Metabolic Effects of Electromagnetiс EHF Radiation and Ozone
Therapy in the Engraftment of the Skin Flap
ANDREW K. MARTUSEVICH1*, IRINA E. SAZONOVA1, ANNA G. SOLOVEVA1,
ALEXANDRA S. FEDOTOVA1, LIDA K. KOVALEVA2
1Privolzhsky Research Medical University,
Nizhny Novgorod, 603005,
RUSSIA
2Kuban State Medical University,
Krasnodar, 350063,
RUSSIA
*Corresponding Author
Abstract: - The aim of this study was to evaluate the effect of ROS on the intensity of oxidative and energy
metabolism in the blood of rats with an operational model of ischemia of the dorsal skin flap in vivo. Our
studies have allowed us to establish that the modeling of an extensive skin defect is accompanied by
pronounced shifts in oxidative metabolism in the blood plasma of animals. At the same time, in the absence of
pathogenetic treatment, signs of oxidative stress are formed, including the intensification of free radical
processes and the inhibition of general antioxidant activity in combination with the accumulation of an
increased amount of lipoperoxidation products (in particular, malondialdehyde). Conducting experimental
therapy with the introduction of ozone or treatment with electromagnetic radiation of the EHF band allows
partially compensating for these metabolic disorders, however, the most optimal option is a combination of
these factors within a single scheme. It should be noted that the results obtained are of great applied importance
for the creation of innovative technologies for the complex medical rehabilitation of orthopedic-traumatological
patients as a tool for influencing reparative processes in the lesion to restore and maintain tissue structures.
Key-Words: - reactive oxygen species, wound, skin flap, ozone therapy, EMR therapy, metabolism.
Received: February 2, 2023. Revised: May 19, 2023. Accepted: June 18, 2023. Published: July 19, 2023.
1 Introduction
Despite significant achievements in the field of
tissue engineering, cellular technologies, and
regenerative medicine, the problem of adequate
restoration of full-fledged skin in case of injury
remains relevant. Therefore, it is expedient to search
for and evaluate the effectiveness of new methods
for stimulating reparative skin regeneration, [1], [2].
Taking into account the fact that one of the most
significant mechanisms of post-traumatic tissue
damage is oxidative stress, [2], [3], [4], [5], [6],
which develops as a result of excessive activation of
free radical processes, impaired functioning of
antioxidant defense systems, for the treatment of
ischemia that occurs during the formation of a
dorsal skin flap, it is advisable to use a regulator of
the state of pro- and antioxidant systems, which can
be reactive oxygen species (ROS), including ozone,
[7], [8], [9].
The sanogenetic significance of ozone in
medicine is associated with its high redox potential,
which accompanies antibacterial,
immunomodulatory, anti-inflammatory, antiviral,
cytostatic, analgesic, and antihypoxic effects, and
also promotes oxidative detoxification of the body,
[9], [10]. The biological effects of ozone depend on
its concentration and the presence of target enzymes
in the cell. At elevated concentrations, ozone
reduces the body's resistance to bacterial infections,
quickly oxidizes many amino acids, and inactivates
antioxidant enzymes, thereby disrupting the course
of many biochemical processes. In small doses,
ozone is used to stimulate repair and regeneration,
ensure rapid wound healing, and activate the
immune response, [2], [11], and in large doses, to
fight pathogens, [12].
However, in the literature, there is still no
convincing data on the complete safety of the use of
ozone, which encourages further research work.
Until now, the final idea of the pathways and
physicochemical aspects of the action of ROS has
not been formed, [6]. In this regard, it is relevant to
WSEAS TRANSACTIONS on ENVIRONMENT and DEVELOPMENT
DOI: 10.37394/232015.2023.19.66
Andrew K. Martusevich, Irina E. Sazonova,
Anna G. Soloveva, Alexandra S. Fedotova,
Lida K. Kovaleva
E-ISSN: 2224-3496
686
Volume 19, 2023
identify all kinds of “points of application” of ROS
in living biological systems, including the influence
of these factors on the body at the molecular,
cellular, and systemic levels, [13], [14]. Therefore, it
is important to study the mechanisms of action of
ROS on the functional state of the pro- and
antioxidant systems of the body, and the activity of
oxidoreductases under conditions of experimental
oxidative stress in vivo.
