Authors
Levchuk A.L., Strukov S.Yu., Ignatiev T.I., Popova K.V., Grin N.A.
Pirogov National Medical Surgical Center, Moscow
Abstract
Wound healing is a single active dynamic process that begins at the moment of injury and ends with the restoration of tissue integrity. Based on the improvement of scientific knowledge and the process of the pharmacological industry, it is possible to introduce surgical techniques and therapeutic measures that will provide significant support to the body’s own capabilities of this severe category of patients to prevent the development and treatment of long-term non-healing chronic post-traumatic wounds.
Objective: to optimize diagnostic approaches and treatment algorithm in patients with chronic soft tissue wounds with an assessment of their compliance with the standards of medical care in a multidisciplinary hospital.
Materials and methods: the clinical study is based on a retrospective analysis of the results of surgical and medical treatment of 82 patients with chronic wounds of the trunk and limbs. The patients were divided into two representative groups. In the first research group (n = 32), local wound treatment in phase II of the wound process was carried out with the use of Velstic-PRO cream, which contains silver preparations and epithelial growth regenerators. The second control group (n = 50) was divided into two subgroups (subgroup I (n = 20) was treated with traditional antiseptics, in subgroup II (n = 30) dressings were changed using Ebermin ointment). The results of treatment in the study groups were evaluated by quantitative (visual screening, planometry and histomorphology) and qualitative (bacterial culture, saturation in the wound, pulse filling index, rate of change in capillary blood filling), characteristics of the course of the wound process on days 3, 7, 15, 20.
Result: the inflammatory reaction of tissues in the first group was stopped much faster by the 3rd day, and by the 7th day, the process of epithelialization of chronic wounds began. In the second group, this period was much longer (2.5 times). By the 15th day, the largest number of patients in the first group (82.4%) were characterized by complete epithelialization of wounds or their preparedness for plastic surgery aimed at closing the skin defect. In the second group (especially in the first subgroup) this period lasted more than 20 days, and the possibility of performing plastic surgery appeared only after 27 days in 43.5% of patients.
Conclusion: topical application of the cream (Velstic-PRO) allows you to optimize the reparative processes in the wound 2 times faster compared to traditional medications, which makes it possible to recommend it in the therapeutic algorithm of chronic post-traumatic wounds after their thorough surgical debridement in the II and III phases of the wound process.
Keywords: chronic posttraumatic wound, algorithm and treatment methods.
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