Current aspects of the wound process treatment using dressings (bandages)

Authors

DOI:

https://doi.org/10.14739/2310-1210.2022.5.252474

Keywords:

wounds, bandages, treatment, pharmaceutical formulation, medicine

Abstract

The review provides information concerning the assortment of modern wound dressings (bandages) which are presented on the pharmaceutical market. The studied group of dressings varies widely in chemical composition and active pharmaceutical ingredients. It has been determined that the development of modern wound dressings provides for the realization of a complex effect on the wound process, which is achieved by the multi-layer structure of the dressing (bandages) with clearly defined functions of each component – the contact layer reduces adhesion to the wound surface; sorption layer provides irreversible sorption, retention and inactivation of wound exudate; pharmacologically active layer influences the main factors of wound process pathogenesis; outer isolating membrane generates wound occlusion.

Conclusions. The events of recent years which related to the Anti-terrorist operation / the Joint Forces Operation in Ukraine indicate the unresolved problem of combat surgical trauma treatment. This is an important issue for the Medical services of the Armed Forces and the health care system of Ukraine. This necessitates expanding the range of wound dressing (bandages) with combined action for military medicine. It has been determined that the treatment in the purulent-necrotic phase of the wound process, it is advisable to use wound dressings with strong osmotic and antibacterial activity and low adhesion to the wound surface. In the second phase of the wound process, it is advisable to use wound dressings with moderate osmotic activity and a combination of antibacterial and reparative properties. In the final phase of the wound process, wound dressings should prevent drying of the wound surface as well as protect and stimulate the growth of granulations.

 

Author Biographies

O. P. Shmatenko, Ukrainian Military Medical Academy, Kyiv

PhD, DSc, Professor, Colonel of Medical Service, Head of the Department of Military Pharmacy

L. L. Davtian, Shupyk National Healthcare University of Ukraine, Kyiv

PhD, DSc, Professor, Head of the Department of Pharmaceutical Technology and Biopharmacy

T. V. Prykhodko, Ukrainian Military Medical Academy, Kyiv

PhD, Associate Professor, Lieutenant Colonel of Medical Service, Department of Military Pharmacy

O. F. Kuchmistova, Ukrainian Military Medical Academy, Kyiv

PhD, Associate Professor, Professor of the Department of Military Pharmacy

V. О. Tarasenko, Ukrainian Military Medical Academy, Kyiv

PhD, DSc, Associate Professor, Professor of the Department of Military Pharmacy

N. O. Коziko, Bogomolets National Medical University, Kyiv, Ukraine

PhD, Associate Professor of the Department of Pharmacy and Industrial Medicine Technology

D. V. Voronenko, State Expert Center of the Ministry of Health of Ukraine, Kyiv

PhD, Expert of the Department of Examination of the Quality of Materials for Clinical Trials

V. V. Osodlo, Ukrainian Military Medical Academy, Kyiv, Ukraine

PhD, Senior Lecturer of the Department of Military Pharmacy

References

Slovo i Dilo. (2020). Shosta richnytsia pochatku АТО : tsyfry і fakty [The sixth anniversary of the beginning of the anti-terrorist operation: figures and facts]. [in Ukrainian]. https://www.slovoidilo.ua/2020/04/14/infografika/bezpeka/shosta-richnycya-pochatku-ato-cyfry-fakty

Zarutskyi, Ya. L., & Bilyi V. Ya. (2018). Voenno-poliova khirurhiia [Military field surgery]. Kyiv: Feniks. [in Ukrainian].

Hospenthal, D. R., Murray, C. K., Andersen, R. C., Bell, R. B., Calhoun, J. H., Cancio, L. C., Cho, J. M., Chung, K. K., Clasper, J. C., Colyer, M. H., Conger, N. G., Costanzo, G. P., Crouch, H. K., Curry, T. K., D'Avignon, L. C., Dorlac, W. C., Dunne, J. R., Eastridge, B. J., Ficke, J. R., Fleming, M. E., … Surgical Infection Society (2011). Guidelines for the prevention of infections associated with combat-related injuries: 2011 update: endorsed by the Infectious Diseases Society of America and the Surgical Infection Society. The Journal of trauma, 71(2 Suppl 2), S210-S234. https://doi.org/10.1097/TA.0b013e318227ac4b

Таrasenko, V. О. (2021). Naukovo-praktychne tа еksperymentalne оbgruntuvannia skladu tа tekhnolohii antymikrobnykh likarskykh zasobiv z anestezuiuchoiu diieiu dlia potreb medychnoi sluzhby Zbroinykh Syl Ukrainy. Dys. d-ra farm. nauk [Scientific-practical and experimental substantiation of the composition and technology of antimicrobial drugs with anesthetic action for the needs of the medical service of the Armed Forces of Ukraine (Doctoral dissertation)]. Ukrainska viiskovo-medychna akademiia, Kyiv. [in Ukrainian].