An additional causative agent that causes the
formation of ROS is physical effects. One of these
organizations represents electromagnetic attacks that
induce free radical processes in biological objects.
Therefore, this agent also has pro-regenerative
properties, but no such data are currently available.
In addition, the effects of a sanogenic combined
source of ROS (including medical ozone) and the
reflection of the consequences are not fully applied.
This study aimed to evaluate the effect of ROS on
the intensity of oxidative and energy metabolism in
the blood of rats with an operational model of
ischemia of the dorsal skin flap in vivo.
2 Materials and Methods
In the experiment, 25 male rats of the Wistar line
weighing 250-300 g were used, obtained from the
Stolbovaya branch of the Federal Center of
Biomedical Research (Moscow). All animals were
kept in standard vivarium conditions in cages with
free access to food and water on the diet. Working
conditions with rats corresponded to the rules of the
European Convention ET/S 129, 1986, and
Directives 86/609 ESC, [15]. The animals were
divided into 5 groups: group 1 intact (healthy rats,
n=5), group 2 control operated animals without
any effects (n=5), and Group 3 - experimental
operated animals with ROS treatment in the
postoperative period (n=5). Animals of the fourth
(experimental) group (n=5) were irradiated daily
(once a day for seven days) with a modified device
"Amphit-0,2/10-01", [16], [17], with a noise
frequency range (53-78 GHz). During the session,
the animals received a dose of EMI of 0.12 MJ (in
accordance with the 10-minute exposure exposure).
The area of the base of the ischemic flap was
exposed to contact radiation. Rats of the fifth group
(n=5) received combined exposure to EMR
radiation and ozone therapy procedures.
In the intact group, no manipulations were
performed during the study. In rats of the
experimental and control groups on the depilated
back under
intramuscular anesthesia (Zoletil 60 mg/kg +
Xyl 6 mg/kg) was used to cut out a 3×10 cm skin
flap on a feeding leg with an axial type of blood
circulation, including the skin and its skin muscle
with a base on a horizontal line connecting the
corners of the shoulder blades, [17]. Then the flap
was placed in place without tension and sewn with
nodular seams with atraumatic suture material 4.0
(Fig. 1). This led to the occurrence of acute
circulatory disorders, which made it possible to use
this model to study both the positive and negative
effects of ROS on the "survival" of the flap. The
maintenance of animals after surgery was solitary.
In the postoperative period, the animals of the
experimental group received daily treatment with
ROS for 14 days. Animals of the third group were
treated daily with Levoxime gel (in the morning)
and ozone cream (in the evening) with an ozonide
content of at least 1500 mg O2/kg (Medozons LLC,
Nizhny Novgorod), 1 ml of 0.9% NaCl solution
with a saturating concentration of ozone in the
oxygen-ozone mixture from the Medozons ozonator
was injected intraperitoneally.-Systems 3000 mcg
/ l and a dose of O3 0.6 mcg per animal. The
concentration of O3 in saline solution was
determined using an ozone analyzer in liquid media
IKOZH-5 (certificate of conformity RU.C. 31.001.A
No. 29545-05, Kirov). As part of the gel, Levoxime
is the main ingredient (by weight) Xymedone (8%)
is a pyrimidine drug. In addition, the gel contains
levomycetin succinate (2%), as well as fillers.
Xymedone (1--hydroxyethyl)-4,6-dimethyl-1,2-
dihydro-2-oxopyrimidine), has proven itself well in
the treatment of purulent and burn wounds of soft
tissues due to its high antioxidant, reparative, anti-
inflammatory, antibacterial activity with minimal
toxicity and hypoallergenic, [18].
