Local Wound Treatment Research Articles

Local Treatment of Wound Infections: A Review of Clinical Trials from 2013 to 2024.

Significance: Management of infection is a critical aspect of wound care. It involves the application of various interventions to treat the wound and prevent the infection from spreading to other parts of the body, which may lead to serious complications, including sepsis. Local treatment of skin wound infections is the favored route of administration, reducing the risk of adverse systemic effects while providing very high therapeutic concentrations at the target site. The purpose of this article was to review clinical trials from 2013 and onward, focusing on local treatment of acute wounds and burns as well as chronic wounds as their primary outcome measurement. Recent Advances: Based on our literature search, 49 clinical trials were focusing on treating infected chronic wounds, and 6 trials studied infection as their primary outcome in acute wounds during the last 10 years. Critical Issues: Currently commercially available local treatments do not prevent the onset of invasive infection. Therefore, there is a need for more effective local therapies. Future Directions: Despite multiple preclinical studies introducing novel and promising strategies in terms of novel antimicrobial agents and delivery methods to prevent and treat skin wound infections locally, many have yet to be tested in a clinical setting. These preclinically tested approaches could still be valuable additions to today's care of infected skin wounds.

FRAGMENTED THIGH INJURY: TREATMENT WITH PREBIOTICS, NANOPARTICLES, AND CELL THERAPY

The purpose of this study was to investigate the possibility of staged local treatment of an infected mine-explosive wound using a gel containing Bacillus spp., cerium oxide nanoparticles, and cell therapy. Object and Methods. The article presents a clinical case demonstrating the effective staged treatment of a 57-year-old patient with a fragmentary fracture of the right femur and a large purulent wound of the right thigh. The patient underwent Ex-fix rod-type femur-tibia stabilization and resection of a post-traumatic aneurysm of the right superficial femoral artery. In the first stage of treatment, two sessions of negative pressure wound therapy (NPWT) were applied, with pressures ranging from 75-115 mm Hg and a session duration of 4-5 days. In the second stage, local treatment involved a combination of antiseptics and probiotics (Bacillus spp.) alongside cerium oxide nanoparticles. By the 7th day, the eradication of pathogenic microflora was achieved, allowing for the third stage of treatment—application of autologous mesenchymal stem cells. Results: The treatment of combat trauma has become increasingly relevant in Ukraine and globally due to its complexity and the rising proportion of multiple and combined injuries, which account for 25-60% of cases. Infectious complications occur in 25% of combat trauma cases and are responsible for 70% of related deaths. Most structural and functional disorders associated with wound infections develop at the time of injury, intensify over time, and require immediate surgical intervention, improvements in local treatment methods, and new approaches for wound closure. Conclusions: The use of a combination of probiotics and NPWT therapy led to a rapid reduction of the inflammatory process. Clinical observations showed accelerated wound cleansing from fibrin and necrotic tissue. The combined treatment significantly reduced the size and depth of wound due to the formation of active pink granulation tissue (observed by days 8-9) and marginal epithelialization by days 10-13. During this period, no pathogenic flora were detected, allowing for the subsequent application of autologous mesenchymal stem cells. This treatment approach reduced the need for antibacterial drugs and prevented the need for additional surgical interventions. The inclusion of cerium oxide nanoparticles was an effective enhancement for cell transplantation, facilitating stem cell delivery and contributing to the treatment of large wounds.

WOUND DRESSINGS FOR SORPTION THERAPY IN THE TREATMENT OF PURULENT WOUNDS: a review article

Surgical infections remain one of the most challenging and urgent issues in modern medicine, reaching a socio-ecological scale of significance nationwide. Despite advances in treating purulent wounds, the prevalence of patients with purulent surgical infections remains high. According to both domestic and international sources, surgical patients with purulent-inflammatory conditions comprise 35–45% of the total patient population in general surgery wards. In some cases, purulent infections become acute and can lead to the generalization of the purulent process, resulting in sepsis and even death. Mortality rates from acute surgical infections range from 19% to 70% within surgical hospitals. Additionally, there has been an increase in the transition of acute purulent processes to chronic stages, which prolongs the treatment duration for these patients. The prevention and treatment of surgical infections are therefore of paramount importance, representing one of the core challenges in surgical care. Optimal local treatment of purulent wounds requires adherence to essential principles, including active surgical intervention, antibiotic therapy throughout the wound healing stages, and local wound management under bandages. An analysis of the literature reveals that sorption-application therapy is gaining prominence in modern surgical practice for local wound management. This approach, which utilizes advanced interactive wound dressings with combined adsorption, osmotic, and necrolytic effects, has shown significant improvements in the effectiveness of purulent wound treatment.

