Three-stage hydropressive debridement purulent wounds: experimental substantiation technology efficiency

Introduction. Infections of the skin and soft tissues remain the most common reason for seeking surgical care. The development of resistance of the pathogenic microflora to antibiotics, changes in the spectrum of pathogens dictate the need for effective local treatment methods, the most promising of which are physical factors of influence. Goal. To develop a technology of three-stage hydropressive debridement, to study the effectiveness of its use in the surgical treatment of purulent soft tissue wounds in an experiment. Materials and methods. The study was performed on the basis of the Burdenko VSMU Research Institute of Experimental Biology and Medicine on 72 sexually mature male Wistar rats, which had purulent wounds modeled. The amount of treatment depended on the study group: in the 1st control group, daily dressings were performed with 0,9 % sodium chloride solution, in the 2nd control group, dressings were supplemented with a hydropressive treatment (GO); in the experimental group, a three-stage hydropressive debridement (THD). The animals were removed from the experiment on the 1st, 3rd, 7th and 10th days after the start of treatment. Objective, planimetric, laboratory, and statistical methods were used to assess the course of the wound process. Research results and discussion. The use of THD technology led to an acceleration in the timing of edema reduction by 25,06 % and hyperemia by 24,53 %, compared with the use of GO; it contributed to the fastest wound cleansing, a decrease in inflammation syndrome, the development of full-fledged granulation tissue, and the earliest closure of the wound defect – up to 94,13% on the 10th day from the beginning of treatment. Conclusion. The closest correlation was noted between leukocytes and bacterial contamination, which confirms the key role of the inflammatory response in controlling microbial load. The negative correlations between follow-up time, wound area, pH, leukocytes, and bacterial contamination reflect the regular healing dynamics most pronounced with the use of THD. The level of malondialdehyde correlated only with the level of white blood cells, which confirms the role of oxidative stress mediated by the inflammatory response and demonstrates the effectiveness of using THD in order to correct these parameters.