Rats were taken out of the experiment on the
14th day after surgery by decapitation with the
preliminary cutting of the carotid artery under
combined anesthesia (Zoletil (60 mg/kg) + Xyl (6
mg/kg)). The blood was stabilized with sodium
citrate (1:9). Plasma and erythrocytes washed twice
in saline solution by centrifugation for 10 min at
1600 g on a CM-6 centrifuge were used for
research. In plasma and suspended erythrocytes in
saline solution (1:4), the activity of free radical
oxidation (SRO) processes was studied using the
method of induced biochemiluminescence, [2], [3],
[7], on the biohemiluminometer BHL-06
(N.Novgorod). The following parameters were
evaluated: tg an indicator that characterizes the
rate of decline of SRO processes in plasma and
indicates total antioxidant activity (AOA); S
chemiluminescence light sum for 30 seconds.
reflects the potential ability of a biological object to
lipid peroxidation (LPO); EPR erythrocytes
peroxide resistance, characterizes the degree of
WSEAS TRANSACTIONS on ENVIRONMENT and DEVELOPMENT
DOI: 10.37394/232015.2023.19.66
Andrew K. Martusevich, Irina E. Sazonova,
Anna G. Soloveva, Alexandra S. Fedotova,
Lida K. Kovaleva
E-ISSN: 2224-3496
687
Volume 19, 2023
severity of LPO in erythrocytes. To assess the
intensity of LPO, the level of the secondary product
of free radical oxidation malonic dialdehyde
(MDA) in plasma and erythrocyte hemolysate was
determined (1:10), [19].
Among the enzymes representing the first link
of the antioxidant defense system, the activity of
superoxide dismutase (SOD), which converts the
superoxide radical into the electroneutral form of
H2O2, and catalase, which recycles peroxide, were
analyzed. The activity of SOD was determined in
the hemolysate of washed erythrocytes (1:10) by
inhibiting the formation of the product of
autoxidation of adrenaline, [20]. To assess catalase
activity in erythrocyte hemolysate (1:100), a
spectrophotometric method was used based on
determining the rate of decomposition of H2O2 by
catalase of the test sample with the formation of
water and oxygen, [21].
The research results were processed according
to the Statistica 6.0 program, with the help of which
the arithmetic mean of the indicators and the error
of the average were calculated. The significance of
the differences between the indicators was
determined using the student’s t-test. Differences at
p<0.05 were considered statistically significant.
3 Results and Discussion
It was found that in rats with skin flap modeling
with basic local treatment, there is a moderate but
statistically significant increase in the intensity of
free radical processes (p<0.05; Fig. 1). This creates
prerequisites for the development of secondary
oxidative damage to cells and tissues that occurs in
response to the presence of an extensive defect of
the skin.
Fig. 1: The intensity of lipoperoxidation in rat blood
plasma under various influences (EMR
electromagnetic radiation of the EHF band, OT -
ozone therapy, EMR+OT a combination of EHF
therapy and ozone therapy; "*" - the statistical
significance of differences relative to intact rats
p<0.05)
It was revealed that different variants of the
applied experimental therapy have an unequal effect
on the intensity of lipid peroxidation. Thus, the use
of EHF radiation significantly reduces the parameter
under consideration (by 11.3% relative to the level
characteristic of intact animals; p<0.05). At the
same time, ozone therapy and combined exposure
retain the value of the indicator at the physiological
level, but the latter option is statistically
significantly lower than rats who received only
basic treatment (by 14.4%; p<0.05).
The second component of the analysis was the
total antioxidant activity of animal blood plasma
(Fig. 2). It was found that in the control group of
rats, this parameter was reduced by 9.8% relative to
healthy animals (p<0.05). Together with a
significant increase in intensive lipoperoxidation in
operated rats, this indicates the presence of
oxidative stress in them, which needs pathogenetic
correction. The possibilities of three experimental
therapy options were studied in the framework of
the study.
