Wound coatings with long-acting enzymes in the treatment of wounds and wound infections using (a clinical case)

This article focuses on improving local treatment tactics for purulent wounds in the context of increasing antibiotic resistance and the incidence of complex man-made and combat injuries. The authors conducted a comparative analysis of the antimicrobial activity of modern antiseptics, using for cleansing wound surfarces before dressings, revealing the superiority of Trihexylon® (Russia) over traditional agents against hospital-acquired strains, including P. aeruginosa and A. baumannii.

The focus is on the pathogenetic rationale for the use of proteolytic enzymes immobilized on modified cellulose carriers. The study compares the properties of native enzymes and modern russian enzyme-containing dressings (PROTEOX, PAM-T, MULTIFERM). It was found that chemical immobilization of trypsin on dialdehyde cellulose provides prolonged necrolytic activity (up to 48–72 hours), protection of enzymes from tissue inhibitors, and a reduction in their antigenicity. The study results demonstrate that the use of such biologically active dressings accelerates wound cleansing of devitalized tissue, suppresses the inflammatory response, and creates optimal conditions for starting regeneration. The use of this technique in combination with surgical debridement reduces hospital stays and prepares the wound surface for plastic closure as quickly as possible.

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