DOI 10.15372/SSMJ20200512
Dynamics of postsurgical wound local changes and healing rate during the use of alpha-glutamyl-tryptophan in combination therapy of patients with skin and soft-tissue infections
Author Affiliations1Vreden Russian Research Institute of Traumatology and Orthopedics of Minzdrav of Russia 195427, Saint-Petersburg, Academika Baikova str., 8; Academician I.P. Pavlov First Sankt-Petersburg State Medical University of Minzdrav of Russia 197022, Saint-Petersburg, L’va Tolstogo str., 6-8
2Vreden Russian Research Institute of Traumatology and Orthopedics of Minzdrav of Russia 195427, Saint-Petersburg, Academika Baikova str., 8
3Vreden Russian Research Institute of Traumatology and Orthopedics of Minzdrav of Russia 195427, Saint-Petersburg, Academika Baikova str., 8
Abstract
Skin and soft-tissue infections (SSTI) take the lead in surgical disorders. Changes of local and systemic immunoreactivity highlight the SSTI and hinder treatment due to disease chronicity. The immunotropic therapy could be the useful tool in SSTI treatment. The aim of the study was to assess the dynamics of local changes and and duration of wound healing during the use of alpha-glutamyl-tryptophan (AGT/Thymogen) in the combination therapy of SSTI patients. Material and methods. A sample of 77 individuals aged 18–55 years with moderate SSTI of different localization and with signs of infectious intoxication participated in the randomized, double-blind, parallel group, placebo-controlled clinical trial. The patients were divided into the main (39 people) and control (38 people) groups. The combination therapy of the main group included 100 μg of AGT by intramuscular injection daily during 7 days, whereas the control group received placebo (0,9 % sodium chloride) along the same schedule. Results and discussion. The combination therapy of SSTI patients with AGT significantly decreased the local inflammation, i.e. pain intensity, hyperemia, edema (p = 0,022), infiltration within damage area (p = 0,03). Besides, AGT treatment leads to statistically and clinically significant reduction in the duration of septic wound healing by an average of 2 days as compared to control group. Thus, statistically, and clinically significant superiority of efficacy of alpha-glutamyl-tryptophan in comparison with placebo in reducing the time of healing of purulent wounds of patients with SSTI has been established.
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References
- May A.K. Skin and soft tissue infections. Surg Clin North Am. 2009; 89: 403–420. doi 10.1016/j.suc.2008.09.006
- Surgical infections of the skin and soft tissues. Russian national recommendations 2nd revised and updated edition. M., 2015; 109 p. [In Russian].
- Sorg H., Tilkorn D.J., Hager S., Hauser J., Mirastschijski U. Skin Wound Healing: An Update on the Current Knowledge and Concepts. Eur. Surg. Res. 2017; 58: 81–94.
- Bowler P.G., Duerden B.I., Armstrong D.G. Wound microbiology and associated approaches to wound management. Clin. Microbiol. Rev. 2001; 14: 244–269. doi 10.1128/CMR.14.2.244-269.2001
- Ovington L. Bacterial toxins and wound healing. Ostomy Wound Manage. 2003; 49 (7A): 8–12.
- Ustin J.S., Malangoni M.A. Necrotizing soft-tissue infections. Crit Care Med. 2011; 39: 2156–2162.
- Enoch S., Leaper D.J. Basic science of wound healing. Surgery. 2008; 26: 31–37. doi 10.1016/j.mpsur.2007.11.005
- Faizullina G.A, Mirsaeva F.Z. Etiopathogenetic features of the boil of the maxillofacial area. Medical Bulletin of the North Caucasus. 2018; 3 (1-1): 38-41. [In Russian]. https://doi.org/10.14300/mnnc.2018.13011
- El-Gilany A. H., Fathy H. Risk factors of recurrent furunculosis. Dermatol. Online J. 2009; 15 (1): 16.
- Van Koppen C.J., Hartmann R.W. Advances in the treatment of chronic wounds: A patent review. Expert Opin. Ther. Pat. 2015; 25: 931–937. doi 10.1517/13543776.2015.1045879
- Gritsyuk T.L., Zaporozhets T.S. Immunoprophylaxis and immunotherapy of purulent-septic complications of surgical interventions. Far Eastern Medical Journal. 2006; 1: 116-120. [In Russian].
- Petlenko I.S., Egorova T.Yu., Petlenko S.V., Bezgodkov Yu.A., Vorontsova T.N. An experimental study of the specific activity of L-Glutamyl - L-Tryptophan. Modern problems of science and education. 2019; 3: 175. [In Russian].
- Shevtsov M.A., Smagina L.V., Kudriavtceva T.A., Petlenko S.V., Voronkina I.V. Glu-Trp-ONa or its acylated analogue (R-Glu-TrpONa) administration enhances the wound healing in the model of chronic skin wounds in rabbits. Drug Design, Development and Therapy. 2015; 9:1717–1727.
- Olivier G., Wael N.H., Gamal B. Wound healing: Time to look for intelligent, ‘natural’ immunological approaches? BMC Immunol. 2017; 18 (1): 23.
- Instructions for medical use of the drug "Timogen®", a solution for intramuscular use of 100 mcg. [In Russian]. https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=d969a9fa-4a1b-4e57-91af-d906d04bd40d&t= (date of request 07.05.2020)
- Cardona A.F., Wilson S.E. Skin and soft-tissue infections. A critical review and the role of telavancin in their treatment. Clin. Infect. Dis. 2015; 61: 69–78. doi 10.1093/cid/civ528
- Vorob'ev A.S., Ovdenko A.G., Malinin V.V., Bogdanov A.N. Optimization of tactics for general and surgical treatment of elderly and senile patients with a fracture of the proximal femur against the background of secondary immunodeficiency. Modern problems of science and education. 2020; 1: 59-70. [In Russian]. doi 10.17513/spno.29487
About Authors (Correspondence):
Kasimova A.R., e-mail: kasi-alina@yandex.ru
Full Text
Received: 28/10/2020
Accepted: 28/10/2020
