ririРаны и раневые инфекции. Журнал имени проф. Б.М. КостючёнкаWounds and wound infections. The prof. B.M. Kostyuchenok journal2408-96132500-0594Regional non-governmental organization “Surgical society - Wounds and wound infections”10.25199/2408-9613-2026-13-1-6-17riri-359Research ArticleОБЗОРЫ, ЛЕКЦИИ, ИСТОРИЯ РАН И РАНЕВЫХ ИНФЕКЦИЙREVIEWS, LECTURES, HISTORY OF WOUNDS AND WOUND INFECTIONSРастворы для инстилляции при вакуумной терапии ран: сравнительный анализ эффективности и безопасности (обзор литературы)Irrigation Solutions for Vacuum-Assisted Wound Therapy: A Comparative Analysis of Efficacy and Safety (Literature Review)https://orcid.org/0000-0001-6583-1890ХамидулинГ. В.KhamidulinG. V.

Хамидулин Георгий Валерьевич – ассистент кафедры медицины катастроф МИ

117198, Москва, ул. Миклухо-Маклая, д. 8 

Georgy V. Khamidulin – assistant at the Department of Disaster Medicine 

8 Miklukho-Maklaya Str., Moscow, 117198 

gkhamidulin@mail.ruhttps://orcid.org/0000-0003-1215-8035ПасхаловаЮ. С.PaskhalovaYu. S.

Пасхалова Юлия Сергеевна – кандидат медицинских наук, старший научный сотрудник отдела ран и раневых инфекций;  доцент кафедры медицины катастроф МИ

117198, Москва, ул. Миклухо-Маклая, д. 8 

117997, Москва, ул. Большая Серпуховская, д. 27 

Yulia S. Paskhalova – MD, Cand. Sci. (Med.), senior researcher at the department of wounds and wound infections; Associate Professor at the department of disaster medicine

8 Miklukho-Maklaya Str., Moscow, 117198 

27 Bolshaya Serpukhovskaya Str., Moscow, 117997 

https://orcid.org/0000-0001-6411-0709МитишВ. А.MitishV. A.

Митиш Валерий Афанасьевич – кандидат медицинских наук, доцент, заведующий отделом ран и раневых инфекций; заведующий кафедрой медицины катастроф МИ

117198, Москва, ул. Миклухо-Маклая, д. 8 

117997, Москва, ул. Большая Серпуховская, д. 27 

Valery A. Mitish – MD, Cand. Sci. (Med.), Associate Professor, head of the department of wounds and wound infections; head of the department of disaster medicine

8 Miklukho-Maklaya Str., Moscow, 117198 

27 Bolshaya Serpukhovskaya Str., Moscow, 117997  

https://orcid.org/0000-0002-0212-5742ОруджеваС. А.OrudzhevaS. A.

Оруджева Саида Алияровна – доктор медицинских наук, врач – анестезиолог-реаниматолог, научный сотрудник отдела ран и раневых инфекций; доцент кафедры медицины катастроф МИ

117997, Москва, ул. Большая Серпуховская, д. 27 

Saida A. Orudzheva – MD, Dr. Sci. (Med.), anesthesiologist and intensive care physician, researcher at the Department of Wounds and Wound Infections; Associate Professor at the department of disaster medicine 

27 Bolshaya Serpukhovskaya Str., Moscow, 117997 

ФГАОУ ВО «Российский университет дружбы народов им. Патриса Лумумбы» Минобрнауки РоссииРоссияPatrice Lumumba People’s Friendships University of RussiaRussian FederationФГАОУ ВО «Российский университет дружбы народов им. Патриса Лумумбы» Минобрнауки России ; ФГБУ «Национальный медицинский исследовательский центр хирургии им. А. В. Вишневского» Минздрава РоссииРоссияPatrice Lumumba People’s Friendships University of Russia ; A. V. Vishnevsky National Medical Research Center of SurgeryRussian FederationФГБУ «Национальный медицинский исследовательский центр хирургии им. А. В. Вишневского» Минздрава РоссииРоссияA. V. Vishnevsky National Medical Research Center of SurgeryRussian Federation202623042026131617Copyright © Хамидулин Г.В., Пасхалова Ю.С., Митиш В.А., Оруджева С.А., 20262026Хамидулин Г.В., Пасхалова Ю.С., Митиш В.А., Оруджева С.А.Khamidulin G.V., Paskhalova Y.S., Mitish V.A., Orudzheva S.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.riri.su/jour/article/view/359 

 

Цель исследования – анализ российских и зарубежных источников литературы, посвященных эффективности и безопасности различных растворов, применяемых при вакуумной терапии ран с инстилляцией.

