asurgeryАмбулаторная хирургияAmbulatornaya khirurgiya = Ambulatory Surgery (Russia)2712-87412782-2591ООО «ГРУППА РЕМЕДИУМ»10.21518/akh2024-027asurgery-452Research ArticleГНОЙНЫЕ И ТРОФИЧЕСКИЕ ПОРАЖЕНИЯPURULENT AND TROPHIC LESIONSПерспективы применения антимикробных биодеградируемых раневых покрытий для лечения гнойных ранThe prospects of application of antimicrobial biodegradable wound dressings for the treatment of purulent woundshttps://orcid.org/0000-0002-4197-2207ГуменюкС. Е.GumenyukS. E.

Гуменюк Сергей Евгеньевич, д.м.н., профессор, заведующий кафедрой хирургических болезней

350063, Краснодар, ул. Митрофана Седина, д. 4

Sergey E. Gumenyuk, Dr. Sci. (Med.), Professor, Head of Department of Surgical Diseases

4, Mitrofan Sedin St., Krasnodar, 350063

gse@mail.ruhttps://orcid.org/0000-0002-3665-3906УшмаровД. И.UshmarovD. I.

Ушмаров Денис Игоревич, ассистент кафедры хирургических болезней

350063, Краснодар, ул. Митрофана Седина, д. 4

Denis I. Ushmarov, Research Assistant, Department of Surgical Diseases

4, Mitrofan Sedin St., Krasnodar, 350063

upo@ksma.ruhttps://orcid.org/0000-0003-4793-783XШокельО. Ю.ShokelO. Yu.

Шокель Ольга Юрьевна, ординатор кафедры акушерства и гинекологии

197341, Санкт-Петербург, ул. Аккуратова, д. 2

Olga Yu. Shokel, Resident at the Department of Obstetrics and Gynecology

2, Akkuratov St., St Petersburg, 197341

1solga2108@mail.ruhttps://orcid.org/0009-0007-0739-3563АйдиноваЕ. А.AydinovaE. A.

Айдинова Елена Александровна, студент лечебного факультета

350063, Краснодар, ул. Митрофана Седина, д. 4

Elena A. Aydinova, Student, Faculty of General Medicine

4, Mitrofan Sedin St., Krasnodar, 350063

aydiniva96@gmail.comhttps://orcid.org/0009-0009-9783-4936БеляковаЯ. В.BelyakovaYa. V.

Белякова Яна Вячеславовна, студент лечебного факультета

350063, Краснодар, ул. Митрофана Седина, д. 4

Yana V. Belyakova, Student, Faculty of General Medicine

4, Mitrofan Sedin St., Krasnodar, 350063

byvvk@bk.ruКубанский государственный медицинский университетРоссияKuban State Medical UniversityRussian FederationНациональный медицинский исследовательский центр имени В.А. АлмазоваРоссияAlmazov National Medical Research CentreRussian Federation202412092024212111119Copyright © Гуменюк С.Е., Ушмаров Д.И., Шокель О.Ю., Айдинова Е.А., Белякова Я.В., 20242024Гуменюк С.Е., Ушмаров Д.И., Шокель О.Ю., Айдинова Е.А., Белякова Я.В.Gumenyuk S.E., Ushmarov D.I., Shokel O.Y., Aydinova E.A., Belyakova Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.a-surgeon.ru/jour/article/view/452

Введение. В связи с ростом числа полиантибиотикорезистентных штаммов микроорганизмов все большую актуальность в хирургии набирает вопрос совершенствования тактики местного лечения ран мягких тканей без использования антибактериальной терапии.Цель. Изучить зависимость антисептического эффекта раневых покрытий на основе хитозана от степени их биодеградации и оценить перспективы применения подобных покрытий для лечения гнойных ран.Материалы и методы. Объектом исследования стали раневые покрытия с инкорпорированным антисептиком полигексанидом (PH) на основе хитозана двух типов: нестабилизированного (Ch-H-PH) и стабилизированного путем сшивки с глутаровым альдегидом (Ch-H-GA-PH). Исследование спектра антимикробной активности проведено in vitro при помощи диско-диффузионного метода с использованием тест-культур Staphylococcus aureus и Escherichia coli. Направленность биодеградации изучали путем проведения сканирующей электронной микроскопии.Результаты и обсуждение. Стабилизированные образцы Ch-H-GA-PH в силу более длительных сроков биодеградации обладали пролонгированным антимикробным действием (max – 36–48 ч; p ≤ 0,05), в то время как образцы Ch-H-PH по причине высокой гидрофильности материала биодеградировали в ранние сроки и реализовывали весь антимикробный потенциал в срок до 24 ч (max – 12 ч; p ≤ 0,05). Полученные результаты коррелировали с данными, представленными в работах зарубежных исследователей по изучению свойств биополимерных материалов в качестве матриц-носителей для лекарственных средств, а также в области поиска путей преодоления полиантибиотикорезистентности в хирургической практике.Выводы. Применение раневых покрытий антисептического типа действия на основе хитозана с различными параметрами биодеградации позволит осуществить программируемый подход к лечению гнойных ран мягких тканей персонифицированно в зависимости от конкретной клинической ситуации.

Introduction. Due to the growing number of polyantibiotic-resistant strains of microorganisms, the issue of improving the tactics oflocal treatment of soft tissue wounds without the use of antibiotic therapy is gaining more and more urgency in surgery.Aim. To study the dependence of the antiseptic effect of chitosan-based wound dressings on the degree of their biodegradation and to evaluate the prospects for the use of such dressings for the treatment of purulent wounds.Materials and methods. The object of the study was wound dressings with incorporated antiseptic polyhexanide (PH) based on chitosan of two types: unstabilized (Ch-H-PH) and stabilized by cross-linking with glutaric aldehyde (Ch-H-GA-PH). The antimicrobial activity spectrum was investigated in vitro by disk-diffusion method using test cultures of Staphylococcus aureus and Escherichia coli. The directionality of biodegradation was studied by scanning electron microscopy.Results and discussion. Stabilized Ch-H-GA-PH samples had prolonged antimicrobial action due tolonger biodegradation times (max – 36–48 h; p ≤ 0.05), while Ch-H-PH samples due to high hydrophilicity of the material biodegraded early and realized the full antimicrobial potential within 24 hours (max – 12 h; p ≤ 0.05). The obtained results correlated with the data provided in the foreign researchers’ publications on the investigation of the properties of biopolymer materials used as matrix carriers for drugs, and in terms of addressing the search for strategies to combat poly-antibiotic resistance in surgical practice.Conclusion. Application of wound dressing s of antiseptic type of action on the basis of chitosan with different parameters of biodegradation will allow to realize a programmed approach to treatment of purulent wounds of soft tissues in a personalized way depending on a specific clinical situation.

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The authors declare that there are no conflicts of interest present.