Fig. 2: Total antioxidant activity of rat blood plasma
under various influences (EMR electromagnetic
radiation of the EHF band, OT - ozone therapy,
EMR+OT a combination of EHF therapy and
ozone therapy; "*" statistical significance of
differences relative to intact rats p<0.05)
It was shown that all the tested factors
contributed to an increase in the antioxidant activity
of the biological fluid, and the isolated use of ozone
therapy and electromagnetic radiation provided an
increase in the level of indicators approximately
equally compared with intact animals (+13.3% and
+ 17.7% for these factors, respectively; p<0.05 for
both cases). Interestingly, their combination made it
possible to achieve a cooperative effect, which was
manifested in an increase in the antioxidant
potential of blood plasma by 44.2% relative to
healthy rats (p<0.05). Taking into account the fact
that no increase in the intensity of lipoperoxidation
WSEAS TRANSACTIONS on ENVIRONMENT and DEVELOPMENT
DOI: 10.37394/232015.2023.19.66
Andrew K. Martusevich, Irina E. Sazonova,
Anna G. Soloveva, Alexandra S. Fedotova,
Lida K. Kovaleva
E-ISSN: 2224-3496
688
Volume 19, 2023
was recorded in this mode, it can be argued that it
makes it possible to realize the most complete
antioxidant effect.
We also assessed shifts in the concentration of
the secondary product of lipoperoxidation
malondialdehyde in the blood plasma of rats of the
formed groups (Fig. 3). It was found that only in
operated animals receiving exclusively basic
treatment, there was an increase in this indicator
compared to the level characteristic of healthy rats
(+10.1%; p<0.05). In the remaining groups, a
decrease in the concentration of the metabolite in
question relative to intact values was observed, most
pronounced with combined exposure (-43.1%;
p<0.05), which fully corresponds to the dynamics of
the intensity of free radical processes and the
antioxidant potential of the biological fluid.
Therefore, such an option, including simultaneous
courses of EHF therapy and ozone therapy, provides
the maximum antioxidant systemic effect.
Fig. 3. Concentration of malondialdehyde in rat
blood plasma under various influences (EMR
electromagnetic radiation of the EHF band, OT -
ozone therapy, EMR+OT a combination of EHF
therapy and ozone therapy; "*" the statistical
significance of differences relative to intact rats
p<0.05)
This indicates that there is no psychogenic
influence on the result of evaluating the
effectiveness of the considered technology of
individualized metabolic correction based on the
parameters of crystallogenic activity of blood
serum, which characterize both mineral and organic
components of the latter.
In general, the results obtained indicate that all
the studied options for exposure (isolated
application of electromagnetic fields, ozone therapy,
and their combinations) have a modulating effect on
free radical processes in the blood and tissues of
animals. Under the conditions of modeling an
engrafting skin flap, oxidative stress develops in the
blood of animals, which is characterized by the
intensification of lipid peroxidation and inhibition of
the antioxidant potential. According to the results
obtained in this study, wound treatment with both
electromagnetic radiation and the use of ozonized
creams contributes to partial relief of laboratory
signs of oxidative stress. At the same time, if for
ozone therapy this fact was known earlier, which
was shown, in particular, in our previous
publications, [2], then for electromagnetic radiation
in the literature there is only evidence of a pro-
regenerative effect in relation to bone and cartilage
tissue, [22], [23], [24], [25]. In this regard, the data
obtained indicate the feasibility of the combined use
of the studied physicochemical agents.
4 Conclusion
Our studies have allowed us to establish that the
modeling of an extensive skin defect is
accompanied by pronounced shifts in oxidative
metabolism in the blood plasma of animals. At the
same time, in the absence of pathogenetic treatment,
signs of oxidative stress are formed, including the
intensification of free radical processes and the
inhibition of general antioxidant activity in
combination with the accumulation of an increased
amount of lipoperoxidation products (in particular,
malondialdehyde).
Conducting experimental therapy with the
introduction of ozone or treatment with
electromagnetic radiation of the EHF band allows
partially compensating for these metabolic
disorders, however, the most optimal option is a
combination of these factors within a single scheme.
It should be noted that the results obtained are of
great applied importance for the creation of
innovative technologies for the complex medical
rehabilitation of orthopedic-traumatological patients
as a tool for influencing reparative processes in the
lesion to restore and maintain tissue structures.