Материалы и методы исследования. В обзор включены публикации PubMed/MEDLINE и eLibrary с дополнительным просмотром ссылок и релевантных публикаций в Web of Science, Scholar Google, КиберЛенинка по ключевым словам за последние 10 лет, в которых проведена сравнительная оценка стандартной вакуумной терапии и ее модификаций с инстилляцией. Рассмотрены растворы изотонического натрия хлорида, антисептиков, антибиотиков, бактериофагов, применяемые в качестве инстиллятов, а также их механизмы действия, показания, эффективность и профиль безопасности.

Результаты исследования

Результаты исследования. Применение вакуумной терапии с инстилляцией обеспечивает быстрое очищение раневой поверхности, снижение степени бактериальной обсемененности, оптимизацию сроков формирования грануляционной ткани и подготовки к пластическому закрытию раны по сравнению со стандартной методикой. Среди растворов для инстилляции физиологический раствор (0,9 % NaCl) отличается безопасностью и универсальностью, традиционные антисептики (раствор Дакена, нитрат серебра) – выраженным противомикробным действием, современные антисептики на основе полигексанида (Пронтосан®) – высокой эффективностью при низкой цитотоксичности, а бактериофаги – избирательным бактериолитическим эффектом, включая активность против антибиотикорезистентных штаммов. Применение для инстилляции растворов антибиотиков требует строгого микробиологического контроля и рационального подбора препаратов с целью минимизации риска антибиотикорезистентности.

Заключение

Заключение. Вакуумная терапия с инстилляцией является современным, патогенетически обоснованным методом лечения инфицированных и хронических ран. Рациональный выбор раствора с учетом характера инфекции, фазы течения раневого процесса и микробного пейзажа позволяет повысить эффективность терапии, максимально приблизить течение процесса к физиологическому и снизить риск осложнений. Особую перспективу представляет использование бактериофагов как безопасной и результативной альтернативы антибиотикам и антисептикам в условиях растущей антибиотикорезистентности.

Objective

Objective. To analyze the efficacy and safety of various irrigation solutions used in Negative Pressure Wound Therapy with Instillation (NPWTi) based on data from domestic and international literature sources.

Materials and Methods

Materials and Methods. The review includes PubMed/MEDLINE and eLibrary publications with additional viewing of links and relevant publications on the Web of Science, Google Scholar, and Cyberleninka by keywords over the past 10 years, which conducted a comparative assessment of standard vacuum therapy and its modifications with instillation.Solutions of isotonic sodium chloride, antiseptics, antibiotics, and bacteriophages used as instillates are considered, as well as their mechanisms of action, indications, efficacy, and safety profile.

Research Results

Research Results. The analysis showed that the use of vacuum therapy with instillation provides rapid cleaning of the wound surface, reducing the degree of bacterial contamination, optimizing the timing of granulation tissue formation and preparation for plastic closure of the wound compared with the standard technique. Among instillation solutions, saline solution (0.9% NaCl) is characterized by safety and versatility, traditional antiseptics (Daken solution, silver nitrate) have a pronounced antimicrobial effect, modern polyhexanide-based on antiseptics (Prontosan®) have low cytotoxicity, and bacteriophages have a selective bacteriolytic effect, including activity against antibiotic resistant strains. The use of antibiotic solutions for instillation requires strict microbiological control and rational selection of drugs to minimize the risk of antibiotic resistance.

