VACUUM THERAPY VICTORY IN COMPLEX SURGICAL REPAIR OF WOUNDS OF THE LOWER KINTSIVOKS WHICH THE TRIVALO DO NOT START

Summary. Aim. In the last decade, a new direction of using diffusion-separating membrane processes has been intensively developed in regenerative medicine — VAC therapy, the use of which would help to strengthen the correction of metabolic imbalance in damaged tissues, as well as to remove the most toxic low-molecular compounds and at the same time preserve the factors of regeneration, protection of the body and wound surfaces from infection in patients with wounds of the lower extremities that do not heal for a long time. Purpose. Improvement of the results of complex surgical treatment of patients with long-term non-healing wounds of the lower extremities. Materials and methods. The paper presents an analysis of the materials of self-observations and a retrospective study of the medical histories of 168 patients with long-term non-healing wounds who were treated at the surgical disease clinic of the KNP Kharkiv Regional Council “Regional Clinical Hospital” in the period from 2018 to 2022. All patients were divided into 2 clinical groups to assess the clinical effectiveness of the proposed treatment methods: the main group (87 people) – on the background of complex therapy, local wound treatment was carried out using the vac-complex, and a comparison group (81 people), these patients were treated with traditional means (water-soluble ointments, antiseptic solutions, etc.) on the background of complex therapy. Results. Our clinical data show that the largest number of patients had long-term non-healing wounds formed after purulent-inflammatory diseases of soft tissues (47.1 %), followed by trophic ulcers in varicose disease (28.7 %) and trophic ulcers in diabetes (24.1 %). The following parameters were included in the complex of clinical evaluation of the effectiveness of local treatment: reduction of the size of the wound surface, cleansing of the wound from purulent-necrotic exudate, the appearance of granulations, the beginning of marginal epithelization. The obtained data indicate that the cleansing of the wound and the onset of the second phase in terms of all parameters characterizing the wound process occurred faster when using the VAC bandage than in the comparison group. Bandages were less painful and more comfortable. At the same time, young granulation tissue was not injured, as was observed in patients in the comparison group. Conclusions. For the local treatment of non-healing wounds for a long time, the use of VAC therapy is recommended, thanks to the use of which, in the main group of patients, faster wound cleansing occurs (6.1±0.8) days, filling with granulations and the appearance of marginal epithelization (8.8±0.5) days, treatment times are reduced (19.5±06) days, p<0.05.