Application of local negative pressure therapy in the complex treatment of extensive wounds: analysis of clinical outcomes and innovative techniques

Introduction. A wound represents a disruption of the anatomical integrity of the skin or mucous membranes resulting from physical or thermal injury. Despite the natural potential for healing, various factors, particularly comorbid conditions, can significantly impede this process. The relevance of the problem of treating extensive and complex wounds is determined by their substantial proportion within the structure of surgical pathology (35–40 %), the high costs associated with treatment, and their significant social impact. Particular challenges arise in the closure of extensive defects, where traditional suturing is often impossible or leads to complications. Objective. To review the available literature on modern methods and approaches to the treatment of extensive and complex wounds and to identify promising directions for further research. Results. Analysis of the literature demonstrated an evolution in the approaches to treating extensive wounds, moving from traditional methods to comprehensive, high-technology strategies. Negative Pressure Wound Therapy (NPWT) has been recognized as a promising direction in various surgical fields. Conclusion. The modern management strategy for extensive wounds should be based on an approach that combines radical surgical debridement, the selection of an optimal plasty method, and the application of adjuvant therapies. The method of local negative pressure (NPWT) has proven its efficacy in reducing complications and improving treatment outcomes. However, there remains a need for large-scale randomized controlled trials to assess cost-effectiveness, develop unified protocols, and study the long-term results of applying new technologies.