Preview

Moscow Surgical Journal

Advanced search

Application of local negative pressure therapy in the complex treatment of extensive wounds: analysis of clinical outcomes and innovative techniques

https://doi.org/10.17238/2072-3180-2025-4-202-208

Abstract

Introduction. A wound represents a disruption of the anatomical integrity of the skin or mucous membranes resulting from physical or thermal injury. Despite the natural potential for healing, various factors, particularly comorbid conditions, can significantly impede this process. The relevance of the problem of treating extensive and complex wounds is determined by their substantial proportion within the structure of surgical pathology (35–40 %), the high costs associated with treatment, and their significant social impact. Particular challenges arise in the closure of extensive defects, where traditional suturing is often impossible or leads to complications.
Objective. To review the available literature on modern methods and approaches to the treatment of extensive and complex wounds and to identify promising directions for further research.
Results. Analysis of the literature demonstrated an evolution in the approaches to treating extensive wounds, moving from traditional methods to comprehensive, high-technology strategies. Negative Pressure Wound Therapy (NPWT) has been recognized as a promising direction in various surgical fields.
Conclusion. The modern management strategy for extensive wounds should be based on an approach that combines radical surgical debridement, the selection of an optimal plasty method, and the application of adjuvant therapies. The method of local negative pressure (NPWT) has proven its efficacy in reducing complications and improving treatment outcomes. However, there remains a need for large-scale randomized controlled trials to assess cost-effectiveness, develop unified protocols, and study the long-term results of applying new technologies.

About the Authors

V. A. Kislyakov
Hospital of A.K. Yeramishantseva; RUDN University named after Patrice Lumumba
Russian Federation

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

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



M. A. Chinikov
Hospital of A.K. Yeramishantseva; RUDN University named after Patrice Lumumba
Russian Federation

Chinikov Maxim Alekseevich – Doctor of Medical Sciences, professor of the Department of Hospital Surgery with the course of Pediatric Surgery of the Medical Institute 

117198, Miklukho-Maklaj str., 6, Moscow



M.K.M. Al-Ariki
RUDN University named after Patrice Lumumba
Russian Federation

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



E. M. Gorshunova
Hospital of A.K. Yeramishantseva
Russian Federation

Gorshunova Elena Mikhailovna – surgeon of the State Budgetary Healthcare Institution 

129327, st. Lenskaya 15, Moscow.



L. K. Misharina
Hospital of A.K. Yeramishantseva
Russian Federation

Misharina Liya Konstantinovna – surgeon of the State Budgetary Healthcare Institution 

129327, st. Lenskaya 15, Moscow.



A.A.L. Mokhareb
RUDN University named after Patrice Lumumba
Russian Federation

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



References

1. Qi L., Zhang C., Wang B., Yin J., Yan S. Progress in Hydrogels for Skin Wound Repair. Macromol Biosci, 2022, Jul, № 22(7), рр. e2100475.

2. Proud D., Bruscino Raiola F., Holden D., Paul E., Capstick R., Khoo A. Are we getting necrotizing soft tissue infections right? A 10- year review. ANZ J Surg., 2014, Jun, № 84 (6), pp. 468–72.

3. Colov E.P., Klein M., Gögenur I. Wound Complications and Perineal Pain After Extralevator Versus Standard Abdominoperineal Excision: A Nationwide Study. Dis Colon Rectum, 2016, № 59(9), pp. 813–821.

4. Kurbanov U.A., Saidov I.S., Davlatov A.A., Dzhanobilova S.M. Optimization of surgical treatment of post-burn contractile scars of the anterior surface of the neck and chest. Avicenna Bulletin, 2017, № 19(4), pp. 506–512. (In Russ.)

5. Alekseev A.A., Paltsyn A.A., Krutikov M.G., Kuznetsov V.A., Grishina I.A., Bobrovnikov A.E., Vasilyeva T.S. Treatment of burn wounds using Activetex wound dressings. Study guide for doctors, M, RMA PO, 2000, p. 13. (In Russ.)

