The high resistance of the bacterial flora to existing antibacterial drugs makes it necessary to look for new approaches in the tactics of treating infectious wound complications. Phage therapy is one of the alternative ways to solve this problem. Foreign military medical organizations, together with private pharmaceutical companies, with the financial support of states, are actively developing all kinds of ways to use bacteriophages in various areas of combating bacterial infectious agents. The article outlines main research programs aimed at studying the possibilities of phage therapy in combat and burn injuries, which are being developed in Western Europe (France, Poland, Belgium, Austria, Switzerland), the USA, China, and Israel.

The multifunctional protein C system regulates both hemostasis and the immune system in response to vascular and inflammatory damage, inhibits thrombinogenesis at an early stage of clotting. A decrease in protein C levels in clinical practice may be associated with vitamin K deficiency, as well as with coumarin therapy. Prolonged use of indirect anticoagulants may be accompanied by a decrease in protein C levels and contribute to the development of rebound thrombosis and thromboembolism. The depth of violations of the protein C system indicates the activation of the microthrombosis process and may affect the outcome of treatment of surgical patients.

Knitted wound dressings based on synthetic polymers (primarily lavsan) have some advantages over dressings based on natural materials (cotton, etc.) – first of all, they cause less irritation of wound surfaces due to the absence of microvilli. However, during storage one can see changes in the properties of lavsan dressings, i. e. the material becomes more rigid. Under the present work, it has been shown that these changes are caused by the significantly increased crystallinity of lavsan fibers during exposure to natural environment. To reduce lavsan crystallinity, it is recommended to process the material with mixtures of polyethylene glycols which are popular ointment bases. Heat enhances the effect and returns the original degree of softness to knitted lavsan dressing materials.

The authors present their experience in applying quantum electronic devices in patients undergoing lower limb amputations.

Object. To develop a technique for potentiating the traditional multimodal anesthesia by optoelectronic devices with wavelength 650 nm (red range) and 470 nm (blue range) (manufactured in Russia) in amputation of lower extremities.

Material and methods. Multimodal anesthesia with quantum electronic devices was performed in 48 patients (11 women and 37 men) aged 68–89 and having comorbidities. In the main group, for contact LED irradiation portable semiconductor LED device AFS к-630/670 emitting in red range with wavelength 650 ± 20 nm and portable AFS device emitting in blue range with wavelength 470 ± 10 nm and power 30 mW at the end of surgery were used. The above mentioned devices were made in the form of bracelets for non-invasive and non-contact application in the multimodal anesthesia during amputations of lower extremities. In the comparison group, multimodal anesthesia was not potentiated by contact LED irradiation.

Results. The discussed Russian bracelets emitting in red and blue bands of the spectrum during amputation of lower extremities promoted the decrease of narcotic dosage (Fentanyl) during general multimodal anesthesia. In the main group, cardiac index increased at the end of surgery, and the total peripheral vascular resistance decreased if to compare to baseline values. In the comparison group, cardiac index increased somewhat less if to compare to baseline values, and the total peripheral vascular resistance decreased somewhat less if to compare to baseline values.

Conclusion. The discussed bracelets emitting in red range (650 nm) which were applied during surgical interventions for the amputation of lower extremities and bracelets emitting in blue range (470 nm) which were applied at the end of surgery reduce the dose of narcotic preparations (Fentanyl) as well as stabilize hemodynamic parameters during surgery. Besides, in the immediate postoperative period, patients who survived amputation of lower extremities and in who the abovementioned bracelets were used do not require additional narcotic painkillers after amputation.

In the given clinical observation, the authors discuss management of a patient with chronic non-lactational mastitis.

A 42-year-old patient with chronic non-lactational granulomatous mastitis had conservative antibiotic therapy for more than a month. During this period, chronic mastitis was diagnosed twice with core biopsy. Ultrasound and mammography examination demonstrated the enlargement of inflammation area. Delayed surgical treatment and specific anatomic structure of the gland, in particular, its ductal structure, high content of adipose tissue, caused the enlargement of the affected area after which half of the tissue volume had to be incised.

After surgery, the patient was prescribed a complex therapy for 1.5 months including physical processing of the wound (ozone-oxygen mixture, NO-flows, negative pressure therapy (NPWT)).

For more than three years of follow-up, the patient had no disease recurrences. The applied complex treatment allowed to get a stable aesthetically acceptable result.

A clinical case of successful surgical treatment of extensive purulent-necrotic lesion of the foot and lower leg in a comorbid patient is described in the article. The lesion had a neuroischemic form of the diabetic foot syndrome. The authors demonstrate the effectiveness of modern techniques for closing extensive soft tissue defects by the combined use of acellular dermal matrices based on collagen and chitosan in the treatment of complex postoperative wounds.