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ENHANCEMENT IN THE TREATMENT OF SEPTIC WOUNDS BY VACUUM THERAPY

The doctrine of the wound process is still one of the challenging issues of modern surgery; it reflects the achievements of theoretical and practical medicine and technical engineering as well. Slow-healing wounds, extensive necrosis in soft tissues, trophic ulcers of shins in patients with circulatory disorders of various aetiology, purulent bedsores, infected burn surfaces and other septic-inflammatory processes are particularly difficult to treat. The principles and methods of surgical treatment and pharmacotherapy over the phases of the wound process are aimed at reducing the infectious complications and core protocols provide standard guidance for appropriate prevention and management of infected wounds. 
The use of vacuum therapy (VAC therapy) according to numerous clinical studies improves both immediate and long-term treatment outcomes, updates standard therapy regimens for septic processes in soft tissues, especially in the presence of associated microbial colonies. 
The aim of the study is to evaluate the clinical efficacy of VAC therapy methods incorporated into a standard management of infected inflammatory wounds. The article presents the analysis of the case histories of 50 patients with acute septic inflammatory processes, who took the treatment course at the surgical department of Poltava Clinical Central District Hospital. The main group of 20 patients included 5 men (average age 52.2 ± 5.1 years) and 15 women (average age 51.4 ± 4.1 years). The control group involved 30 patients: 11 men (mean age 48.6 ± 3.7 years) and 19 women (mean age 54 ± 4.2 years). According to the character of surgical problem, patients were divided as follows: purulent-necrotic form of erysipelas was found in 11 patients (5 patients in the main group, 6 patients in the control), infected thermal burns were diagnosed in 11 patients (4 individuals in the main group and 7 individuals in the control), fооt phlegmon as diabetes complication was found in 13 patients (5 individuals in the main group, 8 individuals in the control), trophic ulcers of shins due to chronic venous insufficiency were detected in 15 patients (6 individuals in the main group, 9 individuals in the control). The VAC therapy methods allowed us to significantly reduce the period of wound cleansing, to accelerate the appearance of granulations, and that is the most importantly, to reduce the treatment duration in 1.5 times. The VAC-therapy for local treatment of septic-inflammatory processes is relatively inexpensive and quite effective therefore, it can be recommended for wider use in surgical practice.