MICROBIOLOGICAL AND HISTOLOGICAL RE-SEARCH OF APPLICATION EFFICACY OF AN-TISEPTIC REMEDIES WITH PROLONGED AC-TION IN THE TREATMENT OF WOUNDS IN PA-TIENTS WITH BURNS

The improvement of topical antimicrobial treatment of infectious complications in patients with burns is one of the most burning problems of medicine. The aim is to study the peculiarities of wound healing process and the microbial colonization rate in wounds of patients in the acute period of burn disease under the use of remedies of decamethoxine. Materials and methods. There were involved 61 pa-tients with 2nd – b – 3rd stages of burns (the burn body area 10 – 60%), which received surgical (early necrectomy, xenodermo-plastics), who received complex general management according to the protocols. In the study group (n=32; middle age was 43,8±6,12) during the wound dressings' change antiseptic deca-san was used and further application of gauze dressings, im-pregnated by antimicrobial composition (AMC) of decamethoxine (DCM) with carboxymethylamylum, oxyethylcellulose, polyvinilacetate was done (Pat. Of Ukraine № 93662). In com-parison group (n=29; middle age was 41,8±8,7 рр.) wounds were managed with povidone-iodine and, damp-drying bandages with it were imposed. The change of bandages in both groups was carried out daily. The estimation of wound healing was done by means of microbiological and histological methods on the 3rd–7th–14th–21st days after burn trauma. Results and discussion. In the main group, inde-pendently from the trauma area, the microbiological study have shown the reduction of the microorganisms amount below 105 CFU/ml on the 7th day in patients, who received remedies on the basis of DCM. Standard topical antimicrobial therapy did not have the expected effect on the elimination of microorganisms and prevented colonization of the wound by opportunistic microflora (P.aeruginosa). In the observation group, manifestations of early com-pensatory and adaptive processes were found directly in the tissues adjacent to the implant (on the 7th day – increased vascular response, cell infiltration), after 14 days histologically there were observed inflammatory processes of serous-purulent nature with the restoration of tissue circulation, epithelial cover, the beginning of the formation of granulation tissue. But in patients with a larger area of defeat, in some cases, necrotized tissue with an implant and the remnants of necrotic tissues, which were rejected by demarcation inflammation, were observed. At the same time in the wounds in comparison group, purulent-destructive inflammation process was observed with a large area of defeat (burn square 31-50%) vascular function remained significantly depressed, but at the same time there was inflammatory cell infiltration. In patients with larger wound area, cases with no wound repair were observed, but the inflammation had a histo-logically little serous nature, and the absence of microbial colo-nization of the wound provided the attachment of the auto-transplant. In most patients in the comparison group after 21 days of wound healing was incomplete: granulation tissue wound was impoverished with blood vessels, contained less pronounced cellular infiltration, and purulent-productive inflammation was observed. In patients with a burn area of 31-50%, the inflammatory process has often spread to undamaged tissues and morphologically it looked like an acute purulent inflammation. Conclusion. Local application of decasan and AMC with prolonged release of DCM, in comparison with the tradi-tional use of antiseptics, accelerates the beginning of wound repair by reducing microbial colonization and reducing the inflammatory period in the wound.