Современные подходы к комплексному лечению гнойно-некротических заболеваний мягких тканей


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В данной статье представлены актуальные сведения о распространенности, модификации этиологических и патогене- тических факторов, а также оценка современных методов лечения гнойно-некротических заболеваний мягких тканей. Особое внимание уделено активно развивающемуся методу физического воздействия на гнойно-некротический процесс – низкочастотной ультразвуковой кавитации (НЧУЗ). Представлена детальная оценка основных свойств ультразвуко- вого воздействия на раневой процесс: механическое очищение раны кавитационной струей, ускорение процесса обмена веществ на внутриклеточном и тканевом уровнях, бактерицидное и бактериостатическое действие на микроорганизмы, усиление действия антибактериальных и антисептических средств, усиление регионарного кровотока, усиление процессов репарации в ране. Применение НЧУЗ актуально на амбулаторно-поликлиническом этапе лечения гнойно-некротических за- болеваний мягких тканей ввиду его высокоэффективности и удобства применения, а также соответствует программе внедрения стационарзамещающих технологий в амбулаторное звено оказания медицинской помощи. Изучение литературы показало, что единичные исследования применения НЧУЗ в амбулаторно-поликлинической практике не содержат четко сформулированных организационно-структурных особенностей и алгоритмов лечения пациентов с гнойно-некротически- ми заболеваниями мягких тканей НЧУЗ кавитацией. Вопросы, связанные с определением оптимальных режимов, кратно- сти и длительности воздействия на рану, оптимальных составов акустических сред, оптимального метода обезболивания при применении НЧУЗ у пациентов с различными нозологическими формами гнойно-некротических заболеваний мягких тканей, остается малоизученным.

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Об авторах

Т.А. Шабловская

Московский государственный медико-стоматологический университет им. А.И. Евдокимова, Москва, Российская Федерация

Автор, ответственный за переписку.
Email: tamara_doc@mail.ru
соискатель кафедры хирургии ФПДО Московского государственного медико-стоматологического университета им. А.И. Евдокимова

Д.Н. Панченков

Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий ФМБА России, Москва, Российская Федерация

Email: dnpanchenkov@mail.ru
д.м.н., проф., зав. кафедрой хирургии ФПДО и лабораторией минимально инвазивной хирургии НИМСИ Московского государственного медико-стоматологического университета им. А.И. Евдокимова

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