Development of medicinal and cosmetic cream based on flavonoids

The article discusses the results of the development of a cream based on Populus balsamifera L. bud flavonoids, which have anti-inflammatory, skin-regenerating effects.A cream's anti-inflammatory and wound-healing activity based on a flavonoid substance has been studied. In an experiment on a model of an incised skin wound, it was determined that a cream based on the sum of flavonoids from balsam poplar buds, containing pinostrobin, pinocembrin, tectochrysin, exhibits anti-inflammatory and wound-healing activities. Considering that the effectiveness of local wound treatment mainly depends on the rational treatment of the first phase of the wound process, we have developed a 1 % flavonoid cream and its production technology.The technology for the production of flavonoid cream includes extraction and isolation of the sum of flavonoids from the raw material of Populus balsamifera L. buds, preparation of flavonoid substance and excipients, preparation of the cream base and cream, packaging and labelling of cream. Based on the results of our experiments, a pilot industrial regulation for the production of a new cream based on the sum of flavonoids of Populus balsamifera L. buds has been developed, and pilot production of an original medicinal and cosmetic cream was organised.

PROGRESS OF KNOWLEDGE IN THE DEVELOPMENT OF CHITOSAN FORMULATIONS WITH INSULIN TO PROMOTE SKIN WOUND HEALING

The treatment of difficult-to-heal wounds is a major problem in modern medicine. The search for new materials and ways to treat wounds is important and timely. Insulin stimulates proliferation, differentiation and migration of skin fibroblasts and keratinocytes. Chitosan has beneficial biological properties and can be an effective carrier of insulin. This review discusses research into the development of chitosan formulations with insulin to aid local treatment of chronic wounds. The PubMed, Google Scholar, Scopus and Web of Science databases were searched for studies on chitosan preparations with insulin in terms of their efficacy in wound healing. Twelve original English-language articles published in peer-reviewed scientific journals were included in the analysis. Insulin preparations in a chitosan matrix in the form of gel, hydrogel, injection and non-woven dressing are highly effective at all stages of the wound-healing process. They show anti-inflammatory and antimicrobial effects. Insulin from the formulations is released in a prolonged or controlled manner. However, it seems necessary to learn more about the mechanisms of insulin action within lesions. Of note, the data are mainly from basic and preclinical studies. Only one clinical study has been conducted.

Comparative clinical and laboratory evaluation of the effectiveness of a nanodispersed silica-based drug with antimicrobial properties for the local treatment of purulent inflammatory diseases of the maxillofacial area

Background. The problem of purulent inflammatory diseases of the maxillofacial area remains one of the most pressing problems of modern dentistry and maxillofacial surgery. The aim of the study is to conduct a comparative evaluation of the effectiveness of a drug based on nanodispersed silica (NDS) with antimicrobial properties for the local treatment of purulent inflammatory diseases of the maxillofacial area. Materials and methods. A comparative assessment of the postoperative period was performed in 71 patients with maxillofacial phlegmon, who were divided into two representative groups: comparison (39 patients), in whose local treatment of purulent wounds was carried out by conventional methods, and the main group (32 patients), where the local treatment was carried out using a drug based on NDC. The level of endogenous intoxication was determined by the level of C-reactive protein (CRP), by the level of blood metabolites of average mass (MAM) and leukocyte intoxication index (LII) in the blood serum. The data obtained were statistically processed and compared. Results. During the study of the dynamics of СRР was found that starting from 3 days in the main group there was a tendency to its faster decrease and normalization before discharge, while in patients of the comparison group it was significantly higher (p < 0.05)., The level of MAM in patients of the comparison group remained significantly (p < 0.05) elevated throughout the treatment in the postoperative period, while in the main group it was on the verge of normal before discharge. Comparison group of patients had significantly higher LII during treatment and at the time of discharge from hospital (p < 0.05) than the main group. Conclusions: The treatment of maxillofacial phlegmon by the developed method provided a more favorable course of the postoperative period than in the comparison group, as evidenced by a significantly (p < 0.05) faster normalization of endogenous intoxication blood parameters.

