Flow Sorption Debridement of Aseptic and Purulent Soft Tissue Wounds

Abstract

Background: Treatment of isolated and combined open soft tissue wounds remains relevant due to the growth of severe injuries, comorbid pathologies, and immunosuppressive conditions, along with a decrease in antibiotic sensitivity of microorganisms. The aim of this study was to compare the effectiveness of the jet oxygen-sorption treatment (JOST) and flow sorption debridement techniques (FSDT) in the therapy of experimental soft tissue wounds. Methods and Results: The effectiveness of the JOST and FSDT was compared in 2 series of experiments on 288 laboratory Wistar rats with simulated soft tissue wounds. Series 1 (S1) involved 144 animals divided into 2 control groups (CG) and 2 experimental groups (EG); the effectiveness of the developed techniques for the aseptic wound treatment was studied in these groups of animals. Series 2 (S2) involved 144 animals divided into 2 CGs and 2 EGs; in S2, purulent soft tissue wounds were studied. The effectiveness of the developed techniques in the complex treatment of experimental wounds was assessed immediately, on Days 1, 3, 5, 7 and 10 after simulating the pathological process. The assessment included the animals’ condition, the dynamics of the course of reparative processes (local symptoms of inflammation; granulation; epithelialization of wounds; and size and dynamics of the area of the defect), and histological research methods. The use of the JOST has practically no benefits in aseptic wound treatment, compared to FSDT. The use of the JOST and FSDT contributed to a significant acceleration of healing process in aseptic wounds that was expressed in the decreased local inflammatory reactions, higher activity of metabolic processes based on the dynamics of RNA and SH-groups. The most pronounced positive dynamics in the treatment of purulent wounds was observed when applying FSDT. Compared with the findings obtained in CG1-S2, FSDT contributed to a reduction in necrolysis termination by 25.7%, fibrinolysis - by 25.5%, granulation - by 20.0%, epithelization - by 18.9%, wound discharge - by 27.8%. Conclusion: The developed technique of FSDT in the complex treatment of soft tissue wounds provides the most pronounced positive dynamics, accelerates reparative tissue processes, and reduces the duration of wound cleansing and healing for both aseptic and purulent wounds.