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. 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. 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. 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.

Purulent-necrotic processes currently represent one of the most prevalent issues in surgery, accounting for approximately 40,0 % of annual medical consultations. Up to 20,0 % of these cases involve extensive purulent lesions of both soft tissues and anatomical cavities, leading to prolonged inpatient treatment. The primary treatment method is surgical debridement; however, performing it in a single operation is not always feasible due to the progression of the necrotic zone. This necessitates staged necrosectomies, resulting in the significant challenge of subsequent wound defect closure. Vacuum-assisted closure (VAC) systems are now actively employed to address such clinical situations. According to guidelines for this treatment method, VAC system application is recommended only on a cleansed wound surface with moderate exudation, a premise questioned by many clinicians. This article attempts to evaluate the efficacy and role of VAC therapy in the surgical management of infected wounds at various sites.

Objective. To analyze the outcomes of VAC therapy in patients with purulent-necrotic soft tissue lesions of different localizations and to assess the role and potential of this method within comprehensive treatment.

Materials and Methods. The study involved 78 patients with extensive purulent-necrotic soft tissue lesions of various localizations. Treatment consisted of surgical management of infected wounds, application of a VAC system, antibacterial therapy, and corrective metabolic support. Treatment efficacy was assessed based on the dynamics of clinical and laboratory parameters, signs of tissue regeneration, and the required duration of hospital stay. To objectify the data, various calculation formulas and indices were used, along with methods of correlation analysis and descriptive statistics.

Research Results. With the application of VAC therapy, significant improvements in the wound defect condition were noted as early as day 3. The Wound Exudation Index decreased to 0.67 ml/cm²/day by day 3 and to 0.26 ml/cm²/day by day 6. Wound surface area reduction was 15.4 % by day 3 and 44.3 % by day 6. The Kalf–Kalif Leukocyte Intoxication Index averaged 15.84 ± 3.24 initially. By day 6 of combined treatment, the indicator decreased to an average of 4.4 ± 1.1. Performing reconstructive surgical interventions became possible within a shorter timeframe compared to conventional treatment strategies.

Conclusion. The integration of negative pressure wound therapy into the comprehensive treatment regimen significantly enhanced the efficacy of managing purulent-necrotic wounds. It promoted reduced healing times, shorter hospital stays, and successful preparation for surgical reconstruction. This confirms the importance and promise of using this method to achieve optimal clinical outcomes.

The article presents materials reflecting the bioengineering potential of innovative biophysical methods for the treatment of chronic wounds based on the application of a plasma-arc system within comprehensive surgical wound management. The use of the unique biological and physical properties of low-temperature plasma in an inert argon gas environment represents a promising approach for the treatment of chronic and postoperative wounds characterized by purulent-necrotic lesions of soft and bone tissues. This method enables the destruction and removal of non-viable tissues, as well as the elimination of bacterial, viral, and fungal infections within the wound.

The article presents the experience of differential diagnosis of morphological forms of Klebsiella pneimoniae by light microscopy in urine sediment from surgical patients of the burn department, whose therapy uses beta–lactam antibiotics in sub-inhibitory concentrations. The urine of patients from the Burn Department of the Center served as the material for the study. General clinical urine analysis was performed using the "dry chemistry" method using test strips on a LabUReader Plus2 urinary semi–automatic analyzer, Hungary. A bacteriological (cultural) study was performed by seeding urine for microflora and antibiotic sensitivity. Microscopic examination of urine sediment was performed by optical light microscopy on a binocular microscope with LED illumination MICROS MS100(XP), Austria. This publication may be of interest to doctors of various specialties, as well as to novice specialists in clinical laboratory diagnostics involved in the study of urine sediment using optical microscopy.

Pyoderma gangrenosa (GP) – a rare chronic inflammatory neutrophilic dermatosis with a complex and poorly understood etiopathogenesis, which is characterized by a specific skin lesion with an evolutionary polymorphism. The article considers a case of severe recurrent gangrenous pyoderma. The tactics of examination and treatment of the patient are described, as well as the problems encountered during the correction of conservative therapy and the use of surgical treatment of this disease.