Samson, А. А., Кuzmin, Yu. V., & Samson, M. А. (2018). Antibakterial'naya terapiyagnoinykh ran [Antibacterial therapy of purulent wounds]. Меdicina nevidkladnykh staniv, (7), 13-18. [in Russian]. https://doi.org/10.22141/2224-0586.7.94.2018.150814

Thomas, S., & Uzun, M. (2019). Testing dressings and wound management materials. In Advanced Textiles for Wound Care (pp. 23-54). Elsevier. https://doi.org/10.1016/b978-0-08-102192-7.00002-3

Коvalenko, О. М. (2010). Suchasni ranovi pokryttia (оhliad) [Modern wound dressings (review)]. Sychasni medychni tekhnolohii, (4), 88-97. [in Ukrainian].

Popadyuk, O., Kutsyk, R. & Voloshyn, M. (2019). Treatment of inflamed skin wounds with biodegradable polymeric film "Biodep nano". Moldovan Medical Journal, 62(2), 29-32. https://doi.org/10.5281/zenodo.3233917

Solomennyi, А. М. (2021). Vyvchennia toksikolohichnykh kharakterystyk rozroblenykh miakykh likarskykh zasobiv [Studying toxicological properties of the developed soft drugs]. Ukrainian Journal of Military Medicine, 2(4), 140-148. [in Ukrainian].

Matousková, E., Broz, L., Stolbová, V., Klein, L., Konigová, R., & Veselý, P. (2006). Human allogeneic keratinocytes cultured on acellular xenodermis: the use in healing of burns and other skin defects. Bio-medical materials and engineering, 16(4 Suppl), S63-S71.

Trembach, О. І., & Khokhlenkova, N. V. (2019). Perspektyvy vykorystannia lipofilnykh roslynnykh ekstraktiv pry likuvanni ran riznoi etiolohii [Prospects for the use of lipophilic plant extracts in the treatment of wounds of various etiologies]. Suchasna farmatsiia : istoriia, realii ta perspektvy rozvytku. Proceedings of the scientific-practical conference (Vol. 1, pp. 259-260). Kharkiv: NFaU. [in Ukrainian].

Farooq, U., Malviya, R., Bansal, V., & Sharma, P. K. (2014). Characterization of Some Polymers as Pharmaceutical Excipient. Advances in Biological Research, 8(3), 123-126.

Chornopyshchuk, R. М. (2017). Lokalna imunokorektsiia v kompleksnomu likuvanni infikovanykh ran: (eksperymentalno-klinichne doslidzhennia). Dys. kand. med. nauk [Local immune correction in the combination treatment of infected wounds (experimentally and clinical research) (Dissertation to obtain a scientific degree of candidate of medical sciences)]. Vinnytsia National Pirogov Memorial Medical University, Vinnytsia. [in Ukrainian].

Pidlisny, O. (2021). Suchasni pidkhody do kompleksnoho likuvannia hniinykh ran (ohliad literatury) [Modern approaches to multimodality therapy of purulent wounds (literature review)]. Zdorovia suspilstva, 9(2), 46-51. https://doi.org/10.22141/2306-2436.9.2.2020.205212

Kornienko, V. V. (2016). Моrfofunktsionalni osoblyvosti regeneratsii shkiry pry opikovii travmi ta zastosuvannia khitozanovykh plivok u vikovomu aspekti. Dys. kand. med. nauk [The morphologic and functional features of skin burn wounds regeneration and application of chitosan membranes in different age (Dissertation to obtain a scientific degree of candidate of medical sciences)]. Sumy State University, Sumy. [in Ukrainian].

