Comparative evaluation of the complex use of hexetidine and photoditazine in combination with ultrasound and phototherapy in the local treatment of purulent wounds

Objective: to study the features of the course of the wound process both with the isolated use of hexethidine and photoditazine, and in combination with ultrasound therapy. Materials and Methods. The in vivo experiment was performed on 144 animals (male Wistar rats) divided into 4 equal groups. A purulent wound model (S=150mm²) was formed in all rats, which was treated with the studied combinations with and without ultrasound therapy. The percentage of area reduction, healing rate, microbial contamination, and morphological picture of wounds were evaluated. Results. In the groups treated with the combination we developed, complete wound healing had occurred by 15 days. The greatest activity was in phase I of the wound process, which is confirmed by the maximum wound healing rate (1-5 days from the start of treatment), as well as by the morphological picture. At the same time, in the group with the use of ultrasound therapy the indices of microbial siltation and percentage of area reduction were reliably better in comparison with the isolated use of the combination. Conclusion. The developed combinations have a positive effect in the treatment of purulent wounds, speeding up the healing process and reducing microbial contamination.

1. Baron J.M., Glatz M., Proksch E. Optimal Support of Wound Healing: New Insights. Dermatology. 2020;236(6):593-600. DOI: 10.1159/000505291

2. Katorkin S.E., Bystrov S.A., Lisin O.E., Rozanova A.A., Bezborodov A.I. Evaluation of the efficacy of modern wound care dressings in the complex treatment of purulent wounds. Ambulatory surgery: hospital-replacing technologies. 2019;(1-2):146-152. DOI: 10.21518/1995-1477-2019-1-2-146-152. EDN: LKHFZM

3. Sukovatyh B.S., Bezhin A.I., Pankrusheva T.A., Grigoryan A.Yu., Ivanov A.V., Zhilyaeva L.V., Kobzareva E.V., Andryuhina E.G., Dubonos A.A. Assessment of experimental and clinical efficacy of immobilized form of chlorhexidine in treatment of purulent wounds. Grekov's bulletin of surgery. 2016;175(1):42-47. EDN: VKXQPT

4. Kamamoto F., Lima A.L.M., Rezende M.R., Mattar-Junior R., Leonhardt M.C., Kojima K.E., Santos C.C.D. A new low-cost negative-pressure wound therapy versus a commercially available therapy device widely used to treat complex traumatic injuries: a prospective, randomized, non-inferiority trial. Clinics (Sao Paulo). 2017;72(12):737-742. DOI: 10.6061/clinics/2017(12)04

5. Nethi S.K., Das S., Patra C.R., Mukherjee S. Recent advances in inorganic nanomaterials for wound-healing applications. Biomater Sci. 2019;7(7): 2652-2674. DOI: 10.1039/c9bm00423h

6. Kessel D. Apoptosis and associated phenomena as a determinants of the efficacy of photodynamic therapy. Photochem Photobiol Sci. 2015;14(8):1397-1402. DOI: 10.1039/c4pp004013b

7. De Silva C.C., Israni N., Zanwar A., Jagtap A., Leophairatana P., Koberstein J.T., Modak S.M. "Smart" polymer enhances the efficacy of topical antimicrobial agents. Burns. 2019;45(6):1418-1429. DOI: 10.1016/j.burns.2019.04.013

8. Shukla S.K., Sharma A.K., Gupta V., Yashavarddhan M.H. Pharmacological control of inflammation in wound healing. J Tissue Viability. 2019 ;28(4): 218-222. DOI: 10.1016/j.jtv.2019.09.002

9. Nelson C.E., Chen A.E., Bellah R.D., Biko D.M., Ho-Fung V.M., Francavilla M.L., Xiao R., Kaplan S.L. Ultrasound features of purulent skin and soft tissue infection without abscess. Emerg Radiol. 2018;25(5):505-511. DOI: 10.1007/s10140-018-1612-0

10. Conner-Kerr T., Oesterle M.E. Current perspectives on therapeutic ultrasound in the management of chronic wounds: a review of evidence. Chronic Wound Care Management and Research. 2017;4:89-98. DOI: 10.2147/CWCMR.S135982