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Microflora of Acute Festering-Necrotic Processes of Soft Tissues under Local Application of Adsorbed Antibiotics

Background: Microbial contamination of chronic wounds plays an important role in prevention of healing and development of complications. Existing approaches for decontaminating of chronic wounds lack efficacy.

Objectives: The aim of the study is to study the effectiveness of local use of the combined form of adsorbed antibacterial drug in the surgical treatment of purulent necrotic processes of soft tissues.

Methods: The study included 45 patients with various chronic wounds and trophic ulcers in the phase of exudation (post-thrombophlebitis disease, peripheral arteries atherosclerosis and diabetic foot syndrome). Drug composition containing gentamicin sulfate, polymethylsiloxan and coordination compound of zinc with L-tryptophan was topically used in study group patients for local treatment once daily covering the whole wound area with thin layer of powder. Microbiological methods included determination of species composition of aerobes and anaerobic flora, cultivation and study of microorganisms' population levels in wound's biofilms.

Results: Microbial spectrum dominated by Gram-positive cocci (S. aureus, S. epidermidis, Streptococcus spp.). Pathogens were presented by members of other taxonomic groups, including the Enterobacteriacea family; in single cases, anaerobic Bacteroides spp and Peptostreptococci were found. The total number of species in both groups of patients at the time of hospitalization were similar – 28 strains of different taxonomic groups. Treatment in research group dramatically reduced microflora population levels: E. coli by 35,6%, P. aeruginosa by 39,5%, S. aureus by 45,1%, S. epidermidis by 24,3%. Population levels of these pathogens become significantly lower than in the control group (P<0.001-0.005).

Conclusion: Local application of sorbent and antibiotic compositions in the local treatment of purulent necrotic processes of soft tissue allows achievement of elimination or significant inhibition of pathogenic and conditionally pathogenic microorganisms from wound surfaces, thus creating conditions for faster healing.

Author(s): Ruslan Sydorchuk , Kristina Pavlovych, Sah Prasad Suman, Oleg Khomko, Oleksandr Plehutsa, Anis Aissaoui, Bohdan Khomko, Kapil Raj Dhital

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