The problem of treating complicated wounds. Methods of suturing in complex treatment. (A literature review)

Introduction. The problem of treating long-term non-healing, extensive, and complicated wounds remains one of the most challenging tasks in surgery. Traditional methods often prove insufficiently effective, leading to prolonged hospitalization, high risk of complications, and unsatisfactory functional and cosmetic results. This necessitates the continuous search for and implementation of innovative technologies capable of radically improving the process of tissue repair. Objective: To systematize and analyze the evolution of methods for treating complex wound defects over the period 2000–2024 to identify key trends, assess the effectiveness of various approaches, and determine the most promising directions for development. The main part. The analysis showed that the development of wound treatment methods has progressed from local medications to complex biotechnological and hardware systems. Major achievements include the creation of combined drug formulations, the improvement of surgical sutures and dermotension techniques, the application of laser and photodynamic technologies, the introduction of cell therapy and tissue engineering, and the use of biocompatible coatings. Modern approaches are aimed at creating a controlled environment for healing and reducing the invasiveness of interventions. Conclusion. Modern wound treatment is characterized by a shift towards complex and personalized therapy that combines mechanical, physical, and biological approaches. However, the search for optimal, cost-effective, and technically accessible methods for closing wounds of different origins and locations remains relevant. A promising direction is the creation of integrated systems capable of dynamically managing all stages of healing, which will significantly improve treatment outcomes and patients' quality of life.