References:
[1] I. B. Glubokova, L.T. Valova, A.V. Kolsanov,
The effectiveness of ointment compositions
and collagenobutol coatings in the treatment
of infected wounds, Experimental and clinical
dermatocosmetology, No. 1, 2005, pp. 27-33.
[2] A. K. Martusevich, A.A. Struchkov, V.V.
Nazarov, A.S. Fedotova, M.Y. Artamonov,
S.P. Peretyagin, Estimation of effectiveness of
local reactive oxygen species for stimulation
of regenerative processes in experimental
burn wound, Applied Sciences, Vol. 12, 2022,
7638.
WSEAS TRANSACTIONS on ENVIRONMENT and DEVELOPMENT
DOI: 10.37394/232015.2023.19.66
Andrew K. Martusevich, Irina E. Sazonova,
Anna G. Soloveva, Alexandra S. Fedotova,
Lida K. Kovaleva
E-ISSN: 2224-3496
689
Volume 19, 2023
[3] A. V. Vorobyov, A.K. Martusevich, A.G.
Solovyova, A.M. Razmakhov, A.S. Luzan,
A.D. Dmitriev, Physical and Biochemical
Characteristics of Biological Fluids in Rats
with Modeled Thermal Injury, Bulletin of
Experimental Biology and Medicine, Vol.
147, No. 4, 2009, pp. 424-426.
[4] E.B. Menshchikova, V.Z. Lankin, N.K.
Zenkov, I.A. Bondar, N.F. Krugovykh, V.A.
Trufakin, Oxidative stress. Prooxidants and
antioxidants, M.: "Slovo", 2006.
[5] I.I. Pavlyuchenko, E.I. Remenyakina, Yu.S.
Panasenkova, I.V. Vashtak, The feasibility of
monitoring lipid peroxidation to assess the
effectiveness of therapeutic programs in a
sanatorium, Fundamental research, No. 7,
2012, pp. 151154.
[6] N.P. Chesnokova, E.V. Ponukalina, M.N.
Bizenkova, General characteristics of sources
of formation of free radicals and antioxidant
systems, The successes of modern natural
science, No. 7, 2006, pp. 37-41.
[7] A.A. Martusevich, A.G. Solovieva, A.K.
Martusevich, Influence of singlet oxygen
inhalation on the state of blood pro- and
antioxidant systems and energy metabolism,
Bulletin of Experimental Biology and
Medicine, Vol. 156, No. 1, 2013, pp. 41-43.
[8] R.R. Iskhakova, F.R. Sayfullina, Ozone
therapy in ophthalmology, Kazan Medical
Journal, Vol. 94, No. 4, 2013, pp. 510-516.
[9] J. Parva, P. Gunjan, Y. Priti, Ozone therapy:
the alter-native medicine of future, Rev. Art.
Pharm. Sci., Vol. 2, No. 4, 2012, pp. 196-203.
[10] J. Zeng, J. Lu, Mechanisms of action involved
in ozone-therapy in skin diseases,
International immunopharmacology, Vol. 56,
2018, pp. 235-241.
[11] M.N. Mandhare, D.M. Jagdale, P.L. Gaikwad,
Miracle of ozone therapy as an alternative
medicine, Int. J. Pharm. Chem. Biol. Sci., Vol.
2, No. 1, 2012, pp. 6371.
[12] V. Seidler, I. Linetskiy, H. Hubalkova, Ozone
and its usage in general medicine and
dentistry. A review article, Prague Med.
Report, Vol. 109, No. 1, 2008, pp. 513.
[13] A.W. Linnane, H. Eastwood, Cellular redox
regulation and prooxidant signaling systems: a
new perspective on the free radical theory of
aging, Ann N Y Acad Sci, Vol. 1067, 2006, pp.
47-55.
[14] T.P. Cash, Y. Pan, M.C. Simon, Reactive
oxygen species and cellular oxygen sensing,
Free radical biology & medicine, Vol. 43, No.
9, 2007, pp. 1219-1225.
[15] N.N. Karkishchenko, S.V. Grachev,
Guidelines on laboratory animals and
alternative models in biomedical research,
M.: Profile, 2010.
