Treatment of chronic wounds of the lower limb with the use of VAC-therapy. Impact on immunity and bacterial films.

OBJECTIVE

Aim: To improve the results of treatment of patients with chronic wounds of the lower extremities by using complex treatment, including surgical interventions, VAC- therapy, as well as studying the effect of negative pressure on bacterial films of wounds, based on microbiological examination and immune-histochemical data.

PATIENTS AND

METHODS

Materials and

Methods

During the period from 2019 to 2023 at the department's clinic, 68 patients with chronic wounds of the lower extremities were examined and treated. These are mainly women (n=63) aged from 35 to 80 years.

RESULTS

Results

Complete wound healing was achieved in all patients. In 79% of patients, the transplanted skin graft took root completely. Partial lysis was observed in 17%, requiring repeated operations. In 4%, the wounds healed without surgery. The VAC- therapy we used prevented the restoration of the biofilm and prevented further infection of the wound. After complex treatment, we observed positive dynamics of clinical and immunological parameters. Indicators of T-cell immunity (CD3+, CD4+, CD19+) were restored, the level of CIC significantly decreased and the level of IgM increased. The level of interleukins on day 21 showed a tendency towards normalization.

CONCLUSION

Conclusions

A modern integrated approach gives the chance to radically solve the problems of healing chronic wounds. VAC- therapy in combination with surgical treatment and antibacterial therapy prevented the restoration of biofilm and further infection of wounds, which led to the wound healing in 100% cases.