Conclusion

Conclusion. Vacuum therapy with instillation is a modern, pathogenetically proven method of treating infected and chronic wounds. Rational choice of the solution, taking into account the nature of the infection, the phase of the wound healing process and the microbial landscape, makes it possible to increase the effectiveness of therapy, bring the course of the process as close as possible to the physiological one and reduce the risk of complications. The use of bacteriophages as a safe and effective alternative to antibiotics and antiseptics in conditions of increasing antibiotic resistance is of particular interest.

вакуумная терапия ранинстилляцияантисептикибактериофагиантибиотикорезистентностьхронические ранытерапия отрицательным давлениемтерапия отрицательным давлением с интилляциейvacuum wound therapyinstillationantisepticsbacteriophagesantibiotic resistancechronic woundsNPWTNPWTiReferencesFalanga V., Isseroff R.R., Soulika A.M., et al. Chronic wounds. Nat Rev Dis Primers. 2022;8(1):50. doi: https://doi.org/10.1038/s41572-022-00377-3Falanga V., Isseroff R.R., Soulika A.M., et al. Chronic wounds. Nat Rev Dis Primers. 2022;8(1):50. doi: https://doi.org/10.1038/s41572-022-00377-3Alam W., Hasson J., Reed M. Clinical approach to chronic wound management in older adults. J American Geriatrics Society. 2021;69(8):2327–2334. doi: https://doi.org/10.1111/jgs.17177Alam W., Hasson J., Reed M. Clinical approach to chronic wound management in older adults. J American Geriatrics Society. 2021;69(8):2327–2334. doi: https://doi.org/10.1111/jgs.17177Cheng B., Jiang Y., Fu X., et al. Epidemiological characteristics and clinical analyses of chronic cutaneous wounds of inpatients in China: Prevention and control. Wound Repair Regeneration. 2020;28(5):623–630. doi: https://doi.org/10.1111/wrr.12825Cheng B., Jiang Y., Fu X., et al. Epidemiological characteristics and clinical analyses of chronic cutaneous wounds of inpatients in China: Prevention and control. Wound Repair Regeneration. 2020;28(5):623–630. doi: https://doi.org/10.1111/wrr.12825Harding K.G. Chronic wounds: a clinical problem requiring ownership and coordination. Br J Dermatol. 2022;187(2):133–134. doi: https://doi.org/10.1111/bjd.21650Harding K.G. Chronic wounds: a clinical problem requiring ownership and coordination. Br J Dermatol. 2022;187(2):133–134. doi: https://doi.org/10.1111/bjd.21650Pinto A.M., Cerqueira M.A., BañobreLópes M., et al. Bacteriophages for Chronic Wound Treatment: From Traditional to Novel Delivery Systems: 2. Viruses. Multidisciplinary Digital Publishing Institute. 2020;12(2):235. doi: https://doi.org/10.3390/v12020235Pinto A.M., Cerqueira M.A., BañobreLópes M., et al. Bacteriophages for Chronic Wound Treatment: From Traditional to Novel Delivery Systems: 2. Viruses. Multidisciplinary Digital Publishing Institute. 2020;12(2):235. doi: https://doi.org/10.3390/v12020235Митиш В.А., Пасхалова Ю.С., Муньос Сэпэда П.А. и др. Ультразвуковая кавитация в лечении нейроишемической формы синдрома диабетической стопы при наличии биопленочных форм бактерий (обзор литературы) // Раны и раневые инфекции. Журнал имени проф. Б.М. Костючёнка. – 2020. – Т. 7. – № 3. – С. 20– 30. doi: https://doi.org/10.25199/2408-9613-2020-7-3-20-31Mitish V.A., Paskhalova Yu.S., Munioz Sepeda P.A., et al. Ultrasonic cavitation in the treatment of neuro-ischemic diabetic foot the presence of biofilm forms of bacteria (literature review). Wounds and wound infections. The prof. B.M. Kostyuchenok journal. 