[16] V.N. Krylov, L.V. Oshevenskiy, The effect of
EHF exposureon isolated smooth muscle
tissue of rat intestines, Millimeter waves in
biology and medicine, No. 2, 2000, pp. 11-14.
[17] A.G. Polyakova, A.G. Solovyova, I.E.
Sazonova, D.V. Zakharova, Influence of
electromagnetic radiation of extremely high
frequencies on the pro- and antioxidant status
of blood in the experiment, Biophysics, Vol.
61, No. 1, 2016, pp. 131-137.
[18] S.G. Izmailov, V.V. Parshikov, Xymedon:
present and future, N.Novgorod: NGMA,
2002.
[19] M. Mihara, M. Uchiyama, Determination of
malonaldehyde precursor in tissues by
thiobarbituric acid test, Anal Biochem., Vol.
86, No. 1, 1978, pp. 271-278.
[20] T.V. Sirota, A new approach to the study of
the process of autoxidation of adrenaline and
its use to measure the activity of superoxide
dismutase, Questions of medical chemistry,
Vol. 45, No. 3, 1999, pp. 109116.
[21] G.V. Sibgatullina, L.R. Khaertdinova, E.A.
Gumerova, Methods for determining the
redox status of cultured plant cells, Kazan:
Kazan (Volga Region) Federal University,
2011.
[22] T. Pesqueira, R. Costa-Almeida, M.E. Gomes,
Magnetotherapy: The quest for tendon
regeneration, J Cell Physiol., Vol. 233, No.10,
2018, pp.6395-6405.
[23] C. do Nascimento, J.P. Issa, A.S. Mello, R.F.
de Albuquerque Junior, Effect of
electromagnetic field on bone regeneration
around dental implants after immediate
placement in the dog mandible: a pilot study,
Gerodontology, Vol. 29, No. 2, 2012, pp.
1249-1251.
[24] X.L. Griffin, M.L. Costa, N. Parsons, N.
Smith, Electromagnetic field stimulation for
treating delayed union or non-union of long
bone fractures in adults, Cochrane Database
Syst Rev., No. 4, 2011, CD008471.
[25] C.L. Ross, D.C. Ang, G. Almeida-Porada,
Targeting Mesenchymal Stromal
Cells/Pericytes (MSCs) With Pulsed
Electromagnetic Field (PEMF) Has the
Potential to Treat Rheumatoid Arthritis, Front
Immunol., No. 10, 2019, 266.
WSEAS TRANSACTIONS on ENVIRONMENT and DEVELOPMENT
DOI: 10.37394/232015.2023.19.66
Andrew K. Martusevich, Irina E. Sazonova,
Anna G. Soloveva, Alexandra S. Fedotova,
Lida K. Kovaleva
E-ISSN: 2224-3496
690
Volume 19, 2023
Contribution of Individual Authors to the
Creation of a Scientific Article (Ghostwriting
Policy)
-Andrew K. Martusevich: Conceptualization,
Formal analysis and Writing original draft.
-Irina E. Sazonova: Investigation, Formal analysis
and Writing original draft and Writing review &
editing.
-Anna G. Soloveva: Investigation, Formal analysis
and Writing original draft and Writing review &
editing.
-Alexandra S. Fedotova, Lida K. Kovaleva:
Investigation, Formal analysis and Writing
original draft & editing.
Sources of Funding for Research Presented in a
Scientific Article or Scientific Article Itself
This research work was supported by the Ministry
of Health of the Russian Federation.
Conflict of Interest
The authors have no conflicts of interest to declare.
Creative Commons Attribution License 4.0
(Attribution 4.0 International, CC BY 4.0)
This article is published under the terms of the
Creative Commons Attribution License 4.0
https://creativecommons.org/licenses/by/4.0/deed.en
_US
WSEAS TRANSACTIONS on ENVIRONMENT and DEVELOPMENT
DOI: 10.37394/232015.2023.19.66
Andrew K. Martusevich, Irina E. Sazonova,
Anna G. Soloveva, Alexandra S. Fedotova,
Lida K. Kovaleva
E-ISSN: 2224-3496
691
Volume 19, 2023