mossjМосковский хирургический журналMoscow Surgical Journal2072-3180ООО «ПРОФИЛЬ – 2С»10.17238/2072-3180-2025-2-184-191mossj-978Research ArticleОБЗОР ЛИТЕРАТУРЫLITERATURE REVIEWПрименение метода локального отрицательного давления на реконструктивно-пластическом этапе ведения обширных гнойно-некротических ранUse of the local negative pressure method at the reconstructive-plastic stage of management of extensive purulent-necrotic woundshttps://orcid.org/0000-0002-0189-3539КисляковВ. А.KislyakovV. A.

Кисляков Валерий Александрович – доктор медицинских наук, профессор кафедры госпитальной хирургии с курсом детской хирургии; заведующий отделением гнойной хирургии 

117198, Москва, ул. Миклухо-Маклая, д. 6;  129327, Москва, ул. Ленская, д. 15

Kislyakov Valery Aleksandrovich – Doctor of Medical Sciences, Professor of the Department of Hospital Surgery with the course of Pediatric Surgery of the Medical Institute; Head of the Department of Purulent Surgery 

117198, Miklukho-Maklaj str., 6, Moscow; 129327, st. Lenskaya 15, Moscow

vakislakov@mail.ruhttps://orcid.org/0009-0000-4533-1661ГоршуноваЕ. М.GorshunovaE. M.

Горшунова Елена Михайловна – хирург 

129327, Москва, ул. Ленская, д. 15

Gorshunova Elena Mikhailovna – surgeon of the State Budgetary Healthcare Institution 129327, st. Lenskaya 15, Moscow

elenagem1994@yandex.ruhttps://orcid.org/0000-0002-9218-6011Аль-АрикиМ.К.М.Al-ArikiM.K.M.

Аль-Арики Малик Киаед Мохаммед – кандидат медицинских наук, ассистент кафедры госпитальной хирургии с курсом детской хирургии

117198, Москва, ул. Миклухо-Маклая, д. 6

Al-Ariki Malik Kiaed Mohammed – Candidate of Medical Sciences, assistant at the Department of Hospital Surgery with the course of Pediatric Surgery of the Medical Institute 

117198, Miklukho-Maklaj str., 6, Moscow

al_ariki_m@mail.ruhttps://orcid.org/0009-0003-0341-9632МишаринаЛ. К.MisharinaL. K.

Мишарина Лия Константиновна – хирург 

29327, Москва, ул. Ленская, д.15

Misharina Liya Konstantinovna – surgeon of the State Budgetary Healthcare Institution

129327, st. Lenskaya 15, Moscow

Lmk102035@gmail.comhttps://orcid.org/0009-0007-0448-1912МохаребА.А.Л.MoharebA.A.L.

Мохареб Абануб Антон Ламей – аспирант кафедры госпитальной хирургии с курсом детской хирургии 

117198, Москва, ул. Миклухо-Маклая, д. 6

Mohareb Abanoub Antone Lamey – PhD student at the Department of Hospital Surgery with the course of Pediatric Surgery of the Medical Institute

117198, Miklukho-Maklaj str., 6, Moscow

Abanobantone5@gmail.comГБУЗ ГКБ им. А.К. Ерамишанцева ДЗМ; ФГАОУ ВО Российский Университет Дружбы Народов имени Патриса ЛумумбыРоссияGBUZ GKB named after A.K. Yeramishantsev DZM; RUDN University named after Patrice LumumbaRussian FederationГБУЗ ГКБ им. А.К. Ерамишанцева ДЗМРоссияGBUZ GKB named after A.K. Yeramishantsev DZMRussian FederationФГАОУ ВО Российский Университет Дружбы Народов имени Патриса ЛумумбыРоссияRUDN University named after Patrice LumumbaRussian Federation20251106202502184191Copyright © Кисляков В.А., Горшунова Е.М., Аль-Арики М., Мишарина Л.К., Мохареб А., 20252025Кисляков В.А., Горшунова Е.М., Аль-Арики М., Мишарина Л.К., Мохареб А.Kislyakov V.A., Gorshunova E.M., Al-Ariki M., Misharina L.K., Mohareb A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mossj.ru/jour/article/view/978

Введение. Обширные гнойно-некротические раны остаются актуальной проблемой современной медицины, несмотря на достижения в хирургии и терапии. Они могут возникать вследствие осложнений сахарного диабета, хирургических вмешательств, ишемии конечностей или инфекционных процессов, таких как некротизирующий фасциит. Основными трудностями при лечении этих ран являются обильная плазмопотеря, медленный рост грануляций, недостаток пластического материала для закрытия дефектов и высокий риск вторичных осложнений. Цель исследования. Анализ эффективности метода локального отрицательного давления (ЛОД) на реконструктивно-пластическом этапе лечения обширных гнойно-некротических ран, а также определение его преимуществ в сочетании с другими методами пластики Материалы и методы исследования. Обобщены данные клинических наблюдений, мета-анализов и исследований, рассматривающие варианты применения локального отрицательного давления в лечении обширных ран, включая сочетание метода с пластикой местными тканями, методами дозированного растяжения, свободной и несвободной аутодермопластикой. Заключение. Метод локального отрицательного давления зарекомендовал себя как эффективное средство стимуляции заживления ран, улучшения условий для пластических операций и снижения риска осложнений. ЛОД способствует росту грануляционной ткани, реваскуляризации трансплантатов и уменьшению бактериальной нагрузки. Тем не менее, его использование требует учета особенностей ран, возможных ограничений и осложнений, а также дальнейших исследований для оптимизации параметров терапии.

Introduction. Extensive purulent-necrotic wounds remain an urgent problem of modern medicine, despite advances in surgery and therapy. They can occur due to complications of diabetes mellitus, surgical interventions, limb ischemia or infectious processes such as necrotizing fasciitis. The main difficulties in the treatment of these wounds are abundant plasma loss, slow growth of granulation, lack of plastic material for closing defects and a high risk of secondary complications. The purpose of the study. Analysis of the effectiveness of the local negative pressure (LNP) method at the reconstructive-plastic stage of treating extensive purulent-necrotic wounds in combination with other plastic methods. Materials and methods of research. The article summarizes the data of clinical observations, meta-analyses and studies considering options for using local negative pressure in combination with different types of autodermoplasty. Conclusion. The local negative pressure method has proven itself as an effective means of stimulating wound healing, improving conditions for plastic surgeries and reducing the risk of complications. LNP promotes the growth of granulation tissue, revascularization of grafts and a decrease in bacterial load. However, its use requires consideration of wound characteristics, possible limitations and complications, as well as further research to optimize therapy parameters.

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The authors declare that there are no conflicts of interest present.