Abstract. Understanding the mechanisms of reparative processes is one of the most topical scientific and practical challenges in modern medicine. Issues related to wound healing, scar formation, and the development of phlegmons attract significant interest among medical professionals. Unfortunately, modern medicine often cannot avoid the use of opioids for therapeutic purposes. To successfully manage and adjust the reparative process during opioid therapy, it is essential to understand the morphological characteristics of skin remodeling during wound healing influenced by opioid exposure. The aim of the study was to determine the features of the microstructural organization and the blood vessel network of the skin during the dynamics of the reparative process under prolonged administration of Nalbuphine in an experimental setting.

Methods. The study material consisted of histological sections of the skin in the area of multiple puncture wounds from 32 white male rats of reproductive age. The following research methods were employed: histological analysis, morphometry of the hemomicrocirculatory system components of the white rat’s skin, statistical processing of the results using computer-based application software, and modeling of the prolonged influence of an opioid on the white rat’s body.

Results. Reparative processes in the skin of both control and experimental animals were primarily associated with the remodeling of the architecture of blood vessels. The reparative processes of multiple post-injection wounds in the control animals exhibited all the characteristic phases of the wound healing process. Some wound defects showed pronounced inflammatory infiltration and vascular reactions. Intense proliferation, angiogenesis, swollen vessels, leukocyte and macrophage infiltration of the skin tissues were observed, along with numerous fibroblasts. In some wound defects, inflammatory infiltration was significantly reduced, and signs of a productive response were observed, with proliferative fibroblasts predominating in the infiltrate. Most wound defects were fully closed, with the regenerate being complete, as evidenced by the presence of hair follicles, sweat glands, and sebaceous glands. The administration of Nalbuphine for two weeks had minimal impact on the reparative processes in the rat’s skin. However, after four weeks of Nalbuphine administration, wound healing processes slowed down and were occasionally complicated by the formation of microabscesses.

After six weeks of opioid exposure, wound defects in the inflammatory phase exhibited edema, infiltration by leukocytes and macrophages, swollen vessels, and venous thrombosis. In defects within the proliferation phase, the epidermis thickened, and the fibrous network of the connective tissue became denser. The regenerated epidermis showed signs of hyperkeratosis, perinuclear edema of basal and spinous keratinocytes. In some wound defects, inflammatory processes intensified, with excessive migration of neutrophilic granulocytes, lymphocytes, and macrophages. Hair follicles were reduced, and the number of sebaceous glands decreased.

Conclusions. Reparative processes in the skin of both control and experimental animals were primarily associated with the remodeling of the architecture of blood vessels. The reparative processes of multiple post-injection wounds in the control animals exhibited all the characteristic phases of the wound healing process. The administration of Nalbuphine for two weeks had minimal impact on the reparative processes in the rat’s skin. However, after four weeks of Nalbuphine administration, wound healing slowed and was occasionally complicated by the formation of microabscesses. Following six weeks of opioid administration, profound destructive changes in the skin were observed, which ultimately prevented the formation of a fully functional regenerate in multiple post-injection wounds.

Ключові слова: skin, wound, microstructure, Nalbuphine, experiment

Повний текст: PDF (Ukr)

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