2020;7(3):20–30. (In Russ.) doi: https://doi.org/10.25199/2408-9613-2020-7-3-20-31Митиш В.А., Хамидулин Г.В., Пасхалова Ю.С. и др. Комплексное хирургическое лечение рецидивирующего постинъекционного абсцесса на фоне системного аутоиммунного заболевания // Хирургия. Журнал им. Н. И. Пирогова. – 2023. – № 12. – С. 123–133. doi: https://doi.org/10.17116/hirurgia2023121123Mitish V.A., Khamidulin G.V., Paskhalova Yu.S., et al. Complex surgical treatment of recurrent post-injection abscess in a patient with systemic autoimmune disease. Pirogov Russian Journal of Surgery. 2023;12:123–133. (In Russ.) doi: https://doi.org/10.17116/hirurgia2023121123Костюченок Б.М. Раны и раневая инфекция. Руководство для врачей. 2-е изд., перераб. и доп. изд. Москва: Медицина, 1990. 591 с.Kostyuchenok B.M. Wounds and wound infection. A guide for doctors. 2nd ed., revised and additional ed. Moscow: Medicine, 1990. 591 p. (In Russ.)Ларичев А.Б. Регуляция раневого процесса и лечение ран методом вакуумтерапии: автореферат диссертации на соискание ученой степени д.м.н. – Москва. – 1998. – 32 с.Larichev A.B. Regulation of the wound process and treatment of wounds by vacuum therapy: abstract of the dissertation for the degree of Doctor of Medicine – Moscow. – 1998. – 32 s. (In Russ.)Morykwas M.J., Argenta L.C., SheltonBrown E.I., McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Annals of Plastic Surgery. 1997;38(6):553–562. doi: https://doi.org/10.1097/00000637-199706000-00001Morykwas M.J., Argenta L.C., SheltonBrown E.I., McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Annals of Plastic Surgery. 1997;38(6):553–562. doi: https://doi.org/10.1097/00000637-199706000-00001Todorović S. Use of negative pressure in wound therapy. Srpski medicinski časopis Lekarske komore. 2023;4(3):311–322.Todorović S. Use of negative pressure in wound therapy. Srpski medicinski časopis Lekarske komore. 2023;4(3):311–322.Normandin S., Safran T., Winocour S., et al. Negative Pressure Wound Therapy: Mechanism of Action and Clinical Applications. Semin Plast Surg. 2021;35(3):164–170. doi: https://doi.org/10.1055/s-0041-1731792Normandin S., Safran T., Winocour S., et al. Negative Pressure Wound Therapy: Mechanism of Action and Clinical Applications. Semin Plast Surg. 2021;35(3):164–170. doi: https://doi.org/10.1055/s-0041-1731792Kumaar A., Shanthappa A.H., Ethiraj P. A Comparative Study on Efficacy of Negative Pressure Wound Therapy Versus Standard Wound Therapy for Patients With Compound Fractures in a Tertiary Care Hospital. Cureus. 2022;14(4):e23727. doi: https://doi.org/10.7759/cureus.23727Kumaar A., Shanthappa A.H., Ethiraj P. A Comparative Study on Efficacy of Negative Pressure Wound Therapy Versus Standard Wound Therapy for Patients With Compound Fractures in a Tertiary Care Hospital. Cureus. 2022;14(4):e23727. doi: https://doi.org/10.7759/cureus.23727Abd El-Raouf Ali Hussein H., Ahmed Hamdy A.-Set al. Outcomes of vac versus conventional dressing in management of diabetic foot ulcer. Al-Azhar Medical Journal. 2020;49(4):1619–1628.Abd El-Raouf Ali Hussein H., Ahmed Hamdy A.-Set al. Outcomes of vac versus conventional dressing in management of diabetic foot ulcer. Al-Azhar Medical Journal. 2020;49(4):1619–1628.Вагнер Д.О., Зиновьев Е.В., Солошенко В.В., Шаповалов С.Г. Опыт применения метода вакуумной терапии в отделе термических поражений. Медикобиологические и социальнопсихологические проблемы безопасности в чрезвычайных ситуациях. – № 3. – С. 26–34. doi: https://doi.org/10.25016/2541-7487-2021-0-3-26-34Vagner D.O., Zinoviev E.V., Soloshenko V.V., Shapovalov S.G. Experience of using vacuum therapy in the burn department. Med.