Local Treatment of Ischemic Skin Wounds Using a Unique Drug Mixture in Combination with Magnetic Therapy

Local Treatment of Ischemic Skin Wounds Using a Unique Drug Mixture in Combination with Magnetic Therapy

Study of microbiological activity of topical antibacterial agents for treatment of combat injuries

The problems of combat injuries are determined by the issue of treatment of purulent complications, because wounds received during combat operations are usually infected, and the most serious complication of such wounds is the development of purulent infection. Objective — to study the features of the aerobic component of combat wounds, the sensitivity of causative agents of wound infection to antibacterial drugs, and the antimicrobial activity of individual drugs in relation to extensively resistant and polyresistant microbial agents in order to develop external therapy algorithms as part of the complex treatment of these injuries. Materials and methods. The data of microbiological studies of patients with combat wounds were used in the work. Results and discussion. Based on the results of monitoring causative agents of purulent­inflammatory complications of wound injuries, a range of leading types of microorganisms was revealed. The isolation of flora resistant to most antibiotics from wounds dictates the need to change the strategy of infection control with strengthening measures to prevent nosocomial transmission, which should be considered when prescribing antibiotic therapy. Conclusions. Based on the results of monitoring the causative agents of purulent-inflammatory complications of wound injuries, a range of leading types of microorganisms was revealed: K. pneumoniae, E. faecalis, S. haemolyticus, P. aeruginosa, E. coli. The dominant microorganisms (by isolation frequency) in the wound contents were: staphylococci (3.0—5.69 lg CFU/ml), enterobacteria (4.69—7.0 lg CFU/ml), enterococci (3.0—4.69 lg CFU/ml). In addition, aerobic bacilli (3.0—3.69 lg CFU/g) and pseudomonads (5.69—7.0 lg CFU/g) were determined in the wound contents, which did not have a dominant character.The use of a topical agent containing dioxidin can contribute to the improvement of the effectiveness of the local treatment of purulent wounds infected with strains of gram-negative bacteria, in particular E. coli, K. pneumoniae and P. aeruginosa, with poly and extensive resistance to antibiotics both in monocultures and in microbial associations, in particular with strains of S. aureus, including MRSA.

M.O.I.S.T. Concept for the Local Therapy of Chronic Wounds: An International Update.

Chronic wounds remain a significant clinical challenge both for those affected and for healthcare systems. The treatment is often comprised and complex. All patients should receive wound care that is integrated into a holistic approach involving local management that addresses the underlying etiology and provides for gold standard therapy to support healing, avoid complications and be more cost effective. There have been significant advances in medicine over the last few decades. The development of new technologies and therapeutics for the local treatment of wounds is also constantly increasing. To help standardize clinical practice with regard to the multitude of wound products, the M.O.I.S.T. concept was developed by a multidisciplinary expert group. The M stands for moisture balance, O for oxygen balance, I for infection control, S for supporting strategies, and T for tissue management. Since the M.O.I.S.T. concept, which originated in the German-speaking countries, is now intended to provide healthcare professionals with an adapted instrument to be used in clinical practice, and a recent update to the concept has been undertaken by a group of interdisciplinary experts to align it with international standards. The M.O.I.S.T. concept can now be used internationally both as an educational tool and for the practical implementation of modern local treatment concepts for patients with chronic wounds and can also be used in routine clinical practice.

IJCM_413A: A cross sectional study to find out status of post exposure prophylaxis among animal bite cases in Raipur city Chhattisgarh.