6. Bashirov A.B., Ismailov Zh.K., Mamalinov G.K., Morozov E.S., Meldeev A.K., Ramazanov E.Sh. Complex treatment of trophic ulcers and long-term non-healing wounds of the extremities. In: Wounds and wound infection: proceedings of the international conference dedicated to the 25th anniversary of the Department of Wounds and Wound Infection of the A.V. Vishnevsky Institute of Surgery of the Russian Academy of Medical Sciences, 1998, pp. 46–47. (In Russ.)

7. Sanchis-Gomar F., Perez-Quilis C., Leischik R., Lucia A. Epidemiology of coronary heart disease and acute coronary syndrome. Ann Transl Med., 2016, № 4, pp. 256.

8. Magomedov A.R. On the treatment of purulent wounds. Bulletin of the Orenburg State University, 2011, № 16, pp. 308–309. (In Russ.)

9. Shin F.E., Starichkov I.G., Rybasov P.I. New in the treatment of purulent wounds. Moscow Surgical Journal, 2011, № 5, pp. 51–54. (In Russ.)

10. Tuisin S.R. Treatment of long-term non-healing wounds using combined dressing materials. Modern Problems of Science and Education, 2010, № 1. (In Russ.) https://science-education.ru/ru/article/view?id=1621

11. Tolstykh P.I., Derbenev V.A., Kuleshov I.Yu., Azimshoev A.M., Eliseeenko V.I., Solov’eva A.B., Melik-Nubarov N.S., Ivanov A.V., Shin E.F. Theoretical and practical aspects of laser photochemistry for the treatment of purulent wounds. Russian Biotherapeutic Journal, 2008, № 7 (4), pp. 20–24. (In Russ.)

12. Batiskin S.A., Zoloev G.K. Methodological aspects of lower leg amputation in patients with lower limb ischemia. Meditsina v Kuzbasse, 2014, № 13 (1), pp. 8–12. (In Russ.)

13. Alimzhanov A.K., Golovnya M.A., Zhamashev D.K. Modern approaches to the treatment of extensive wound defects. Bulletin of KazNMU, 2015, № 1, pp. 301–302. (In Russ.)

14. Baryshev A.G., Polovinkin V.V., Dikarev A.S., Bogdanov S.B., Khachaturyan N.V., Valyakis D.A., Pavlov I.V., Mostovaya A.Yu. Application of a two-stage method of plasty of the postoperative defect after removal of a Buschke-Lowenstein tumor. Innovative Medicine of Kuban, 2016, № 3, pp. 44–47. (In Russ.)

15. Galichenko K.A., Blinova E.V., Simakina E.A., Sukhov A.V., Shimanovsky D.N., Gilevskaya Yu.S., Skachilova S.Ya., Timoshkin S.P., Kytko O.V., Sorokvasha I.N., Bogoyavlenskaya T.A. Study of postoperative wound healing processes in Z-plasty of the skin in an experiment against the background of the use of a cerium-containing compound N-acetyl-6-aminohexanoic acid. Operative Surgery and Clinical Anatomy (Pirogov Scientific Journal), 2022, № 6(3), pp. 5–11. (In Russ.)

16. Kislyakov V.A., Gorshunova E.M., Al-Ariki M.K., Misharina L.K., Mohareb A. Use of the local negative pressure method at the reconstructive-plastic stage of management of extensive purulent-necrotic wounds. Moscow Surgical Journal, 2025, № 2, pp. 184–191. (In Russ.) https://doi.org/10.17238/2072-3180-2025-2-184-191

17. Zens Y., Barth M., Bucher H.C., Dreck K., Felsch M., Groß W., Jaschinski T., Kölsch H., Kromp M., Overesch I., Sauerland S., Gregor S. Negative pressure wound therapy in patients with wounds healing by secondary intention: A systematic review and meta-analysis of randomised controlled trials. Systematic Reviews, 2020, № 9 (1), рр. Article 238.

18. Shiroky J., Lillie E., Muaddi H., Sevigny M., Choi W.J., Karanicolas P.J. The impact of negative pressure wound therapy for closed surgical incisions on surgical site infection: A systematic review and meta-analysis. Surgery, 2020, № 167(5), pp. 1001–1009.