- biol. soc.-psihol. probl. bezop. črezvyčajnyh situac. 2021;3:26–34. (In Russ.) doi: https://doi.org/10.25016/2541-7487-2021-0-3-26-34Kumar B., Mohil R.S., Mohan S.K., et al. Comparison of vacuum assisted closure therapy with conventional dressing in the management of necrotizing fasciitis wound. Int Surg J. 2021;8(12):3587–3594. doi: https://doi.org/10.18203/2349-2902.isj20214750Kumar B., Mohil R.S., Mohan S.K., et al. Comparison of vacuum assisted closure therapy with conventional dressing in the management of necrotizing fasciitis wound. Int Surg J. 2021;8(12):3587–3594. doi: https://doi.org/10.18203/2349-2902.isj20214750Kim P.J., Attinger C.E., Constantine T., et al. Negative pressure wound therapy with instillation: International consensus guidelines update. International Wound Journal. 2020;17(1):174–186. doi: https://doi.org/10.1111/iwj.13254Kim P.J., Attinger C.E., Constantine T., et al. Negative pressure wound therapy with instillation: International consensus guidelines update. International Wound Journal. 2020;17(1):174–186. doi: https://doi.org/10.1111/iwj.13254Gabriel A., Camardo M., O'Rorke E., et al. Effects of Negative-Pressure Wound Therapy With Instillation versus Standard of Care in Multiple Wound Types: Systematic Literature Review and Meta-Analysis. Plastic & Reconstructive Surgery. 2021;147(1S-1):68S–76S. doi: https://doi.org/10.1097/PRS.0000000000007614Gabriel A., Camardo M., O'Rorke E., et al. Effects of Negative-Pressure Wound Therapy With Instillation versus Standard of Care in Multiple Wound Types: Systematic Literature Review and Meta-Analysis. Plastic & Reconstructive Surgery. 2021;147(1S-1):68S–76S. doi: https://doi.org/10.1097/PRS.0000000000007614Kanapathy M., Mantelakis A., Khan N., et al. Clinical application and efficacy of negative pressure wound therapy with instillation and dwell time (NPWTI ‐d): A systematic review and meta‐analysis. International Wound Journal. 2020;17(6):1948–1959. doi: https://doi.org/10.1111/iwj.13487Kanapathy M., Mantelakis A., Khan N., et al. Clinical application and efficacy of negative pressure wound therapy with instillation and dwell time (NPWTI ‐d): A systematic review and meta‐analysis. International Wound Journal. 2020;17(6):1948–1959. doi: https://doi.org/10.1111/iwj.13487Milica N.N., Soldusova V.V., Steblianko V.V. Vacuum instillation therapy in the treatment of purulent-necrotic forms of diabetic foot. Modern Medical Technology. 2020;4:71–75. doi: https://doi.org/10.34287/MMT.4(47).2020.12Milica N.N., Soldusova V.V., Steblianko V.V. Vacuum instillation therapy in the treatment of purulent-necrotic forms of diabetic foot. Modern Medical Technology. 2020;4:71–75. doi: https://doi.org/10.34287/MMT.4(47).2020.12Horodova-Andrieieva T., Akimov O., Kostenko V., et al. The effect of the use of vacuum therapy and instillation of L-arginine in the treatment of purulent wounds on the activity of nitric oxide cycle enzymes. Emergency medicine. 2025;21(1):71–76. doi: https://doi.org/10.22141/2224-0586.21.1.2025.1834Horodova-Andrieieva T., Akimov O., Kostenko V., et al. The effect of the use of vacuum therapy and instillation of L-arginine in the treatment of purulent wounds on the activity of nitric oxide cycle enzymes. Emergency medicine. 2025;21(1):71–76. doi: https://doi.org/10.22141/2224-0586.21.1.2025.1834Hofmann H.-S. Minimally Invasive Vacuum-Assisted Closure Therapy With Instillation (Mini-VAC-Instill) for Pleural Empyema. Surg Innov. 2015;22(3):235–239.Hofmann H.