Duleba, V. P., & Hnativ, Z. Ya. (2020). Ochishchennia akrylamidu dlia іnhibitoriv polimeryzatsii dlia vyhotovlennia vysokoiakisnykh flokyliantiv na оsnovi poliakrylamidu [Purification of acrylamide from polymerization inhibitors in the manufacture of high quality flocculants based on polyacrylamide]. CTAS, 3(2), 109-113. [in Ukrainian]. https://doi.org/10.23939/ctas2020.02.109

Verdolino, D. V., Thomason, H. A., Fotticchia, A., & Cartmell, S. (2021). Wound dressings: curbing inflammation in chronic wound healing. Emerging topics in life sciences, 5(4), 523-537. https://doi.org/10.1042/ETLS20200346

Shmatenko, О. P., Pidlisny, О. V., Prykhodko, Т. V., Solomennyi, А. М., Pritula, R. L., Semenchenko, G. B., & Таkhtaulova, N. О. (2020) Теkhnolohichni аspekty stvorennia miakykh likarskykh zasobiv dlia likuvannia hniinykh ran [Technological aspects of creating soft dosage forms for the treatment of purulent wounds]. Ukrainian journal of military medicine, 1(1), 50-63. [in Ukrainian]. https://doi.org/10.46847/ujmm.2020.1(1)-050

Anghel, I., Holban, A. M., Grumezescu, A. M., Andronescu, E., Ficai, A., Anghel, A. G., Maganu, M., Laz R, V., & Chifiriuc, M. C. (2012). Modified wound dressing with phyto-nanostructured coating to prevent staphylococcal and pseudomonal biofilm development. Nanoscale research letters, 7(1), 690. https://doi.org/10.1186/1556-276X-7-690

Norman, G., Dumville, J. C., Mohapatra, D. P., Owens, G. L., & Crosbie, E. J. (2016). Antibiotics and antiseptics for surgical wounds healing by secondary intention. The Cochrane database of systematic reviews, 3(3), CD011712. https://doi.org/10.1002/14651858.CD011712.pub2

Кravtsiv, М. І. (2010). Kompleksne likuvannia hniinykh ran miakykh tkanyn (eksperymentalno-klinichne doslidzhennia). Avtoref. dys kand. меd. nauk [Complex Treatment of Suppurative Wounds of Soft Tissue (experimental and clinical research) (Dissertation abstract)]. The National medical academy of post-graduate education named P. L. Shupyk of Ministry of Health of Ukraine, Kyiv. [in Ukrainian].

Volkovoy, V. A., Derkach, N. V., Bahlai, T. O., Yeromenko, O. D., & Karabut, L. V. (2018). Studying of the wound healing effect of ointment with groated leaves of Black Alder (Alnus Glutinosa) on the model of plane wound. News of Pharmacy, 3(95), 54-58. https://doi.org/10.24959/nphj.18.2221

Zhao, M., Shi, J., Cai, W., Liu, K., Shen, K., Li, Z., Wang, Y., & Hu, D. (2021). Advances on Graphene-Based Nanomaterials and Mesenchymal Stem Cell-Derived Exosomes Applied in Cutaneous Wound Healing. International journal of nanomedicine, 16, 2647-2665. https://doi.org/10.2147/IJN.S300326

Torchilin, V. (2009). Multifunctional and stimuli-sensitive pharmaceutical nanocarriers. European Journal of Pharmaceutics and Biopharmaceutics, 71(3), 431-444. https://doi.org/10.1016/j.ejpb.2008.09.026

Mattioli-Belmonte, M., Zizzi, A., Lucarini, G., Giantomassi, F., Biagini, G., Tucci, G., Orlando, F., Provinciali, M., Carezzi, F., & Morganti, P. (2007). Chitin Nanofibrils Linked to Chitosan Glycolate as Spray, Gel, and Gauze Preparations for Wound Repair. Journal of Bioactive and Compatible Polymers, 22(5), 525-538. https://doi.org/10.1177/0883911507082157

Sievens-Figueroa, L., Bhakay, A., Jerez-Rozo, J. I., Pandya, N., Romañach, R. J., Michniak-Kohn, B., Iqbal, Z., Bilgili, E. & Davé, R. N. (2012). Preparation and characterization of hydroxypropyl methyl cellulose films containing stable BCS Class II drug nanoparticles for pharmaceutical applications. International Journal of Pharmaceutics, 423(2), 496-508. https://doi.org/10.1016/j.ijpharm.2011.12.001

