| Popis: |
Treatment of trophic ulcers of lower extremities is one of the most important problems of surgery. The aim of the study is to determine the features of the microbial landscape of trophic ulcers in various methods of local treatment. The results of studies on the microflora of trophic ulcers of lower extremities in 245 patients of the main and control groups were analyzed. In 96 patients with trophic ulcers (the main group), Miliacil and magnetolaser therapy were used locally in the treatment of trophic ulcers. For the treatment of 60 patients of the first control group with trophic ulcers, Miliacil and laser radiation were applied topically. In the second control group (59 patients), only Miliacil was used. In the third control group (30 patients), 1% dioxidine solution was used topically for the first 7–10 days, and then the treatment was followed by applying the sea buckthorn oil. The microbiological studies of the trophic ulcer contents demonstrated that Miliacil in combination with laser radiation and especially in combination with magnetic laser therapy had a more pronounced antimicrobial effect than only miliacil and even more so than the 1% dioxidine solution and sea buckthorn oil. It was found that in 161 (65.7%) patients the pathogens were inoculated in the form of a monoculture and in 84 (34.3%) - in the form of microbial associations. According to the composition of strains, among monocultures, 67 (41.6%) patients had Staphylococcus aureus, 39 (24.2%) - Proteus, 24 (14.9%) - E. coli, 20 (12.4%) - Pseudomonas aeruginosa and 11 (6.9%) -Streptococcus. The Staphylococcal associations were predominant, they were found in 68 (80.9%) patients. 336 strains of microorganisms were isolated and 296 (88%) of them were resistant to three or more antibiotics. At the end of treatment, in 87 (90.6%) patients of the main group, there was not observed any microflora in the ulcer inoculations. At the end of treatment, the ulcer microflora was not observed in 51 (85%) patients in the first control group, in 36 (61%) patients in the second control group, and in seven (23.3%) patients in the third control group. Thus, as result of studies conducted the specific features of the microbial landscape of trophic ulcers with different methods of topical treatment have been established. |
