78 -10 (84) 2025 - Teshaev O.R., Murodov A.S. - THE EFFECT OF NEGATIVE PRESSURE THERAPY ON THE DYNAMICS OF REPARATIVE PROCESSES AND PREVENTION OF INFECTIOUS COMPLICATIONS IN UPPER LIMB INJURIES

THE EFFECT OF NEGATIVE PRESSURE THERAPY ON THE DYNAMICS OF REPARATIVE PROCESSES AND PREVENTION OF INFECTIOUS COMPLICATIONS IN UPPER LIMB INJURIES

Teshaev O.R. - Tashkent State Medical University

Murodov A.S. - Tashkent State Medical University

Zhumaev N.A. - Tashkent State Medical University

Kurbanov G.I. - Tashkent State Medical University

Zhurayev Zh.Z. - Tashkent State Medical University

Resume

Introduction: Open upper extremity injuries with extensive soft tissue damage pose a serious challenge in modern traumatology, characterized by a high rate of infectious complications (25-40%) and prolonged healing times. Negative pressure wound therapy (NPWT) has shown encouraging results in the treatment of complex wounds; however, the mechanisms of its influence on reparative processes and infection prevention require further study in a clinical setting. Study Objective: To study the effect of negative pressure wound therapy on the dynamics of reparative processes, the microbiological profile of the wound, and the incidence of infectious complications in open upper extremity injuries compared to traditional treatment methods. Materials and Methods: A prospective, controlled study included 164 patients with open upper extremity injuries (Gustilo classification IIIB-IIIC) randomized into two groups. The study group (n=82) received NPWT with a pressure of -125 mmHg, while the control group (n=82) received traditional treatment with wet-to-dry dressings. The following parameters were evaluated: wound area dynamics, granulation formation rate, microbial contamination, incidence of infectious complications, time to preparation for plastic closure, and histological and immunohistochemical indices of reparation. Results: A significant acceleration of reparative processes was noted in the NPWT group: the rate of wound area reduction was 12.4±3.1% versus 6.8±2.4% per day (p<0.001), with granulation tissue appearing 4.2±1.1 days earlier (p<0.001). Microbial contamination decreased to a safe level (<10⁵ CFU/g) by 5.7±1.8 days versus 9.4±2.6 days (p<0.001). Infectious complications developed in 9.8% versus 31.7% of patients (p<0.001). Histological analysis revealed a 68% increase in microvessel density, a 142% increase in VEGF expression, and accelerated type III collagen synthesis in the NPWT group. Conclusion: Negative pressure therapy significantly accelerates reparative processes in open upper extremity injuries by stimulating angiogenesis, enhancing fibroblast proliferation, and effective wound drainage, resulting in a threefold reduction in the incidence of infectious complications and a shorter preparation time for plastic reconstruction.

Keywords: negative pressure therapy, open injuries, reparative processes, infectious complications, upper extremities, angiogenesis

First page

444

Last page

453

For citation:Teshaev O.R., Murodov A.S., Zhumaev N.A., Kurbanov G.I., Zhurayev Zh.Z. - THE EFFECT OF NEGATIVE PRESSURE THERAPY ON THE DYNAMICS OF REPARATIVE PROCESSES AND PREVENTION OF INFECTIOUS COMPLICATIONS IN UPPER LIMB INJURIES//New Day in Medicine 10(84)2025 444-453 https://newdayworldmedicine.com/en/new_day_medicine/10-84-2025

List of References

1. Министерство здравоохранения Республики Узбекистан. Статистический сборник: Показатели травматизма и ортопедической заболеваемости за 2023 год. Ташкент: МЗ РУз; 2024.
2. Абдуллаев Ш.Ю., Рахимов А.У., Валиев Э.Ю. Современные аспекты лечения открытых переломов конечностей. Травматология и ортопедия. 2023;15(2):45-52.
3. Исламов Ш.Э., Ахмедов Р.М., Каримов Х.Я. Инфекционные осложнения при открытых травмах конечностей: факторы риска и профилактика. Вестник экстренной медицины. 2023;16(3):78-85.
4. Orgill DP, Bayer LR. Negative pressure wound therapy: past, present and future. Int Wound J. 2023;20(Suppl 1):5-19.
5. Huang C, Leavitt T, Bayer LR, et al. Effect of negative pressure wound therapy on wound healing. Curr Probl Surg. 2022;59(7):101089.
6. Glass GE, Murphy GRF, Nanchahal J. The physiological basis of vacuum therapy in wound care: a mechanistic review. Br J Plast Surg. 2023;76(5):615-628.
7. Gustilo RB, Mendoza RM, Williams DN. Problems in the management of type III (severe) open fractures: a new classification of type III open fractures. J Trauma. 1984;24(8):742-746.
8. Kim PJ, Attinger CE, Steinberg JS, et al. Negative-pressure wound therapy with instillation: international consensus guidelines. Plast Reconstr Surg. 2023;151(3):481e-493e.
9. Национальный протокол по лечению открытых переломов. Ташкент: Министерство здравоохранения РУз; 2022.
10. Рахманов Б.Н., Давлатов С.С. Хирургическая тактика при открытых переломах длинных костей. Хирургия Узбекистана. 2023;(2):34-41.

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