Background: Rabies is a viral zoonosis that occurs in more than 100 countries and territories Although a number of carnivores and bat species serve as natural reservoirs, rabies in dogs is the source of 99% human infections and poses a potential threat to more than 3.3 billion people. In humans, rabies is highly fatal once clinical symptoms have developed. According to the World Health Organization, human rabies can be prevented completely by proper post exposure prophylaxis. In India alone, 20,000 deaths (i.e., about 2/100,000 population at risk) and 2 million bites, mostly by dogs, are estimated to occur annually. India has 36% global and 65% Asian rabies burden in terms of cases. Local treatment of wounds is of maximal value when applied immediately after exposure (within minutes if possible). Animal experiments have shown that local wound treatment can reduce the chances of developing rabies by up to 80%. Objectives: To find out the status of post exposure prophylaxis and associated factors among animal bite cases in Raipur city Chhattisgarh. Methodology: Type of study: A community based cross sectional survey Conducted at: Raipur District. Duration of study: Over a period of 3 months (November 2023- January 2024). Study Subjects: General Population. Inclusion criteria: General population, Raipur. Exclusion Criteria: 1) Patients who do not give consent. 2)Unconscious Very ill patients or patients with Mental illness. Results: Total of 1124 participants 41 had animal bite, 63.41% were males and 36.59% were females. Among the biting animals 83% were dogs, while cats were 15% and 2% were monkeys. Out of 41 cases 90.24% had Category II bite while 9.75% had Category III bite. 33 out of 41 i.e. 80.48% victims took Anti Rabies vaccine, while rest 19.52% preferred treatment from traditional healer. Conclusion: Majority of animal bite were of dog bite and were classified under Category II. Improved awareness, forestalling animal rabies, and better access to affordable and potent human rabies vaccines are essential for the elimination of human rabies.

Analysis of methods for modeling deep defects of the skin and articular cartilage on laboratory animals in the experiment

The creation and implementation of new methods and means of local treatment of wounds occurs in stages, however, a number of difficulties arise at each stage. The article discusses one of the main problems that arise at the preclinical stage when modeling deep defects of the skin and articular cartilage – the difficulty of accurately reproducing full-layer defects of the skin and articular tissue. Various factors influencing the success of such modeling also investigated, including the type of animal, the size of the defect and its location.

Effect of silver colloid dressing over conventional dressings in diabetic foot ulcer: A prospective study.

Topical silver treatments and silver dressings are increasingly being utilized for the local treatment of wounds; nevertheless, the evidence for their usefulness is unclear. The aim of this study was to investigate the impact of conventional dressings and silver colloid dressing on diabetic foot ulcers (DFU) with and without compression therapy. This prospective, double-blind experiment included 50 patients with non-ischemic DFUs, split into two groups of 25 patients each. The study was conducted for a period of six months. The primary endpoint was to evaluate the entire epithelialization (total healing) of all ulcers on the study leg. The ulcer area significantly decreased in the colloidal silver group (67.77 ± 17.82%) compared to the conventional saline group (21.70 ± 23.52%). When compared to the conventional group, the colloidal silver group required considerably fewer days to reach the endpoint (23.15 ± 8.15 days vs. 48.35 ± 18.07 days), and by day 14, ulcer area reduction (from 100%) was greater (48% in the silver group vs. 89.69% in the conventional group). In managing DFUs, unstructured hydrogel wound dressings using silver colloids based on ionic silver are more effective than regular saline dressings since they heal wounds more quickly in fewer days while also drastically reducing ulcer areas over time.

Physical-chemical and biopharmaceutical research of ointments with cyminal

Local wound treatment remains one of the most pressing problems of modern medicine. The effectiveness of local drug therapy with the use of various medications depends on the differentiated use of drugs depending on the phase of the wound process.
 Taking into account modern wound treatment technologies, it is important to develop the composition and technology of an application drug (cream, ointment, gel) taking into account not only the phase of the wound process, but also the Time-concept component, in particular the ability of the drug to create an optimal moist environment and have antimicrobial properties, since the absence of infection in the wound is the basis for successful healing.
 The aim of our study was to develop an optimal composition of ointment for wound treatment based on technological and physicochemical studies.
 The rheological properties of the samples were studied using a Reotest-2 rotational viscometer (USA) with a water circulating heater. The structural viscosity was determined at a temperature of 20 ± 0,2 °C. Thermostatization was performed in the ITZH-0-03 thermostat.
 The temperature was determined by a laboratory thermometer with a division price of 0,1 °C. The acid-base balance was determined potentiometrically according to the State Standard Form I. The pharmacokinetic parameters of the drug were determined by dialysis through a semipermeable membrane.
 The experimental ointment is a non-Newtonian fluid. Its fluidity begins after a certain mechanical stress is applied, i.e., after the kinetic energy of the particles of the structural frame increases, which leads to the breakdown of bonds between its elements. The maximum destruction of the system occurs at a temperature of 40 °С. The experimental data showed that the pH of the ciminal ointment is in the range from 5,5 to 7.5, which is optimal for the treatment of infected wounds. The pharmacokinetic parameters of the drug were determined: reaction rate of release of active substances; reaction rate constants, half-life. The kinetic processes of ciminals release from the drug are described by the first-order equation.
 The composition and technology of the ointment have been substantiated on the basis of experimental studies.