Rogulska, O. Y., Petrenko, Y. U. O., Kalinkevich, O. V., Kalinkevich, A. N., & Petrenko, O. Y. (2014). Adhesion and proliferation of adipose derived mesenchymal stromal cells on chitosan scaffolds with different degree of deacetylation. Biopolymers and Cell, 30(2), 135-140. https://doi.org/10.7124/bc.00088C

Kadajji, V. G., & Betageri, G. V. (2011). Water soluble polymers for pharmaceutical applications. Polymers, 3(4), 1972-2009. https://doi.org/10.3390/polym3041972

Rivero, S., García, M. A., & Pinotti, A. (2009). Composite and bi-layer films based on gelatin and chitosan. Journal of Food Engineering, 90(4), 531-539. https://doi.org/10.1016/j.jfoodeng.2008.07.021

Shaprynskyi, V. O., Skalskyi, S. S., Palamarchuk, S. V., & Shaprynskyi, Y. V. (2015). Suchasni pidkhody do likuvannia hniinykh ran. Nevyrisheni problem [Modern approaches to the treatment of purulent wounds. Unsolved problems]. Hospital surgery. Shpytalna khirurhiia. Zhurnal іmeni L. Ya. Коvalchuka, (3), 70-73. [in Ukrainian]. https://doi.org/10.11603/2414-4533.2015.3.5034

Maiboroda, O. I., Shmatenko, O. P., Kuchmystova, O. F., Kuchmystov, V. O., & Prykhodko, T. V. (2018, November 9). Mistse ekstemporalnykh likarskykh zasobiv na osnovi roslynnoi sirovyny v systemi tsyvilnoi ta viiskovoi medytsyny [The place of extemporaneous medicinal products based on plant raw materials in the system of civil and military medicine]. Science and society. The 8th International conference (pp. 78-88). Hamilton. [in Ukrainian].

Guryev, S., Tanasienko, P., & Martsinkovsky, I. (2022). Vakuum-aktyvna terapiia u kоmpleksnomu likuvanni postrazhdalykh іz vohnepalnymy poranenniamy [Vacuum-assisted closure therapy in the comprehensive treatment of victims with gunshot wounds]. Trauma, 18(5), 83-86. [in Ukrainian]. https://doi.org/10.22141/1608-1706.5.18.2017.114123

Tarasenko, V. O., Drozdova, A. O., & Miropolska, O. V. (2020). Naukovo-teoretychni pidkhody do rozrobky mazi dlia likuvannia opikovoi khvoroby u viiskovosluzhbovtsiv [Scientific-theoretical approaches to the development of an ointment for the treatment of burn disease in military personnel]. Konferentsiia molodykh vchenykh UVMA (Vol. 2, pp. 71-72). Kyiv. [in Ukrainian].

Кuchmistova, О. F., Shmatenko, О. P., Таrasenko, V. О., & Кuchmistov, V. О. (2020). Strukturyzatsiia naukovykh pidkhodiv dо stvorennia novykh pereviazuvalnykh materialiv, zasobiv, pokryttiv : alternatyvni dzherela tа innovatsiini tekhnolohii [Structuring of scientific approaches to the creation of new dressing materials, means, coatings: alternative sources and innovative technologies]. Fundamental and applied research in the modern world. Abstracts of the 3th International scientific and practical conference (pp. 393-402). BoScience Publisher. [in Ukrainian].

Fistal, E. Ya., & Soloshenko, V. V. (2009). Nash opyt klinicheskogo ispol'zovaniya gidrofobnykh setchatykh ranevykh pokrytii [Our clinical experience with hydrophobic mesh wound dressings]. Meditsina neotlozhnykh sostoyanii, (1), 21-24. [in Russian].

Моlochkov, А. V., & Оvsyannikova, G. V. (2016). Меtronidazol v naruzhnom lechenii rozatsea [Metronidazole in the topical treatment of rosacea]. Ukrainskyy zhurnal dermatologii, venerologii, kosmetologii, (2), 85-88. [in Russian].

