使用复合材料治疗下肢化脓性伤口而不使用抗生素的特点

V. Bielai, V. P. Shevchenko, I. А. Danylenko
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摘要

总结。介绍。下肢TU长期愈合的原因是细菌污染溃疡形成生物膜和抗生素耐药性增加。问题的紧迫性。脓性伤口的数量、微生物耐药性和下肢TU复发的显著频率(20 - 70%)决定并证实了该问题的相关性。的目标。在不使用抗生素、材料和方法的情况下,提高CVI背景下下肢TU患者的治疗效果。TU患者分为两组。第一组(主)57例采用磷灰石聚合物引流绷带治疗,第二组(对照)53例采用传统方法治疗。研究了TU创面的涂片。结果和讨论。治疗前TU微生物污染强度为107 CFU/ml,应用APDB后第3天为104 CFU/ml,第5天为103 CFU/ml。平均创面愈合率为0.42 cm2/d。结论。在不使用抗生素的情况下应用APDB可减少微生物污染。主组平均治疗时间19.6 d,对照组平均治疗时间28.2 d。主组患者伤口愈合速度高2.1倍。在治疗第14天对主组患者的活检中,胶原纤维的顺序明显增加,成纤维细胞的数量明显增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
FEATURES OF THE USE OF COMPOSITE MATERIALS FOR THE TREATMENT OF PURULENT WOUNDS OF THE LOWER EXTREMITIES WITHOUT THE USE OF ANTIBIOTICS
Summary. Introduction. The reasons for the long-term healing of TU of the lower extremities are bacterial contamination of ulcers with the formation of biofilms and growing antibiotic resistance. The urgency of the problem. The number of purulent wounds, microbial resistance and a significant frequency of recurrences of TU of the lower extremities (20–70 %) determine and substantiate the relevance of the problem. Goal. Increasing the effectiveness of treatment of patients with TU of the lower extremities against the background of CVI, without the use of antibiotics, Materials and methods. Patients with TU were divided into two groups. The first (main) group (n=57) included patients who were treated with an apatite polymer drainage bandage, the second group (comparison) included patients who were treated with traditional methods (n=53). Smears from the wound surface of TU were studied. Results and their discussion. The intensity of microbial contamination of TU before the start of treatment was 107 CFU/ml, on the 3rd day after APDB application — 104 CFU/ml, on the 5th day — 103 CFU/ml. The average rate of wound healing was 0,42 cm2/day of wound surface area. Conclusions. Application of APDB without the use of antibiotics leads to a decrease in microbial contamination. The average duration of treatment in the main group was 19,6 days, in the comparison group — 28,2 days. The speed of wound healing in patients of the main group is 2,1 times higher. In the biopsies of patients of the main group on the 14th day of treatment, a significantly greater order of collagen fibers and a greater number of fibroblasts were found.
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