Pain Assessment in Patients Undergoing Maggot Debridement Therapy in the Process of Local Treatment of Chronic Wounds

(1) Background: Developing and implementing strategies for local wound care focused on improving the quality of life related to health status and reducing treatment costs for this patient group poses a challenge to contemporary healthcare systems. The utilization of Maggot Debridement Therapy (MDT) is one potential form of local therapy for preparing wounds for the healing process. The debridement of the wound bed with medical maggots is highly precise, and the defensins produced by the larvae eliminate bacteria and stimulate tissue regeneration. However, the presence of larvae in the wound may lead to the occurrence of pain symptoms. The aim of the study was to assess the intensity of pain during larval therapy in patients with chronic wounds treated in outpatient settings. (2) Patients and Methods: The study employed a diagnostic survey and estimation; the tool consisted of a research protocol comprising three parts (questionnaires). Inclusion criteria for the study were voluntary consent to participate (completion of the MDT acceptance questionnaire), chronic wounds of vascular etiology or pressure injuries, full-thickness skin or deep tissue damage, and pain intensity not exceeding four on the NRS (Numerical Rating Scale: 0—no pain, 10—the most severe pain) at the time of the study. Patient observation during the 3-day treatment was conducted by a wound care clinic nurse, assessing pain intensity once every 24 h during the larval dressing changes. (3) Results: Out of 348 individuals who qualified for MDT during the study period, 215 individuals participated in the study: 94 women (43.7%) and 121 men (56.3%). The age of the participants ranged from 28 to 97 years (mean 69.87 ± 12.95). Each participant experienced mild pain (2.26 ± 1.60 on the NRS) on the day of qualification for the study. An increase in pain intensity, according to subjective assessments, was reported by 29.3% of participants (n = 63). On the third day of MDT therapy, an increase in pain intensity was observed, reaching a mean value of 4.79 ± 2.12 (p < 0.0001). Participants with pressure injuries showed the lowest pain intensity, which increased in consecutive days for all types of wounds. Additionally, the increase in pain intensity in patients with vascular etiology wounds was greater compared to patients with pressure injuries (p < 0.001). (4) Conclusions: Local wound therapy with Lucilia sericata larvae increases pain intensity in the consecutive days of treatment. The wound area and the time since its occurrence may determine pain symptoms.

МОРФОФУНКЦИОНАЛЬНЫЕ ИЗМЕНЕНИЯ В ОРГАНАХ ИММУННОЙ СИСТЕМЫ КРЫС С ГНОЙНЫМИ РАНАМИ НА ФОНЕ АЛЛОКСАНОВОГО ДИАБЕТА ПРИ РАЗЛИЧНЫХ СПОСОБАХ МЕСТНОГО ЛЕЧЕНИЯ

Gangrene of the limb and purulent-inflammatory processes against the background of diabetes mellitus have the largest share among surgical diseases. The purpose of the study is to identify morphofunctional changes in the organs of the immune system under experimental conditions when using various methods of treating purulent wounds when modeling alloxan diabetes. Experimental studies were carried out on 150 animals (white outbred rats), in which purulent wounds were simulated against the background of alloxan diabetes. In control I group, the nature of the course of the purulent-inflammatory process was studied without correction of treatment, in control II group, purulent wounds were treated with miliacil, in control III group, EHF therapy was used. For local treatment of wounds of the main group of experimental animals, EHF therapy and miliacyl were used. In addition to taking into account clinical data, mesenteric lymph nodes, thymus, and pancreas were examined in animals of all groups after euthanasia. The most favorable treatment results were observed in experimental animals of the main group. As a result of a histological study of the thymus, atrophy of the thymic parenchyma (cortex and medulla) was discovered, combined with hyperplasia of the interlobar perivascular spaces with a simultaneous increase in the proportion of adipose tissue. The phenomenon of accidental involution of the thymus was less pronounced in animals of the main group than in rats of control groups. Morphofunctional changes in the organs of the immune system were established with various methods of treating purulent wounds against the background of alloxan diabetes. The developed new treatment method inhibits (limites) the involution of the thymus gland, corrects the humoral component of immunity and ensures optimization of reparative processes in the wound area.