Polyakova, D. S. (2019). Іbuprofen : perevahy zastosuvannia pry hostrykh respiratornykh zakhvoriuvanniakh [Ibuprofen: advantages of use in acute respiratory diseases]. Ukrainskyi medychnyi chasopys, (1), 1-3. [in Ukrainian]. https://www.umj.com.ua/wp/wp-content/uploads/2019/02/4738.pdf?upload=

Al-Kassas, R. S., Gilligan, C. A., & Li Wan Po, A. (1993). Processing factors affecting particle size and in vitro drug release of sustained-release ibuprofen microspheres. International Journal of Pharmaceutics, 94(1-3), 59-67. https://doi.org/10.1016/0378-5173(93)90009-5

Atiyeh, B. S., Dibo, S. A., & Hayek, S. N. (2009). Wound cleansing, topical antiseptics and wound healing. International wound journal, 6(6), 420-430. https://doi.org/10.1111/j.1742-481X.2009.00639.x

Connelly, D. (2018). Breakdown of the OTC medicines market in Britain. Pharmaceutical Journal, 300, 7913. https://doi.org/10.1211/pj.2018.20204913

Neely, A. N., Gardner, J., Durkee, P., Warden, G. D., Greenhalgh, D. G., Gallagher, J. J., Herndon, D. N., Tompkins, R. G., & Kagan, R. J. (2009). Are topical antimicrobials effective against bacteria that are highly resistant to systemic antibiotics?. Journal of burn care & research, 30(1), 19-29. https://doi.org/10.1097/BCR.0b013e3181921eed

Pierce, C. A., & Voss, B. (2010). Efficacy and safety of ibuprofen and acetaminophen in children and adults: a meta-analysis and qualitative review. The Annals of pharmacotherapy, 44(3), 489-506. https://doi.org/10.1345/aph.1M332

Kanabar, D. J. (2017). A clinical and safety review of paracetamol and ibuprofen in children. Inflammopharmacology, 25(1), 1-9. https://doi.org/10.1007/s10787-016-0302-3

Sarganas, G., Buttery, A. K., Zhuang, W., Wolf, I. K., Grams, D., Rosario, A. S., Scheidt-Nave, C., & Knopf, H. (2015). Prevalence, trends, patterns and associations of analgesic use in Germany. BMC pharmacology & toxicology, 16, 28. https://doi.org/10.1186/s40360-015-0028-7

Trøstrup, H., Bjarnsholt, T., Kirketerp-Møller, K., Høiby, N., & Moser, C. (2013). What Is New in the Understanding of Non Healing Wounds Epidemiology, Pathophysiology, and Therapies. Ulcers, 2013, 1-8. https://doi.org/10.1155/2013/625934

Reva, G. V., Usov, V. V., Obydennikova, T. N., Martynenko, E. E., Danilenko, M. V., Girya, O. Yu., Maloman, N. V., Krasnikov, Yu. A., Kiselev, A. Yu., Mitraschov, K. C., & Reva, I. V. (2016). Methods of treatment in patients with burns. International Medizinischer Kongress Euromedica - Hannover 2016. Moderne Aspekte der Prophylaxe, Behandlung und Rehabilitation (pp. 60-61). http://www.ewg-board.eu/daten/euromedica-hannover-2016-www.pdf

Коvalenko, О. M., Коvalenko, А. О., & Оsadcha, О. І. (2017). Vplyv ranovykh pokryttiv nа pH rany pry poverkhnevykh opikakh [Impact of the wound coverings on the wound pH in superficial burns of the skin]. Кlinichna khirurhiia, (2), 28-30. [in Ukrainian].

Vogt, P. M., Kolokythas, P., Niederbichler, A., Knobloch, K., Reimers, K., & Choi, C. Y. (2007). Innovative Wundtherapie und Hautersatz bei Verbrennungen [Innovative wound therapy and skin substitutes for burns]. Der Chirurg, 78(4), 335-342. https://doi.org/10.1007/s00104-007-1325-5

Lu, G., Ling, K., Zhao, P., Xu, Z., Deng, C., Zheng, H., Huang, J., & Chen, J. (2010). A novel in situ-formed hydrogel wound dressing by the photocross-linking of a chitosan derivative. Wound repair and regeneration, 18(1), 70-79. https://doi.org/10.1111/j.1524-475X.2009.00557.x

Niculescu, A. G., & Grumezescu, A. M. (2022). An Up-to-Date Review of Biomaterials Application in Wound Management. Polymers, 14(3), 421. https://doi.org/10.3390/polym14030421

(2016). Hidrohelevi poviazki - іnnovatsiinyi metod likuvannia opikiv і ran, yaki vazhko zahoiuiutsia [Hydrogel dressings are an innovative method of treating burns and wounds that are difficult to heal]. Uchastkovyi vrach, (8), 5-6. [in Ukrainian].

