Infection of burn wounds caused by antibiotic-resistant pathogens is the leading cause of systemic infectious complications in burned patients and a key link in the pathogenesis of burn disease, causing its course and outcome. The use of phage therapy to overcome antibiotic resistance of infection agents is a promising direction, the development of which can improve the results of treatment of burned. The article discusses: 1) features of the infectious process in burned; 2) the effect of antibacterial chemotherapy of burn wound infection on the microbiome and the processes of reparative regeneration; 3) principles of phage therapy; 4) ways of delivering bacteriophages; 5) development of resistance to bacteriophages 6) personalization of phage therapy.

Objective: To evaluate clinical and microbiological effectiveness of the combined preparation Simprazole® (ornidazole 500 mg + ciprofloxacin 500 mg) in patients with skin and soft tissue infections.

Material and methods. This prospective study was conducted in a multidisciplinary hospital from February to May 2023. Outcomes after treating patients with purulent wounds of the skin and soft tissues of various origins and location were analyzed. Patients with the extremely severe infectious processes and decompensated diseases of cardiopulmonary, respiratory and other vital systems were excluded from the study. Resistance and sensitivity of isolated strains to antibiotics was assessed in patients’ tests in 7 or 14 days. Patients with strains sensitive to ciprofloxacin were enrolled in the study. In addition to the antibacterial therapy, they had local treatment (dressings and wound debridement).

Results. The involved 60 patients had a combined surgical treatment in the hospital. Clinical and laboratory findings have shown that the combined preparation consisting of ciprofloxacin and ornidazole has a high clinical and bacteriological effectiveness (95 and 96.7 %, respectively) in patients with purulent wounds of the skin and soft tissues regardless of pathogens etiology (aerobic or anaerobic) and anaerobic component, if these pathogens are sensitive to ciprofloxacin. The discussed preparation is well tolerated in 99 % of cases; no registered adverse reactions.

Conclusion. The combined preparation Simprazole® (500 mg of ornidazole and 500 mg of ciprofloxacin) has a wide spectrum of action and original mechanisms of impact at microbes. It is an effective and safe drug for treating skin and soft tissue infections from both clinical and microbiological points of view.

Pain management at phase 1 of the wound process includes wound cleaning due to the lysis of purulent-necrotic masses, control of the pathogenic microflora, and evacuation of wound discharge. These factors are achievable with a new composite depo-material having the textile base, hydrogel composition based on biopolysaccharide sodium alginate with immobilized active components – proteolytic enzyme of plant origin- papain and antimicrobial salt-like silver. Biosynthesis of silver nanoparticles and its presence in the composition in the cation form increases efficacy and eliminates toxicity of the treatment due to low silver concentration.

The article presents a clinical observation of a successful comprehensive treatment of a phlegmon on the foot dorsum in a patient with idiopathic distal polyneuropathy. The authors demonstrate how the purulent process was relieved, then transferred to the wound healing state and to the regeneration state followed by the plastic surgery due to the technique of active surgical treatment of wounds and purulent-necrotic foci developed at the A. V. Vishnevsky Institute of Surgery (Moscow). The described wound has healed with primary intention even under the surgical infection. An important component of the active surgical treatment is local therapy, which is rapidly developing at present and which includes such methods as negative pressure, ultrasonic cavitation, laser technologies and others. However, classic bandaging of purulent wounds does not lose its relevance. Moreover, polyethylene glycol-based ointments, in particular, timed-proven Levomekol®, preserve their high activity and effectiveness both in the first (inflammation) and second (regeneration) stages of the wound healing process, for both eliminating the infection and preparing wounds for further plastic surgery.

The article provides a brief analysis of the action mechanisms of modern combinations by glucose-lowering drugs for type 2 diabetes mellitus, diabetic foot syndrome and obesity. Using the example of clinical observations, the positive dynamics of reducing body weight and glycated hemoglobin was demonstrated. It also shows how good control of type 2 diabetes makes it possible to effectively treat such a formidable complication as diabetic foot syndrome.