Comprehensive treatment of gunshot wounds using vacuum therapy and technomolecular silver preparations

Abstract

Introduction. Burn wounds from the moment of their occurrence are primarily infected, and are accompanied by a violation of microcirculation, which contributes to the formation of massive necrosis of soft tissues, and leads to the delayed healing of such wounds. The speed of wound healing depends on a number of factors, not least of which is local treatment. An effective solution to this problem is the use of vacuum therapy (Vacuum Assisted Closure), which in combination with technomolecular silver preparations improves the course of all phases of the wound process, promotes active drainage of the wound, which reduces the level of microbial contamination of the wound, reduces local swelling of tissues, activates local blood circulation, which promotes faster healing of wounds. The aim of the study. To improve the results of treatment of patients with gunshot wounds of soft tissues, using vacuum therapy and technomolecular silver preparations. Materials and methods. In 2022, there were 35 patients with gunshot wounds of soft tissues of various degrees of complexity undergoing inpatient treatment in the surgical and trauma departments of the Uzhhorod City Multidisciplinary Hospital. Patients were divided into two groups. The first group, the control group, included 18 patients who were treated with VAC therapy and water-based antiseptics in the complex treatment of wounds after dismantling the VAC therapy device. In the second, main group of patients, the complex of wound healing measures included VAC therapy and the use of technomolecular silver preparations in the form of a spray, which was applied to the wound once a day, after dismantling the VAC therapy device. Research results . The use of VAC-therapy accelerates the time of wound cleaning, and the use of technomolecular silver preparations promotes the active growth of granulations in significant wound defects, and active marginal epithelization on the surface where the granulations filled the defect. After dismantling the VAC-therapy device, the bacterial landscape of wounds decreased in almost all patients compared to the beginning of treatment. Also, preparations of technomolecular silver were applied for a long time to wounds in which autodermoplasty was performed, which contributed to good engraftment of transplanted skin flaps and faster healing of wounds. The duration of inpatient treatment of patients in the control group was 23.5±2.3 days, and in the main one – 19.4±2.1 days, which is 1.2 times faster than in the control group of patients. Conclusion. The use of the vacuum therapy method in the complex treatment of gunshot wounds, in combination with technomolecular silver preparations, helps to quickly clean the wound from necrotic tissues, activates the growth of granulations, and promotes good engraftment of transplanted skin flaps, which in general contributes to faster healing of wounds, and accordingly shortens the duration of an inpatient treatment.