Treatment of chronic wounds of the lower limb with the use of VAC-therapy. Impact on immunity and bacterial films

OBJECTIVE: Aim: To improve the results of treatment of patients with chronic wounds of the lower extremities by using complex treatment, including surgical interventions, VAC- therapy, as well as studying the effect of negative pressure on bacterial films of wounds, based on microbiological examination and immune-histochemical data. PATIENTS AND METHODS: Materials and Methods: During the period from 2019 to 2023 at the department's clinic, 68 patients with chronic wounds of the lower extremities were examined and treated. These are mainly women (n=63) aged from 35 to 80 years. RESULTS: Results: Complete wound healing was achieved in all patients. In 79% of patients, the transplanted skin graft took root completely. Partial lysis was observed in 17%, requiring repeated operations. In 4%, the wounds healed without surgery. The VAC- therapy we used prevented the restoration of the biofilm and prevented further infection of the wound. After complex treatment, we observed positive dynamics of clinical and immunological parameters. Indicators of T-cell immunity (CD3+, CD4+, CD19+) were restored, the level of CIC significantly decreased and the level of IgM increased. The level of interleukins on day 21 showed a tendency towards normalization. CONCLUSION: Conclusions: A modern integrated approach gives the chance to radically solve the problems of healing chronic wounds. VAC- therapy in combination with surgical treatment and antibacterial therapy prevented the restoration of biofilm and further infection of wounds, which led to the wound healing in 100% cases.