Akulenko S. V., Berezovskaya G. B., Bovykina G. A., Bogdanova A. S., Buryak M. V., Vil'danova R. R., Volodina V. P., Gorshkova L. M., Efremova M. I., Knyazeva M. V., Kolesov S. V., Kukovinets O. S., Kurilo A. A., Malov A. A., Moskalenko D. V., Radionova V. A., Semenov K. A., Sigaeva N. N., Titova S. V., . . . Yarnykh T. G. (2015). Innovatsionnye podkhody k razvitiyu meditsiny, farmatsevtiki i ekologo-biologicheskikh issledovanii : monografiya [Innovative approaches to the development of medicine, pharmaceuticals and ecological and biological research]. Оdessa: Kupriyenko SV. [in Russian].

Bilai, I. M., & Tsys, O. V. (2020). Nanotehnolohichni doslidzhennia ta yikh perspektyvy v suchasniy medytsyni [Nanotechnological research and its prospects in modern medicine]. Nanotechnology and nanomaterialsin pharmacy and medicine. Proceedings of the 4th Ukrainian scientific-practical Internet Conference with Intennational Participation (pp. 16-16). Kharkov: NFaU. [in Ukrainian].

Аnisimova, D. І., & Vyshnevska, L. І. (2020). Rozrobka skladu ta tekhnolohii mazi antyseptychnoi dii dlia likuvannia ranovoho protsesu tа hniino-zapalnykh zakhvoriuvan stafilokokkovoi еtiolohii [Development of the composition and technology of an antiseptic ointment for the treatment of the wound process and purulent-inflammatory diseases of staphylococcal etiology]. Modern achievements and prospects for the development of apitherapy in Ukraine. Proceedings of the All-Ukrainian scientific-practical conference (pp. 16-19). Kharkiv: NFAU. [in Ukrainian].

Abrantes, C. G., Duarte, D., & Reis, C. P. (2016). An Overview of Pharmaceutical Excipients: Safe or Not Safe?. Journal of pharmaceutical sciences, 105(7), 2019-2026. https://doi.org/10.1016/j.xphs.2016.03.019

Martemyanov, V. V. (2009). Zastosuvannia servetok z іmmobilizovannym metalokompleksom Cu2+ dlia likuvannia hniinykh ran miakykh tkanyn : avtoref. dys… kand. med. nauk [Application of surgical drapes with immobilizing metal complex Cu2+ for treatment of purulent wounds of soft tissues]. Dnepropetrovsk State Medical Academy, Dnepropetrovsk. [in Ukrainian].

Popadyuk, О. Ya. (2015). Perspektyvy zastosuvannia nanooksydu tsynku v likuvanni hniynykh ran [Prospects of zinc nano oxide application in the treatment of purulent wounds]. Medychni perspektyvy, 20(1), 10-14. [in Ukrainian].

Muzzarelli, R. A. A. (2009). Chitin and chitosans for the repair of wounded skin, nerve, cartilage and bone. Carbohydrate Polymers, 76(2), 167-182. https://doi.org/10.1016/j.carbpol.2008.11.002

Percev, І. M., Ruban, О. А., Dacenko, B. М., & Tamm, Т. І. (2013). Biofarmatsevtychnyi klaster pry stvorenni likiv. Povidomlennia II. Biofarmatsevtychni doslidzhennia, yikh rezultatyvnist ta vplyv na podalshyi rozvytok farmatsevtychnykh tekhnolohii [Biopharmaceutical cluster in developing of drugs. Part II. Analysis of results of biopharmaceutical research and its influence on the further development of pharmaceutical technology]. Farmatsevtychnyi zhurnal, (2), 44-51. [in Ukrainian].

Published

2022-10-22

How to Cite

1.
Shmatenko OP, Davtian LL, Prykhodko TV, Kuchmistova OF, Tarasenko VО, Коziko NO, Voronenko DV, Osodlo VV. Current aspects of the wound process treatment using dressings (bandages). Zaporozhye medical journal [Internet]. 2022Oct.22 [cited 2024Apr.23];24(5):599-606. Available from: http://zmj.zsmu.edu.ua/article/view/252474

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Section

Review