Сучасні медичні технології (Sep 2019)

Microbiological aspects of limbs wound infection and its complex treatment with the use of vacuum-therapy in persons injured in war actions

  • M. D. Zheliba,
  • A. V. Verba,
  • H. L. Bohush,
  • I. P. Martsynkovskyy,
  • V. M. Kondratyuk,
  • V. P. Kovalchuk,
  • A. A. Fomin,
  • N. S. Fomina

DOI
https://doi.org/10.34287/MMT.3(42).2019.4
Journal volume & issue
no. 3(42)
pp. 50 – 55

Abstract

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Relevance. Topicality treatment problem of injured with gunshot wounds determined of the emergence of centers of armed conflict in eastern Ukraine with the use of modern methods of warfare. In the structure of sanitary losses during antiterrorist operation the overwhelming majority (62,5%) belongs to wounded limbs (lower – 37%, upper – 25,5%), in 35–40% of cases they are accompanied by fractures of the bones. The most dangerous complication of injuries is the development of purulent infection. Purpose of the study. Of research is the study of the specifics of the microbial picture of the fighting gunshot wounds of the limbs for rate its significance in the development of infectious complications and improvement of the results of complex treatment by the use of vacuum bandages. Materials and methods. In this work clinical, microbiological and cytological studies were used to control the course of the wound process in 162 victims with gunshot wounds of limbs followed by statistical processing of the results. Results. Microbiological examination of wounds showed that the main representatives of bacterial cultures are gram-negative nonfermenting sticks (68%), which in 53% of cases are Acinetobacter spp. and in 15% of cases Pseudomonas spp. Gram-positive Cocci were detected in 24% of the seedlings. Of the total number of isolates isolated from the wound, regardless of the timing of the receipt of materials after injury, the majority (79,5%) was characterized by resistance to antibiotics. Strains of gram-negative non-fermentative sticks possessed the highest level of resistance. The application of vacuum wound dressings has had a positive effect on the wound process and shortened the time of healing and wound preparation to a plastic closure. Conclusion. In the current military conflict, the dominant microflora of gunshot wounds is represented by acinetobacter and pseudomonas, which are resistant to most antibiotics. The use of vacuum therapy helps accelerate the processes of cleansing and regeneration of the wound shortens the timing of treatment.

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