Abstract:
Aim. NPWT therapy (Negative-Pressure Wound Therapy) or VAC therapy (Vacuum-Assisted Clousure) – a modern method of
wound healing, which significantly improves the course of all stages of the wound process and is relevant today due to the large number of
wounded during hostilities in eastern Ukraine. Often these injuries are combined and lead to the formation of large soft tissue defects. The
aim of the study. Improving the results of treatment of the wounded with extensive defects of the soft tissues of the torso and extremities
through the use of NPWT therapy. Materials and methods. Under our supervision in the period from 2017 to 2023 there were 60 wounded
who were hospitalized in the surgical departments of the Military Medical Clinical Center of the Southern Region, who received vacuum
therapy in the treatment of wounds. 63.3% had gunshot wounds to the extremities, and 36.7% had soft tissue injuries to the torso. The age
of the wounded ranged from 19 to 58 years, among them young people under 30 years of age. Before installing the device, it was necessary
to perform surgical treatment with excision of necrotic tissue and removal of fibrin layers. Negative pressure was set at –125 mmHg
(arterial) in the non-stop mode for soft tissue defects of the extremities and variable pressure in the –40 mmHg (arterial) mode; –70 mmHg
(arterial) for wounds of the anterior abdominal wall. The duration of treatment with NPWT therapy was from 5 to 25 days. The systems were
replaced at least once every 3–5 days. Criteria for discontinuation of NPWT therapy were: cleansing the wound of necrotized tissues and
fibrin, improving clinical performance, filling the wound defect with granulation tissue. Results and discussion. The use of this method of
treatment allowed to close wound defects by autodermoplasty in 35% patients, primary-delayed sutures in 18%, secondary sutures in 25%
and local tissue plastics in 22%. Complications after NPWT therapy in the form of re-suppuration of the wound, bleeding or perforation of hollow organs and large vessels were not observed. Conclusions. The use of NPWT therapy can significantly increase the effectiveness of
comprehensive treatment of the wounded with damage to the soft tissues of the torso and extremities. It allows you to quickly clean the
wound surface, fill the wound defect with granulation tissue and prepare the wound for plastic closure.
