPRA International Journal of Socio-Economic and Environmental Outlook (SEEO) ISSN: 2348-4101
Volume: 7 | Issue: 5| December 2020 | SJIF Impact Factor (2020): 7.005 | Journal DOI: 10.36713/epra0314 | Peer-Reviewed Journal
2020 EPRA SEEO | www.eprajournals.com | Journal DOI URL: https://doi.org/10.36713/epra0314
24
PREVENTION OF THE FORMATION OF
POSTOPERATIVE HYPERTROPHIC SCARS ON THE
FACE
Yusupova Dildora Zuhridinovna
Department of Diseases and Injuries of the Maxillofacial Region
Tashkent State Dental Institute
Abdullaev Sharif Yuldashevich
Department of Diseases and Injuries of the Maxillofacial Region
Tashkent State Dental Institute
Khalilov Abdufarrukh Abdufattokhovich
Department of Diseases and Injuries of the Maxillofacial Region
Tashkent State Dental Institute
Tashkent, Uzbekistan
ANNOTATION
To date, the problem of rehabilitation of patients with cicatricial lesions of the facial skin has not lost its relevance. The
article is devoted to the prevention of the formation of postoperative hypertrophic scars on the face and their treatment.
KEY WORDS:
maxillofacial area, scars, sodium succinate, operation, prevention
RELEVANCE
Until today, the problem of rehabilitation of
patients with cicatricial lesions of the facial skin has
not lost its relevance. This is due to several factors:
- a high level of injuries and an increase in the
number of surgical interventions for congenital
malformations, oncological and other diseases in the
maxillofacial region;
- the increased demands of patients and surgeons for
aesthetic results; improvement of existing diagnostic
and treatment methods;
- influence on the psychoemotional sphere, social
status and social adaptation of patients.
Analysis of the distribution of rank values in
the
structure
of
the
morbidity
of
dermatocosmetological patients indicates that in the
general structure of treatment, cicatricial lesions of
the face and neck are 25.0%. The highest
appealability for cosmetic defects falls on women
aged 31-40 and accounts for 21.5% of the total
number of patients. Among various social groups of
the population, the highest level of attendance was
found among persons of intellectual labor, the ratio
of men and women is 33% and 67%. (Panova
0.2008).
As you know, the process of scar formation
after damage to the surface layer of tissues during
injuries and operations is a biological law and is
perceived as an "inevitable evil" by both surgeons
and patients. One of the important features of the
process of tissue scarring is the fact that the final scar
formation is completed several months (and
sometimes years) after the operation is performed,
and within the same time frame is assessed by the
patient (1).
We can conditionally distinguish three main
situations in which the process of scar formation
(and, therefore, their subsequent assessment) has
significant differences. So, with open injuries and
their surgical treatment, both the patient and the
surgeon are faced with damage that has already
occurred by chance, which, on the one hand, actually
relieves the surgeon of responsibility for the quality
of future scars, and, on the other hand, is perceived
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EPRA International Journal of Socio-Economic and Environmental Outlook (SEEO) ISSN: 2348-4101
Volume: 7 | Issue: 5| December 2020 | SJIF Impact Factor (2020): 7.005 | Journal DOI: 10.36713/epra0314 | Peer-Reviewed Journal
2020 EPRA SEEO | www.eprajournals.com | Journal DOI URL: https://doi.org/10.36713/epra0314
25
by the patient as the result of accidental
circumstances. In urgent and elective surgical
operations, when the patient's tissue is dissected with
a surgical scalpel, it is usually about saving the
patient's health, and often life.
Therefore, the surgeon is concerned, first of
all, not with the quality of the future scar, but with
how to more successfully solve the main problem of
treatment (for example, opening a phlegmon,
resecting a tumor, etc.)(2).
