Effects of photodynamic therapy with Photoditazine combined with amphyphilic plymers at reparative processes

Abstract

Objective. To improve outcomes of surgical treatment of patients with purulent wounds in soft tissues using laser photodynamic therapy with photosensitizer Photoditazine combined with water-soluble amphiphilic polymers immobilized on hydroxyapatite nanoparticles in a form of gel. Findings of a comprehensive examination of 100 patients with purulent wounds in soft tissues were analyzed in the study. Materials and methods. Patients were divided into two groups: studied group (n-50) in which patients had photodynamic therapy (PDT) with Photoditazine combined with amphiphilic polymers immobilized on hydroxyapatite nanoparticles in gel form and controls (n-50) who had traditional therapy. Walls and the bottom of the wound were covered with destructive necrotic tissues abundantly infiltrated with polymorphonuclear leukocytes. Results. In the studied group, histological examination of purulent wound biopsy specimens showed a more rapid clearance of wound surface from purulent necrotic masses and more rapid formation of granulation tissue comparing to the controls who had traditional therapy. On the 7th day, in the control group one could see a contraction of wound channel, less fibrino-necrotic masses and less neutrophil infiltration. The granulation tissue was seen at the border with intact tissues. On the same day, in PDT group, one could see a decreased volume of the fibrinose-leukocyte layer, maturation of the granulation tissue with more macrophages and fibroblasts. If to compare with traditional treatment, laser photodynamic therapy of purulent wounds in soft tissues with Photoditazine combined with the amphiphilic polymer increases phagocytic activity of macrophages, effectively decreases bacterial tissue contamination and accelerates the formation and maturation of granulation tissue as it has been shown by morphological studies.