urmjУральский медицинский журналUral Medical Journal2949-4389Ural State Medical University10.52420/umj.24.4.78MLZQKJurmj-1936Research ArticleОригинальные статьи | Original articlesOriginal articlesЭффективность противорубцовой терапии в реабилитации детей, перенесших оперативное лечение переломов кистиEffectiveness of Anti-scar Therapy in the Rehabilitation of Children Following Surgical Treatment of Hand Fractureshttps://orcid.org/0000-0003-3157-4579ГордиенкоИ. И.GordienkoI. I.

Гордиенко Иван Иванович — кандидат медицинских наук, доцент, проректор по научно-исследовательской и инновационной деятельности, доцент кафедры детской хирургии, институт хирургии, УГМУ; травматолог-ортопед травматолого-ортопедического отделения № 1, Детская ГКБ № 9.

Екатеринбург

Ivan I. Gordienko — Candidate of Sciences (Medicine), Associate Professor, Vice-Rector for Research and Innovations, Associate Professor of the Department of Pediatric Surgery, Institute of Surgery, Ural State Medical University; Orthopedic Traumatologist of the Traumatological and Orthopedic Department No. 1, Children’s City Clinical Hospital No. 9.

Ekaterinburg

ivan-gordienko@mail.ruhttps://orcid.org/0009-0000-3431-7813СлукинаА. Е.SlukinaA. E.

Слукина Анастасия Евгеньевна — студент института педиатрии и репродуктивной медицины.

Екатеринбург

Anastasia E. Slukina — Specialist’s Degree Student of the Institute of Pediatrics and Reproductive Medicine, Ural State Medical University.

Ekaterinburg

anast.slukina@gmail.comhttps://orcid.org/0000-0001-9132-215XЗорниковД. Л.ZornikovD. L.

Зорников Данила Леонидович — кандидат медицинских наук, доцент, доцент кафедры медицинской микробиологии и клинической лабораторной диагностики, институт профилактической медицины.

Екатеринбург

Danila L. Zornikov — Candidate of Sciences (Medicine), Associate Professor, Associate Professor of the Department of Medical Microbiology and Clinical Laboratory Diagnostics, Institute of Preventive Medicine, Ural State Medical University.

Ekaterinburg

zornikovdl@gmail.comПятыгинаД. A.PyatyginaD. A.

Пятыгина Дарья Андреевна — студент института педиатрии и репродуктивной медицины.

Екатеринбург

Daria A. Pyatygina — Student of the Institute of Pediatrics and Reproductive Medicine, Ural State Medical University.

Ekaterinburg

piatygina.d@yandex.ruhttps://orcid.org/0000-0001-9050-3629ЦапН. А.TsapN. A.

Цап Наталья Александровна — доктор медицинских наук, профессор, заведующий кафедрой детской хирургии, институт хирургии, УГМУ; детский хирург отделения неотложной хирургии, Детская ГКБ № 9.

Екатеринбург

Natalia A. Tsap — Doctor of Sciences (Medicine), Professor, Head of the Department of Pediatric Surgery, Institute of Surgery, Ural State Medical University; Pediatric Surgeon of the Department of Emergency Surgery, Children’s City Clinical Hospital No. 9.

Ekaterinburg

tsapna-ekat@rambler.ruУральский государственный медицинский университет; Детская городская клиническая больница № 9РоссияUral State Medical University; Children’s City Clinical Hospital No. 9Russian FederationУральский государственный медицинский университетРоссияUral State Medical UniversityRussian Federation20252708202524478–89Copyright © Гордиенко И.И., Слукина А.Е., Зорников Д.Л., Пятыгина Д.A., Цап Н.А., 20252025Гордиенко И.И., Слукина А.Е., Зорников Д.Л., Пятыгина Д.A., Цап Н.А.Gordienko I.I., Slukina A.E., Zornikov D.L., Pyatygina D.A., Tsap N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.umjusmu.ru/jour/article/view/1936Введение

Введение. Переломы кисти у детей в ряде случаев требуют хирургического лечения, в т. ч. с применением методики открытой репозиции, что сопряжено с риском формирования послеоперационных рубцов. Функциональный и эстетический исходы лечения во многом зависят от этапа послеоперационной реабилитации.

