Acceleraion of Healing of Experimentally Modeled Septic Wounds with Use of Local Cryotherapy

Abstract

BACKGROUND: Purulent diseases of the skin and subcutaneous tissue remain a widespread and urgent problem. The most promising methods of treatment with the active use of physical factors affecting the purulent focus are in the conditions of modern increasing resistance of microorganisms. AIM: To determine the effect of local ultra-low temperatures on the inflammatory and reparative processes in an experimental septic wound of soft tissues for planning a subsequent clinical study of the effectiveness of debridement using cryotherapy. MATERIALS AND METHODS: The experiment was conducted on 40 Wistar–Kyoto male rats of 9-month age, weighing 200 to 230 grams. The wound was created by excising an oval skin flap 2.0 × 1.5 cm in the withers region, followed by injection of 1.5 ml of Staphylococcus aureus solution at a concentration of 109 CFU/1 ml into the hypodermis. The animals were divided to 4 groups: a control group with the natural course of the healing process, and the main groups, which included a group with single daily treatment of the wound with Levomekol ointment, a group with a single daily treatment of the wound with vapor-drop jet of liquid nitrogen, and a group with single daily treatment with a combination of the above methods. The treatment was carried out during the exudative phase of the wound process. With the disappearance of exudation and of paravulnar edema and hyperemia, debridement in the main groups was stopped. In the dynamics, a comparative observation and study of planimetric changes in the wound were carried out. RESULTS: A more rapid decline of the severity of hyperemia, paravulnar edema and exudation, accelerated filling the wound with granulation tissue, accelerated epithelialization were seen in treatment with cryotherapy compared with treatment with Levomekol. These effects led to increase in the rate of wound healing due to the shortening of all phases of the wound process by at least 2 days. There were no statistically significant side effects, healing and survival occurred in all animals. CONCLUSION: In was found in the study that the use of cryotherapy leads to a rapid subsidence of symptoms, activates the processes of granulation and epithelization. Mutual potentiation of the positive effects of debridement using ultra-low temperatures and antibacterial agents has been established. Cryotherapy proved to be a safe and effective means of treating septic wounds, which does not prevent and makes it possible to conduct further clinical studies.