Experimental justification of lymphotropic therapy in the prevention and treatment of surgical infection of gunshot wounds of the limb

Purpose of the study was to experimentally study the possibility of the effect of lymphotropic antibiotic therapy and regional stimulation of lymphatic drainage on the healing of a gunshot wound of an extremity.

Material and methods. Experimental studies were carried out on 50 rabbits, in which, by using light and electron microscopy, as well as studying the pharmacokinetics of gentamicin, morphological changes in tissues and the lymphatic bed were studied, as well as the pharmacodynamics of the antibiotic in lymphotropic (main group, 25 animals) and traditional (control group, 25 animals,) treatment limbs.

Results. Studies have shown that the lymphatic system undergoes significant changes during gunshot wounds, with the development of insufficiency of lymphatic drainage of the tissues of the affected limb, accumulation of edematous fluid, dysmetabolic products and microbes in the interstitium. With traditional methods of antibiotic therapy, already 6 hours after a single injection, the soft tissues and regional lymph nodes of the affected limb contain only “traces” of the antibiotic. Lymphotropic antibiotic therapy and lymphostimulation contribute to a significant reduction in edema, inflammation and acceleration of tissue regeneration, as well as prolonged (up to 24 hours) accumulation of therapeutic concentrations of the antibiotic in the tissues under study (p < 0.05 when compared with intramuscular administration).

Conclusion. Lymphotropic therapy, when compared with traditional treatment, accelerates the healing, helps reduce edema, enhance the resorption of necrotic masses, foreign particles and microbes, early restoration of muscle fibers in the area of commotion, and more physiological remodeling of the wound defect. The use of lymphotropic therapy in the clinic will allow the successful use of primary surgical treatment with the application of primary sutures and early reconstructive plastic surgery, as well as reduce the likelihood of developing a surgical infection.

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