-S. Minimally Invasive Vacuum-Assisted Closure Therapy With Instillation (Mini-VAC-Instill) for Pleural Empyema. Surg Innov. 2015;22(3):235–239.Ромащенко П.Н., Сазонов А.А., Майстренко Н.А. и др. Применение вакууминстилляционной лапаростомии в лечении пострадавшего с огнестрельным ранением живота. Вестник хирургии имени И. И. Грекова. – 2023. – Т. 182. – №6. – С. 50–54. doi: https://doi.org/10.24884/0042-4625-2023-182-6-50-54Romashchenko P.N., Sazonov A.A., Maistrenko N.A., et al. Application of vacuum-instillation laparostomy in gunshot abdominal wounds. Grekov’s Bulletin of Surgery. 2023;182(6):50–54. (In Russ.) doi: https://doi.org/10.24884/0042-4625-2023-182-6-50-54Пасхалова Ю.С., Митиш В.А., Хамидулин Г.В. и др. Анализ эффективности фаговой терапии у коморбидных пациентов с ранами и хирургической инфекцией различной этиологии по результатам сравнительного клинического исследования // Хирургия. Журнал им. Н.И. Пирогова. – 2025. – № 3. – С. 124–138. doi: https://doi.org/10.17116/hirurgia2025031124Paskhalova Yu.S., Mitish V.A., Khamidulin G.V., et al. Phage therapy analysis of effectiveness in comorbid patients with wounds and surgical infections of various etiology based on the results of a comparative clinical study. Pirogov Russian Journal of Surgery. 2025;3:124–138. (In Russ.) doi: https://doi.org/10.17116/hirurgia2025031124Kanapathy M. Clinical application and efficacy of negative pressure wound therapy with instillation and dwell time (NPWTI ‐d): A systematic review and meta‐analysis. International Wound Journal. 2020;17(6):1948–1959.Kanapathy M. Clinical application and efficacy of negative pressure wound therapy with instillation and dwell time (NPWTI ‐d): A systematic review and meta‐analysis. International Wound Journal. 2020;17(6):1948–1959.De Pellegrin L. Effects of negative pressure wound therapy with instillation and dwell time (NPWTI ‐d) versus NPWT or standard of care in orthoplastic surgery: A systematic review and m ETA‐ANALYSIS. International Wound Journal. 2023;20(6):2402–2413.De Pellegrin L. Effects of negative pressure wound therapy with instillation and dwell time (NPWTI ‐d) versus NPWT or standard of care in orthoplastic surgery: A systematic review and m ETA‐ANALYSIS. International Wound Journal. 2023;20(6):2402–2413.Митиш В.А., Пасхалова Ю.С. Местное лечение ран. Учебное пособие. Москва: ГЭОТАР-Медиа, 2026. 128 с.Mitish V.A., Paskhalova Yu.S. Local wound treatment. The training manual. Moscow: GEOTAR-Media, 2026. 128 p. (In Russ.)Потапов В.А., Кохан Е.П., Асанов О.Н., Мусаилов В.А. Применение вакуумтерапии и бактериофагов в комплексном лечении глубокой стернальной инфекции. Вестник Национального медикохирургического Центра им. Н. И. Пирогова. – 2021. – Т. 16. – № 2. – С. 66–71. doi: https://doi.org/10.25881/20728255_2021_16_2_66Potapov V.A., Kohan E.P., Asanov O.N., Musailov V.A. Use of vacuum therapy and bacteriophages in the complex treatment of deep sternal wound infection. Bulletin of Pirogov National Medical & Surgical Center. 2021;16(2):66–71. (In Russ.) doi: https://doi.org/10.25881/20728255_2021_16_2_66Grabowski Ł., Łepek K., Stasiłojć M., et al. Bacteriophage-encoded enzymes destroying bacterial cell membranes and walls, and their potential use as antimicrobial agents. Microbiological Research. 2021;248:126746. doi: https://doi.org/10.1016/j.micres.2021.126746Grabowski Ł., Łepek K., Stasiłojć M., et al. Bacteriophage-encoded enzymes destroying bacterial cell membranes and walls, and their potential use as antimicrobial agents. Microbiological Research. 