THE MODERN APPROACH TO CHOOSING OF METHODS OF EXAMINATION OF PATIENTS WITH HEAD AND NECK SKIN SCARS

Avetikov D. S., Bukhanchenko O. P., Ivanyts’ka O. S.,Havryl’iev V. M., Boyko I. V.

METHODS AND METHODOLOGIES

Scentific article

The relevance of the problem.Pathological scars of facial skin, resulting from surgical interventions, burns and mechanical injuries, remain relevant and socially significant issues of modern maxillofacial surgery. Noteworthy is the fact that the number of patients appealing with this problem to the surgeons, dermatologists, and cosmetologists increases every year. The amount of information on the causes and mechanism of the occurrence of pathological scars of the skin has increased significantly in recent times, but most of the hypotheses have not been tested in the human body. Conventional algorithms for selecting methods of treating patients with scars are available. The development of such algorithm is difficult due to the uncertainty of criteria for the differential diagnosis of various types of scars. The aim of the researchwas to improve the assessment of patients with scars of head and neck due to determining structural and functional features of the scar-modified tissues based upon ultrasound examination and RGB investigation. Objects and methods of the research.Fifty persons with scar changes of head and neck were examined. Further analysis of the structure of scar-modified tissue was performed using ultrasound examination and RGB investigation. Results of the research.The assessment of ultrasound-gram was carried out using the index obtained by deducting of the coefficients of the indicators of echogenicity. Among the differences in the ultrasound scan of the picture should be noted somewhat blurred upper limit of dermal-epidermal connections and a more pronounced lower boundary that splits the scarred tissue with hypodermis. The digital characteristic of the variational series of echogenicity indicators obtained at certain points may indicate a correlation between the scar density in different zones, the degree of its echogenicity at these points and its affiliation to a certain type of scar. Using the RGB system, we studied the distribution of colour constants of red, green and blue in 4 points: the area of intact skin, the medial and distal edge of the scar, and the area of the middle zone of the scar. It has been established that statistically significant differences in the digital colour indices are observed when visualizing all types of scars, which can serve as an important criterion for their diagnosis. The analysis of the results of digital visualization of graphic digital images showed that statistically reliable differences in digital indices, being observed during visualization of different types of scars, could be an important criterion of their differential diagnostics. Conclusion. Thus, the ultrasound examination and the RGB-examination of patients with scars of the maxillofacial region is an effective method of non-invasive diagnostics of pathological scars which allows to evaluate the changes in scar-modified tissues in dynamics. When applying the above systems, it is possible to open new horizons for the creation of adequate newest treatment technologies, depending on the type of scar. Such a comprehensive approach to the examination of patients with scars of the maxillofacial region ensures optimal choice of treatment method and achieving the maximal therapeutic effect.

pathological scar, ultrasound examination, RGB-system

1. Avetikov DS, Hutnyk AA, Boiko IV, Ivanytska OS, Tsvetkova NV. Biomekhanichne obgruntuvannia odnoosnoi deformatsii shkirno-zhyrovykh klaptiv skronevoi ta vylychnoi dilianok pry vykonanni verkhnoi ritidektomii. Klinichna khirurhiia. 2015;(873):55-7. [in Ukrainian].
2. Avetíkov DS, Gutnik AA, Pronína OM. Deformatsíyní mozhlivostí m’yakikh tkanin ríznikh dílyanok golovid v zalezhností vídí pri pri odnoosnomu roztyaguvanní. Vísnik problem bíologíí̈í meditsini. 2010;4:178-82. [in Ukrainian].
3. Avetíkov DS, Danil’chenko SÍ, Pronína OM. Gístotopografíchne obgruntuvannya pídyomu ta mobílízatsíí̈klaptív u dílyankakh, shcho pobudovaní za tipom kovzannya. Vísnik problem bíologíí̈í meditsini. 2010;3:241-6. [in Ukrainian].
4. Avetikov DS, Steblovskij DV, Popovich IJu, Lokes KP, Bojko IV. Izuchenie biomehanicheskih svojstv kozhi soscevidnoj oblasti pri vypolnenii kosmeticheskoj oto plastiki. Klіnіchna hіrurgіja. 2015;(876):41-4. [in Russian].
5. Vu VK, Avetikov DS, Shlykova OA. Vozniknovenie odontogennoj flegmony associirovannoj s polimorfnym variantom 896A/G gena TLR4, no ne 2258G/A gena TLR2. Klіnіchna hіrurgіja. 2014;(10):54-6. [in Russian].
6. Loza KhO, Stavytskyi SO, Loza YeO, Voloshyna LI, Avetikov DS. Klinichna kharakterystyka stanu rubtsevo-zminenykh tkanyn shkiry pislia operatsii. Klinichna khirurhiia. 2016;4(885):61-3. [in Ukrainian].
7. Skrypnyk VM, Kaidashev IP, Shlykova OA, Avetikov DS. Polimorfizm G28197A>G henu elastynu vyznachaie skhylnist do utvorennia patolohichnykh rubtsiv. Problemy ekolohii i medytsyny. 2012;(16):61-4. [in Ukrainian].
8. Avetikov D, Loza K, Starchenko I, Loza EO, Marushchak MI. Experimental-morphological substantiation of expediency to use the skin glue «Dermabond» for postoperative wound closure. 2015;(7-8):244-5.
9. Lakin Gregory. Plastic Surgery Review. Gregory Lakin. Germany: Thieme; 2015. 235 p.
10. Neligan P. Plastic Surgery. Volume 2 Aesthetic. Neligan. USA: Elsevier; 2013. 555 p.

«Bulletin of problems biology and medicine» Issue 1 Part 1 (142), 2018 year, 243-246 pages, index UDK 617.51/53-003.92:616-07-037

10.29254/2077-4214-2018-1-1-142-243-246