POSSIBILITIES OF TREATMENT OF I NFECTED ULCERS OF THE LOWER EXTREMITIES IN CHRONIC VENOUS INSUFFICIENCY WITHOUT THE USE OF ANTIBIOTICS

  • I. D. Duzhyi
  • L. F. Sukhodub
  • V. S. Bielai
  • S. M. Zhdanov
  • Y. M. Loboda
Keywords: trophic ulcer, chronic venous insufficiency, apatite polymer bandage, antibiotic resistance.

Abstract

Summary. Introduction. Purulent diseases and purulent complications in modern medicine remain a complex and not always a positive problem, because in the development of such diseases is quite prominent microbial factor. Overcoming the latter is getting harder every year.

The urgency of the problem. The fact is that before our eyes, almost exponentially, the number of microorganisms resistant to existing antibiotics is increasing. Not to mention the toxic effects of many of them on certain organs due to their natural tropism, we note allergic effects, individual intolerance and dysbacterial effects, we note that the cost of some drugs for 1–2 days of use is equal to pension (monthly «income» of most retirees). Given this, you need to look for an opportunity to do without the use of antibiotics, which determines the urgency of the problem.

Goal. Explore the possibility of treating infected lower extremity ulcers without the use of antibiotics.

Materials and methods. The possibility of treating purulent ulcers of the lower extremities on the background of chronic venous insufficiency by using apatite polymeric drainage bandage based on hydroxyapatite supplemented with zinc oxide has been studied.

Results and discussion. Polyvalent microbial association was established in 100 % of patients, staphylococcal colonization prevailed in 75 % of them. On 3–4 days of treatment, a decrease in inflammation, regression of symptoms, reduction of microbial insemination, the appearance of signs of repair, improvement of foot function were recorded.

Conclusions. 1) The possibility of treating infected wounds by using apatite polymer drainage bandage has been confirmed; 2) On 3–4 days of application of the drainage bandage there is a regression of the inflammatory process in the area of the ulcer; 3) Microbial contamination of the wound surface for 4 days is reduced from 108 to 73.5 CFU/ml; 4) Subjective sensation and foot function improve by 3–4 days of treatment.

References

1. Bonkemeyer Millan S, Gan R, Townsend PE. Venous Ulcers: Diagnosis and Treatment. Am Fam Physician. 2019;100(5):298–305. PMID: 31478635
2. Vashchuk VV, Kyryk TP, Kushnirchuk MI, Baidala RP. Nova metodyka mistsevoi terapii trofichnykh vyrazok nyzhnikh kintsivok. Kharkivska khirurhichna shkola. 2018;1(88):51–53. [In Ukrainian]
3. Shlyakova AA, Korneva KG, Kudykin MN, Strongin LG. Peculiarities of chronic venous insufficiency course in patients with diabetes mellitus type 2. Novosti Khirurgii. 2013; 21(4): 57–61. [In Russian]
4. Norman G, Dumville JC, Westby MJ, Stubbs N, Soares MO. Dressings and topical agents for treating venous leg ulcers. Cochrane Database Syst Rev. 2018 Jun; 2018(6): CD012583. DOI: 10.1002/14651858.CD012583
5. O’meara S, Richardson R., Lipsky A.B. Topical and systemic antimicrobial therapy for venous leg ulcers. JAMA. 2014; 311(24):2534-2535. DOI: 10.1001/jama.2014.4574.
6. Kirienko AI, Bogachev VYu, Zolotukhin IA, Panina NG. Vliyaet li e`kstravazal`naya korrekcziya klapanov bedrennoj veny` na techenie varikoznoj bolezni? Angiologiya i sosudistaya khirurgiya. 2002; 8(2): 39–44. [In Russian]
7. Chernukha LM, Cherniak VA. Novitni rekomendatsii z likuvannia khronichnykh zakhvoriuvan ven nyzhnikh kintsivok. Khirurhiia, Ortopediia, Travmatolohiia, Intensyvna terapiia [Internet]. 2020 [cited 2020 Nov 19]; 4(42). Available from: https://health-ua.com/article/62366- novtn-rekomendatc-z-lkuvannya-hronchnih-zahvo-ryuvan-ven-nizhnh-kntcvok-20 [In Ukrainian]
8. Pogrebnjak A, Sukhodub LF, Sukhodub LB, Bondar O, Kumeda M, Shaimardanova B, Turlybekuly A. Composite material with nanoscale architecture based on bioapatite, sodium alginate and ZnO microparticles. Ceramics International. 2019; 45(6): 7504-7514. DOI: 10.1016/j. ceramint.2019.01.043].
Published
2021-08-20
How to Cite
Duzhyi, I. D., Sukhodub, L. F., Bielai, V. S., Zhdanov, S. M., & Loboda, Y. M. (2021). POSSIBILITIES OF TREATMENT OF I NFECTED ULCERS OF THE LOWER EXTREMITIES IN CHRONIC VENOUS INSUFFICIENCY WITHOUT THE USE OF ANTIBIOTICS. Kharkiv Surgical School, (3), 21-26. https://doi.org/10.37699/2308-7005.3.2021.05
Section
GENERAL AND EMERGENCY SURGERY