«AGGRESSIVE» MECHANICAL ANTISEPTIC IN COMPLEX TREATMENT OF WOUND INFECTION

Summary. Introduction. Wound infection is currently becoming an even more actual problem. Treatment of wound infection remains a difficult task. The introduction of NPWT has contributed to significant progress in the treatment of this pathology. But there are not always conditions for this. The method has a number of contraindications. The goal is to optimize the method of complex treatment of infected wounds by regular implementation of “aggressive” measures of mechanical antiseptics. Materials and methods. 28 patients with purulent and necrotic forms of wound infection who did not have the conditions for placement of the VAK system were examined. Dressings were performed daily, starting with a soapy bath (10% soapy solution at a temperature of 35-37oC), which lasted 8-15 minutes. Then staged debridement was performed. The wound and the area of skin around the wound were washed with a sterile foam sponge. Curettage of the wound surface was performed. Remains of dead tissue, fibrin, and detritus were removed using a Volkmann spoon. The course of the wound process was evaluated based on the dynamics of cleaning the wound from dead tissues, fibrin and pus, the appearance of granulations, regression of pain and tissue swelling around the wound, the dynamics of protein concentration in the wound exudate, and the dynamics of body temperature. Results and their discussion. With active tactics, the first granulations appeared a day and a half earlier, the wound was cleaned of dead tissues, pus and fibrin. An average of 1.3 days passed between the appearance of granulations and wound cleansing in patients of the main group. Among patients in the control group, the “transitional” period lasted 1.6 days. Faster appearance of granulations and cleaning of the wound contributed to an earlier start of epithelization. Active tactics ensured a faster decrease in the concentration of protein in the exudate. At the end of the first week, the concentration of protein in the exudate in patients of the main group (28.1±1.7) g/l was significantly (p<0.01) lower than in the control group (37.3±1.3). When using active tactics, normalization of body temperature occurred one day earlier (p<0.05). Conclusion. Active tactics ensure a more favorable course of the wound process: faster cessation of destructive processes and earlier initiation of regeneration processes.