Цель — обосновать целесообразность проведения противорубцовой терапии с применением геля, содержащего цепалин, гепарин и аллантоин, в составе комплексной реабилитации детей после оперативного лечения переломов кисти.

Материалы и методы

Материалы и методы. В проспективное нерандомизированное исследование включено 28 детей в возрасте от 5 до 17 лет, перенесших открытую репозицию и остеосинтез переломов костей кисти. Пациенты разделены на 2 группы: основную (n = 15) — с включением в реабилитацию местной противорубцовой терапии гелем, содержащим цепалин, гепарин и аллантоин, в течение 6 мес.; контрольную (n = 13) — без включения специфической терапии рубца. Оценка результатов лечения проводилась по Манчестерской шкале рубцов (MSS) через 6 нед., 3 и 6 мес. после начала терапии.

Результаты

Результаты. В основной группе отмечена положительная динамика по всем характеристикам рубца, статистически значимые изменения зафиксированы по натяжению тканей — (1,20±0,68) балла на 6-й нед. наблюдения до (0,53±0,52) балла через 6 мес. (p = 0,009). Различия между основной и контрольной группами достигли статистической значимости спустя 6 мес. по рельефу (0,60 против 1,00; p = 0,038) и натяжению тканей (0,53 против 1,31; p = 0,001). Различия суммарной оценки по шкале MSS между группами также достигли статистической значимости спустя 6 мес. (3,93 против 5,62; p = 0,007).

Заключение

Заключение. Применение геля, содержащего цепалин, гепарин и аллантоин, способствует снижению выраженности рубцовых изменений по ряду параметров, что позволяет рекомендовать этот препарат для включения в стандарты комплексной реабилитации детей, перенесших оперативное лечение переломов кисти.

Introduction

Introduction. In certain cases, pediatric hand fractures may require surgical intervention, including open reduction, which is associated with an elevated risk of postoperative scar formation.

The aim of the study is to substantiate the feasibility of incorporating anti-scar therapy with а gel containing cepalin, heparin, and allantoin into the comprehensive rehabilitation of pediatric patients following surgical treatment of hand fractures.

Materials and methods

Materials and methods. The prospective non-randomize study included 28 pediatric patients aged 5 to 17 years who underwent open reduction and fixation for hand fractures. The participants were divided into two groups: the main group (n = 15) received topical scar therapy with а gel containing cepalin, heparin, and allantoin for a period of 6 months, while the control group (n = 13) underwent standard rehabilitation without any targeted scar treatment. The condition of post-operative scars was assessed using the Manchester Scar Scale (MSS) at 6 weeks, 3 months, and 6 months postoperatively.

Results

Results. In the main group, positive dynamics were observed across all scar characteristics, with statistically significant changes recorded for the “tissue tension” parameter — from (1.20±0.68) points at week 6 of follow-up to (0.53±0.52) points after 6 months (p = 0.009). Differences between the main and control groups reached statistical significance at the 6-month mark for the parameters “surface relief ” (0.60 vs. 1.00; p = 0.038) and “tissue tension” (0.53 vs. 1.31; p = 0.001). The difference in the total MSS score between the groups also reached statistical significance after 6 months (3.93 vs. 5.62; p = 0.007).

Conclusion

Conclusion. The application of а gel containing cepalin, heparin, and allantoin is associated with a reduction in scar-related changes across multiple parameters, thereby supporting its integration into comprehensive rehabilitation protocols for pediatric patients following surgical treatment of hand fractures.

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The authors declare that there are no conflicts of interest present.