19. Kislyakov V.A., Gorshunova E.M., Al-Ariki M.K. Experience of using the method of local negative pressure in complex treatment of necrotizing soft tissue infections. Moscow Surgical Journal, 2024, № 3, pp.129–135. (In Russ.) https://doi.org/10.17238/2072-3180-2024-3-129-135

20. Gombert A., Dillavou E., D’Agostino Jr.R., Griffin L., Robertson J.M., Eells M. A systematic review and meta-analysis of randomized controlled trials for the reduction of surgical site infection in closed incision management versus standard of care dressings over closed vascular groin incisions. Vascular, 2020, № 28 (3), pp. 274–284.

21. Mendame Ehya R.E., Zhao Y., Zheng X., Yi.W., Bounda G.A., Li Z., Xiao W., Yu.A. Comparative effectiveness study between negative pressure wound therapy and conventional wound dressing on perforator flap at the Chinese tertiary referral teaching hospital. J Tissue Viability, 2017, Nov, № 26 (4), pp. 282–288.

22. Venkateswaran R., Bhagvat S., Dutt A., Padekar H.D., Mirkhushal N., Chetan A.A. Primary Closure Versus Delayed Primary Closure of Class III and IV Surgical Wounds Following Emergency Laparotomy: A Prospective Comparative Study. Cureus, 2023, Nov 17, № 15 (11), рр. e48965.

23. Norman G., Shi C., Goh E.L., Murphy E.M.A., Reid A., Chiverton L., Stankiewicz M., Dumville J.C. Negative pressure wound therapy for surgical wounds healing by primary closure. Cochrane Database of Systematic Reviews, 2022, Issue 4, No CD009261.

24. Fedyushkin V.V., Baryshev A.G., Triandafilov K.V., Golikov I.V., Shubro E.N. Analysis of the results of using a new method of dosed vacuum dermotension in the treatment of extensive soft tissue wound defects. In: Wounds and wound infections: collection of scientific papers of the 5th international scientific and practical congress, 2021, pp. 205–207. (In Russ.)

25. Matusiak D., Wichtowski M., Pieszko K., Kobylarek D., Murawa D. Is negative pressure wound therapy beneficial in modern-day breast surgery? Contemp Oncol (Pozn), 2019, № 23 (2), pp. 69–73.

26. Fernandez L.G., Norwood S.H., Orsi C., Heck M., Gonzalez K., Williams N., Matthews M.R., Scalea T.M., Swindall R. Use of a Modified ABTHERA ADVANCE™ Open Abdomen Dressing with Intrathoracic Negative-Pressure Therapy for Temporary Chest Closure After Damage Control Thoracotomy. Am J Case Rep, 2022, Sep 25, № 3 рр. 23, e937207.

27. Kostyrnoj A.V., Polenok P.V., Govorunov I.V., Karakursakov N.E. Designs for temporary closure of laparotomy wound. Modern Medicine: Topical Issues. 2016, № 4–5, pp. 144–152. (In Russ.)

28. Hofmann A.T., Gruber-Blum S., Lechner M., Petter-Puchner A., Glaser K., Fortelny R. Delayed closure of open abdomen in septic patients treated with negative pressure wound therapy and dynamic fascial suture: the long-term follow-up study. Surg Endosc., 2017, Nov; № 31(11), pp. 4717–4724.

29. Mo R., Ma Z., Chen C., Meng X., Tan Q. Short- and long-term efficacy of negative-pressure wound therapy in split-thickness skin grafts: a retrospective study. Ann Palliat Med., 2021 Mar, № 10 (3), pp. 2935–2947.


Review

For citations:


Kislyakov V.A., Chinikov M.A., Al-Ariki M., Gorshunova E.M., Misharina L.K., Mokhareb A. Application of local negative pressure therapy in the complex treatment of extensive wounds: analysis of clinical outcomes and innovative techniques. Moscow Surgical Journal. 2025;(4):202-208. (In Russ.) https://doi.org/10.17238/2072-3180-2025-4-202-208

Views: 116

JATS XML


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2072-3180 (Print)