Effective local treatment of necrotizing fasciitis using a chlorine solution obtained by electrolysis

Introduction. Severe surgical wound infection as necrotizing fasciitis is one of the leading causes of death in the postoperative period. Large wounds affecting the skin and soft tissues are a particular problem, as such wounds are difficult to heal, especially in immunocompromised patients. Local treatment is important, and different antiseptics are in clinical use. Case outline. A 45-year-old woman with terminal kidney failure, with hypothyroidism and iodine allergy was admitted to the hospital with multiple abscess formation in abdominal wall. After first surgery necrotic fasciitis and sepsis were diagnosed. Complete parenteral therapy, including antibiotics, other supportive therapy and hemodialysis was performed. Successive debridement and local treatment with chlorine solution obtained by electrolysis as irrigation solution and wet wound dressing used daily lead to complete healing. Delayed wound closure was performed. She was discharged in good general condition, and the wound was healed completely. Conclusion. The application of a chlorine solution obtained by electrolysis (Aqualor H 200, Serbia) in a concentration of 0.2 mg/l is effective for local treatment of wounds by washing and applying wet dressing in the wound on skin and soft tissue, especially necrotizing fasciitis as wound with mixed bacterial infection.

Use of Negative Pressure Wound Therapy in Pedicled Flaps can Improve Graft Integration and Minimize Complications

AbstractNegative pressure wound therapy (NPWT) has been used in the treatment of open fractures to improve local wound treatment, to allow skin integration when skin grafting is needed. During the last decade, the use of this device contributes to decreasing the venous congestion in microsurgical procedures in free flaps and finger replantation. The negative pressure increases the vascularization and decreases the edema, allowing the integration of tissue. Nine patients were included in this protocol. These patients had an open wound, and primary healing was not an option. Therefore, reconstructive surgery was needed. One female and eight male patients were included. Five reconstructive surgeries were performed in the lower limb and four in the upper limb due to an open fracture, skin defect secondary to infection, avulsion injury of the upper limb, and electric burn. Following the reconstructive procedure, NPWT was applied immediately peripheral to the pedicled flap. Our protocol indicates that the suction was placed for 5 days, set at continuous pressure of −100 mm Hg. At the end of the treatment, no complications were observed, and full integration of the flap was achieved. NPWT avoids local complications such as hematoma, shearing forces, and infection.

Application of chitosan-based wound dressings in local treatment of parenchymal organ wounds: a preclinical experimental study