In both the first and second cases, after the
completion of the main stage of the intervention, the
surgeon, applying sutures, is concerned not so much
with the quality of the future scar as with how to
ensure uncomplicated (primary) wound healing
In most situations, it is this circumstance that
creates the necessary conditions for solving the main
problem of treatment, allows the patient to be
discharged from the hospital in a short time, and
therefore is one of the important criteria for the
effectiveness of surgical work.
PURPOSE OF THE STUDY
Evaluation of the effectiveness of topical
application of a drug based on sodium succinate
(HYALUAL) in combination with platelet-rich
plasma in wound healing in patients after facial
surgery
RESEARCH MATERIALS
The analysis of the results of treatment of 46
patients who were hospitalized in the Department of
Adult Maxillofacial Surgery of the TGSI clinic for
the period 2017-2019, who underwent surgical
interventions for facial injuries, was carried out. The
distribution was as follows; 38 patients underwent
surgery for injuries of the lower jaw and articular
process, 8 patients - surgery for the removal of
benign tumors of the lower jaw. In the postoperative
period, 7 patients had a weeping, sluggish
granulating postoperative wound(3).
The patients were divided as follows: Group
1, main - a preparation based on sodium succinate
(HYALUAL) was injected into the wound in
combination with platelet-rich plasma. Controlgroup
2
–
standard suture was performed sing
antiseptics(4).
The method of topical application of the
preparation based on sodium succinate (HYALUAL)
in combination with platelet-rich plasma was as
follows: after debridement of the surgical field,
treatment of the skin area, the wound was injected
with 2 ml of HYALUAL, pre-mixed with its own
platelet-rich plasma, which was prepared according
to the standard technique immediately before
operations. This procedure was carried out twice -
just before suturing and on the day of removal (7
days). Photo documentation was used daily as
control.
RESULTS AND DISCUSSION
.
The results of the analysis of the treatment of
patients showed that in the patients of the control
group, the edema of the tissues around the wound
was stopped on the 4th day, which is longer than in
the patients of the main group for 2 days. Cleansing
of the wound from pathological exudate in the main
group was observed on ... day 3, complete cleansing
of the wound in the control group took place on day
5.
Epithelialization in the control group appeared
on the 7th day, while in the main group,
epithelialization began on the 5th day.
Further observation shows that the scar
formed after the use of a preparation based on
sodium succinate (HYALUAL) in combination with
platelet-rich plasma has a lower tendency to
hypertrophy, which is explained by the fact that
sodium succinate contained in the preparation
performs a unique function of a regulator of
physiological and biochemical processes(6).
It has a direct effect on cellular metabolism
and influences the transport of free oxygen to tissue.
This ability of sodium succinate to intensify
the utilization of oxygen by tissues and the reduction
of NAD- (Nicotinamide adenine dinucleotide - a
coenzyme present in all living cells is part of the
enzymes of the group of dehydrogenases that
catalyze redox reactions; serves as a carrier of
electrons and hydrogen, which it takes from oxidized
substances) - dependent cellular respiration underlies
its antihypoxic action.
Hyalurunic acid, in the composition of the
drug, plays an important role in tissue
hydrodynamics, the process of cell migration and
proliferation, as well as in a number of interactions
with surface receptors of cells.
And the growth factors contained in platelets
enhance the repair processes, the arrangement of
collagen fibers is ordered.
CONCLUSION
The use of a drug based on sodium succinate
(HYALUAL) in combination with platelet-rich
plasma in the prevention of hypertrophic scarring
was more effective than standard treatment. This
method made it possible to stop the phenomena of
local tissue edema, to shorten the time required for
wound cleansing, and also contributed to the
formation of a thinner, aesthetic scar.
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EPRA International Journal of Socio-Economic and Environmental Outlook (SEEO) ISSN: 2348-4101
Volume: 7 | Issue: 5| December 2020 | SJIF Impact Factor (2020): 7.005 | Journal DOI: 10.36713/epra0314 | Peer-Reviewed Journal
2020 EPRA SEEO | www.eprajournals.com | Journal DOI URL: https://doi.org/10.36713/epra0314
26
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