2021;248:126746. doi: https://doi.org/10.1016/j.micres.2021.126746Zeng W., Chen P., Li S., et al. Hand-Powered Vacuum-Driven Microfluidic Gradient Generator for High-Throughput Antimicrobial Susceptibility Testing. Biosens Bioelectron. 2022;205:114100. doi: https://doi.org/10.1016/j.bios.2022.114100Zeng W., Chen P., Li S., et al. Hand-Powered Vacuum-Driven Microfluidic Gradient Generator for High-Throughput Antimicrobial Susceptibility Testing. Biosens Bioelectron. 2022;205:114100. doi: https://doi.org/10.1016/j.bios.2022.114100Nebeluk N., Tyne D.V., Saharia K., Doub J.B. What Are the Optimal Irrigating Wound Vacuum Parameters When Using Bacteriophage Therapeutics? Surgical Infections. 2025; 26(8):557–560. doi: https://doi.org/10.1089/sur.2025.029Nebeluk N., Tyne D.V., Saharia K., Doub J.B. What Are the Optimal Irrigating Wound Vacuum Parameters When Using Bacteriophage Therapeutics? Surgical Infections. 2025; 26(8):557–560. doi: https://doi.org/10.1089/sur.2025.029Nikolich M.P., Filippov A.A. Bacteriophage Therapy: Developments and Directions. Antibiotics. 2020;9(3):135. doi: https://doi.org/10.3390/antibiotics9030135Nikolich M.P., Filippov A.A. Bacteriophage Therapy: Developments and Directions. Antibiotics. 2020;9(3):135. doi: https://doi.org/10.3390/antibiotics9030135Meshkin D.H., Fan K.L., Charipova K., et al. Long-Term Outcome Assessment Between Antiseptic and Normal Saline for Negative Pressure Wound Therapy with Instillation. Advances in Wound Care. 2021;10(10):535–543. doi: https://doi.org/10.1089/wound.2021.0023Meshkin D.H., Fan K.L., Charipova K., et al. Long-Term Outcome Assessment Between Antiseptic and Normal Saline for Negative Pressure Wound Therapy with Instillation. Advances in Wound Care. 2021;10(10):535–543. doi: https://doi.org/10.1089/wound.2021.0023Zhong M., Guo J., Qahar M., et al. Combination therapy of negative pressure wound therapy and antibiotic‐loaded bone cement for accelerating diabetic foot ulcer healing: A prospective randomised controlled trial. International Wound Journal. 2024;21:e70089. doi: https://doi.org/10.1111/iwj.70089Zhong M., Guo J., Qahar M., et al. Combination therapy of negative pressure wound therapy and antibiotic‐loaded bone cement for accelerating diabetic foot ulcer healing: A prospective randomised controlled trial. International Wound Journal. 2024;21:e70089. doi: https://doi.org/10.1111/iwj.70089Guo H., Xue Z., Mei S., et al. Clinical efficacy of antibiotic-loaded bone cement and negative pressure wound therapy in multidrugresistant organisms diabetic foot ulcers: a retrospective analysis. Front Cell Infect Microbiol. 2025;14:1521199. doi: https://doi.org/10.3389/fcimb.2024.1521199Guo H., Xue Z., Mei S., et al. Clinical efficacy of antibiotic-loaded bone cement and negative pressure wound therapy in multidrugresistant organisms diabetic foot ulcers: a retrospective analysis. Front Cell Infect Microbiol. 2025;14:1521199. doi: https://doi.org/10.3389/fcimb.2024.1521199Shiels S.M., Sgromolo N.M., Wenke J.C. Negative pressure wound therapy does not diminish efficacy of topical antibiotic powder in a preclinical contaminated wound model: an animal study. Bone & Joint Research. 2021;10(2):149–155. doi: https://doi.org/10.1302/2046-3758.102.BJR-2020-0171.R1Shiels S.M., Sgromolo N.M., Wenke J.C. Negative pressure wound therapy does not diminish efficacy of topical antibiotic powder in a preclinical contaminated wound model: an animal study. Bone & Joint Research. 