Abstract
Background. Purulent-inflammatory lesions of the skin and soft tissues remain one of the most common pathologies in surgical practice, accounting for up to 35% of hospitalizations and up to 60% of outpatient visits. Their treatment is often complicated by the chronicity of the process, resistance to antibiotics and a high risk of patient disability. Despite positive clinical results, morphological aspects of wound healing have not been studied sufficiently. Aim: to evaluate the clinical effectiveness of application sorbent and bacteriophage (Piophage) in the treatment of purulent wounds in an experimental model, by comparative analysis of pathohistological changes and dynamics of the main phases of the wound process (cleansing, granulation, epithelialization, complete healing) in Wistar rats in comparison with local treatment with hypertonic sodium chloride solution and Levomikol ointment. Methods. The experiment was conducted on 40 white Wistar rats aged 3-4 months, weighing 180-220 g, which were kept under standard conditions of the vivarium of the P.L. Shupyk National University of Health Care of Ukraine. Modeling of purulent inflammation was carried out by subcutaneous injection of 1 ml of bacterial suspension prepared from rat feces, containing E. coli, S. epidermidis and E. faecalis in appropriate concentrations. Morphological changes were studied at different stages of the wound process. Animals were divided into three groups. Group IA (n=17) − treatment with an experimental sorbent based on aerosil and tinidazole and lidocaine immobilized on its matrix; group IB (n=13) − use of the bacteriophage preparation "Piophage" which includes specific bacteriophages at a concentration of not less than 1×105 phage particles for these types of microorganisms. Group II (n=10) performed modeling of the inflammatory process according to the specified method, made an incision at the site of bacterial solution injection, introduced sorbent and sutured the wound tightly with an aseptic dressing. Results. In group IA, the fastest wound healing was observed. In group IB, epidermization was lower, mainly at the edges of the wound. In group II, minimal signs of repair, preservation of inflammation. Morphological and immunohistochemical dynamics confirmed the superiority of the application sorbent over bacteriophage and traditional treatment. Conclusions. The application sorbent provides the fastest and most complete regeneration of purulent wounds, surpassing bacteriophage and traditional treatment in all phases of healing