Infectious and inflammatory processes in sutured soft tissue wounds are met in 3–22% of cases despite the strict following of aseptic and antiseptic rules, application of new antiseptic agents with high bactericidal effect as well as improved techniques for prevention and management of wound infection.
Objective. To perform a comparative analysis on healing processes in sutured soft tissue wounds after surgical interventions in which purulent-necrotic processes have developed.
Materials and methods. All patients were divided into two groups – main and control. Patients from the main group (n = 58) had vacuum drainage of subcutaneous tissues in sutured wounds after surgery from June 2019 till November 2021. Case-histories of 80 patients from the control group were analyzed retrospectively; the researchers assessed outcomes after surgical management. In these patients, drainage of subcutaneous tissues in sutured wounds after surgery for purulent-necrotic processes in soft tissues was done using the traditional flow-washing technique. Both studied groups were comparable in sex, age and co-morbidity.
Results. In the control group, complications in the form of suppurated lesions were noted in 17 (17.5 %) patients. In 10 (12.5 %) patients with marginal skin necrosis, there was suture dehiscence. None of 58 patients from the main group in whom surgical wounds were treated with the technique of vacuum drainage developed by us had any purulent-septic complications. In all cases, wounds healed with the primary intention.
Conclusion. The technique of vacuum drainage developed by us allowed to achieve better outcomes at the early postoperative period.

The authors describe a clinical case of successful treatment of a patient with an ischiorectal abscess complicated by extensive purulentnecrotic phlegmon on the anterior abdominal wall and right thigh. Topical negative pressure wound technique (NPWT) was used. Its combination with surgical debridement and rational systemic antibiotic therapy has been shown to contribute to successful treatment of this life-threatening pathology.

The article presents a clinical case of successful complex surgical management of a 62-year-old patient with chronic post-traumatic tibial osteomyelitis. A two-stage surgical treatment was aimed to sanitize a chronic purulent focus in the tibia lower third and to perform a complex reconstructive surgery aimed to correct bone and soft tissue defects. The reconstructive stage of the discussed complex surgical treatment consisted in combined plasty: a cavity in the bone was filled with bone grafts obtained from the iliac crest; and a skin and soft tissue defect was corrected with an islet sural musculocutaneous flap on the distal feeding pedicle. As a result, the surgeons could effectively correct tibia and soft tissues defects with good functional and cosmetic results.

A clinical case of successful treatment of a patient with chronic calcaneus gunshot osteomyelitis and necrotic wound in the calcaneal region is discussed. A two-staged surgical management of the wound defect with a sural flap is described. It promoted a complete recovery of the patient.