2021;10(2):149–155. doi: https://doi.org/10.1302/2046-3758.102.BJR-2020-0171.R1Kitano D., Sakurai A., Kuwazuru K., et al. Intra-soft tissue and intramedullary antibiotic perfusion in combination with negative pressure wound therapy. J Wound Care. 2023;32(Supll):14–S23. doi: https://doi.org/10.12968/jowc.2023.32.Sup11.S14Kitano D., Sakurai A., Kuwazuru K., et al. Intra-soft tissue and intramedullary antibiotic perfusion in combination with negative pressure wound therapy. J Wound Care. 2023;32(Supll):14–S23. doi: https://doi.org/10.12968/jowc.2023.32.Sup11.S14Terabe Y., Kaneko N., Ando H. Negative Pressure Wound Therapy with Instillation and Dwell Time Using Antiseptic Solution in Chronic Limb-threatening Ischemia. Plastic and Reconstructive Surgery – Global Open. 2024;12(2):e5578. doi: https://doi.org/10.1097/GOX.0000000000005578Terabe Y., Kaneko N., Ando H. Negative Pressure Wound Therapy with Instillation and Dwell Time Using Antiseptic Solution in Chronic Limb-threatening Ischemia. Plastic and Reconstructive Surgery – Global Open. 2024;12(2):e5578. doi: https://doi.org/10.1097/GOX.0000000000005578Tahir S., Parvin F., Wang M., et al. The efficacy of antimicrobial solutions against multispecies bacterial biofilm with or without negative pressure wound therapy in an in vitro wound model. Journal of Antimicrobial Chemotherapy. 2024;79(12):3178–3185. doi: https://doi.org/10.1093/jac/dkae338Tahir S., Parvin F., Wang M., et al. The efficacy of antimicrobial solutions against multispecies bacterial biofilm with or without negative pressure wound therapy in an in vitro wound model. Journal of Antimicrobial Chemotherapy. 2024;79(12):3178–3185. doi: https://doi.org/10.1093/jac/dkae338Wang G., Xu H., Xu G., et al. Clinical outcomes of negative pressure wound therapy with instillation vs standard negative pressure wound therapy for wounds: A meta‐analysis of randomised controlled trials. International Wound Journal. 2023;20(5):1739–1749. doi: https://doi.org/10.1111/iwj.13989Wang G., Xu H., Xu G., et al. Clinical outcomes of negative pressure wound therapy with instillation vs standard negative pressure wound therapy for wounds: A meta‐analysis of randomised controlled trials. International Wound Journal. 2023;20(5):1739–1749. doi: https://doi.org/10.1111/iwj.13989Diehm Y.F., Loew J., Will P.A., et al. Negative pressure wound therapy with instillation and dwell time (NPWTI ‐d) with V. A. C. VERAFLO in traumatic, surgical, and chronic wounds – A helpful tool for decontamination and to prepare successful reconstruction. International Wound Journal. 2020;17(6):1740– 1749. doi: https://doi.org/10.1111/iwj.13462Diehm Y.F., Loew J., Will P.A., et al. Negative pressure wound therapy with instillation and dwell time (NPWTI ‐d) with V. A. C. VERAFLO in traumatic, surgical, and chronic wounds – A helpful tool for decontamination and to prepare successful reconstruction. International Wound Journal. 2020;17(6):1740– 1749. doi: https://doi.org/10.1111/iwj.13462Popivanov G., Penchev D., Chipeva S., et al. 14 Conventional versus instillation NPWT in the treatment of surgical site infections – an interim analysis of ongoing prospective trial. British Journal of Surgery. 2025;112(Supplement_4). doi: https://doi.org/10.1093/bjs/znaf024.020Popivanov G., Penchev D., Chipeva S., et al. 14 Conventional versus instillation NPWT in the treatment of surgical site infections – an interim analysis of ongoing prospective trial. British Journal of Surgery. 2025;112(Supplement_4). doi: https://doi.org/10.1093/bjs/znaf024.020

The authors declare that there are no conflicts of interest present.