Background. Injuries of various origins with damage to parenchymal organs remain one of the urgent issues of emergency surgery, despite all the achievements of medical science of the first quarter of the XXI century. One way to improve the quality of treatment for patients with this pathology consists in developing new wound dressings or modifying the properties of existing ones. Hemostatic efficacy is claimed to be one of the main requirements for such dressings.Objective. To perform a comparative analysis of the efficacy of the developed biodegradable wound dressings based on chitosan in the treatment of experimental wounds of parenchymal organs.Methods. The study involved laboratory animals (male rabbits weighing 2900 ± 150 g) to form experimental wounds of parenchymatous organs. The methodology involved wounding the liver via internal method, with the creation of a tissue defect of a given volume, or forming a linear incised wound with fixed parameters followed by application of a developed wound dressing. In the control group of animals, a collagen hemostatic sponge was used as a wound dressing. The animals used in the experiment were kept in accordance with GOST 33044-2014 “Principles of good laboratory practice”. The experiment involved studying the properties of two samples of wound dressings developed on the basis of modified Chitosan Soft (Ch-S) and Chitosan Hard (Ch-H) chitosan, having different properties due to their different structural parameters. The applied ultrasound control of the experimental wound area, with visualization of the samples of the investigated material in the process of biodegradation, enabled the features of the wound process to be studied in more detail. Statistical processing of the study results was carried out by methods of variational statistics, including the calculation of mean values (M), standard errors of mean values (± m). The criterion of the level of statistical significance considered a value of p <0.05. Histomorphological examination of samples was carried out using classical methods.Results. An experimental study conducted on laboratory animals in the treatment of liver wounds, followed by a comprehensive assessment of the results obtained, revealed high efficacy in the developed wound dressings in comparison with the control. The following parameters predicted in the development of wound dressing samples were confirmed: stable hemostatic and scaffold functions, biodegradability, adhesiveness and stimulating effect on bioreparative processes in the wound area. In addition, the ultrasound control algorithm in vivo was adapted in animals to assess the dynamics of the wound process and biodegradation of the studied wound dressings in wounds of parenchymal organs in the experiment, previously used in studying the dynamics of the wound process in soft tissues.Conclusion. The developed samples of chitosan-based wound dressings proved their efficacy in an experimental model of the wound process in parenchymal organs. The applied ultrasonic method for monitoring the biodegradation of the studied wound dressing, as well as the dynamics of the wound process in the liver tissue, revealed the correspondence between the visualized image and the histomorphological picture of the studied tissues, the structure and properties of the wound dressing.

Local personalised treatment of long-term non-healing wounds

Introduction. A significant number of nosologies can result in long-term non-healing wounds that mostly have similar principles of local treatment. However, positive clinical outcomes are not always obtained in the management of such wounds. The authors have developed a personalized technology for local treatment of chronic wounds depending on their etiology. Aim. Was to investigate the effectiveness of the proposed methods and personalized approaches for local treatment of long-term nonhealing wounds. Materials and methods. Innovative methods of cleaning and stimulating regeneration of non-healing wounds have been developed in the study; their effectiveness was tested in 3 blocks of the study. The first block of the study included patients with long-term non-healing wounds of venous etiology, the second and third blocks included patients with long-term non-healing arterial and neurotrophic wounds, respectively. Each block involved two series of tests studying the developed methods of cryodestruction and stimulation of regeneration, respectively. In the 1st block, the 3rd series of tests was additionally conducted; it included patients with wounds larger than 20 cm2 in size. Results. The developed methods of cryodestruction accelerate the course of phase I of the wound process by 12% in patients with longterm non-healing wounds of venous etiology, by 27% in patients with critical ischemia of the lower extremities, by 70% in patients with neurotrophic etiology (p ≥ 0.05). The use of the proposed methods of stimulating regeneration significantly reduced the average area of wounds in the study blocks. The main components of treatment stimulating regeneration in long-term non-healing wounds have been identified considering wound etiology. Conclusion. The use of the developed algorithm for local personalized treatment of long-term non-healing wounds considering underlying disorders contributes to an earlier cleaning of the wound surface, elimination of inflammation and an increased activity of regeneration processes when compared with conventional approaches.

The potential use of Lucilla sericata larvae in the local treatment of wounds in diabetic foot syndrome – a literature review

Introduction: The increasing prevalence of diabetes poses a heightened risk of vascular complications in the lower limbs. The costs associated with wound management are substantial, accounting for approximately 1-3% of total healthcare expenditures in developed countries. Implementing and maintaining preventative, interdisciplinary, and comprehensive care have become prioritized objectives for scientific societies.
 Purpose: This study conducts a literature review and analysis concerning the application of Lucilia sericata larvae in the local treatment of wounds in diabetic foot syndrome.
 Method: Literature analysis spanning from 2012 to 2023 was conducted, utilizing PubMed and Termedia databases with keywords such as diabetic foot ulcer, Lucilia sericata, and maggot debridement therapy. Exclusion criteria comprised studies that treated wounds locally using methods other than larval therapy.
 Conclusions: Larval therapy in patients with diabetic foot syndrome accelerates wound debridement by stimulating reparative processes within the wound. The use of Lucilia sericata larvae may contribute to the reduction of antibiotic therapy duration, decreased hospitalization rates, and lowered amputation risks.