USING NITRIC OXIDE DONOR SOLUTION WITH VACUUM THERAPY IN THE TREATMENT OF PURULENT WOUNDS OF SOFT TISSUES

Abstract

In recent years, the incidence of purulent septic soft tissue diseases has decreased insufficiently. In order to improve the results of surgical treatment of purulent soft tissue processes, vacuum therapy with instillations of L-arginine, a nitric oxide donor solution, has been developed. This method is complementary to the complex surgical treatment: it accelerates wound cleaning, reduces microbial contamination, and causes a wound surface decreasing, promotes the development of tissue granulation and epithelisation processes. This article presents the clinical case of successful application of vacuum therapy with the nitric oxide donor (L-arginine) installation in a patient after the drainage of phlegmon in the right thigh. The patient underwent a course of vacuum instillation therapy, which consisted of three changes of sponge and tubes after their use for three days. After a course of local instillation vacuum therapy, the patient's condition became better. Starting from day 3, there was a decrease in the number of leukocytes and erythrocyte sedimentation rate in the general blood test and, accordingly, decreased leukocyte intoxication index, and on day 4 there was no hyperaemia and oedema. When opening the phlegmon from the wound infected by St. aureus, and during vacuum instillation therapy with a solution of donor nitric oxide microbial decontamination the results of intermediate cultures were not observed. The wound was completely cleaned, filled with pale pink granulations, which allowed for 10 days to put secondary sutures on the wound, which were removed on the 7th day in the ambulatory after complete healing of the wound.