milmedВоенная медицинаMilitary Medicine2074-5044Белорусский государственный медицинский университет10.51922/2074-5044.2025.1.69milmed-108Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESПрименение терапии ран отрицательным давлением в травматологии и ортопедии.Часть 2. Частные клинические случаи применения метода: обоснованность, эффективность, рекомендацииThe use of negative pressure wound therapy in traumatology and orthopedics. part 2. particular cases of application of the method: validity, effectiveness, tipsКрукА. Н.KrukA. M.СитникА. А.SitnikA. A.ЛиновА. Л.LinovA. L.БакановскийА. В.BakanouskiA. V.КочубинскийА. В.KochubinskiA. V.КорзунО. А.KorzunO. A.ВолотовскийП. А.VolotovskiP. A.ГУ «Республиканский научно-практический центр травматологии и ортопедии»Belarus202522082026016977Copyright © Крук А.Н., Ситник А.А., Линов А.Л., Бакановский А.В., Кочубинский А.В., Корзун О.А., Волотовский П.А., 20262026Крук А.Н., Ситник А.А., Линов А.Л., Бакановский А.В., Кочубинский А.В., Корзун О.А., Волотовский П.А.Kruk A.M., Sitnik A.A., Linov A.L., Bakanouski A.V., Kochubinski A.V., Korzun O.A., Volotovski P.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://milmed.ejournal.by/jour/article/view/108

Цель исследования: проанализировать литературные данные о применении терапии ран отрицательным давлением в клинической практике, в частности, в травматологии и ортопедии; изучить эффективность применения методики в конкретной клинической ситуации и дать оценку её целесообразности, в том числе экономической эффективности; обобщить многолетний клинический опыт коллектива авторов в данной области.Несмотря на универсальность метода, в каждой конкретной клинической ситуации существуют некоторые тонкости применения систем терапии отрицательным давлением. С другой стороны, несмотря на бесспорно положительный эффект применения терапии отрицательным давлением, в некоторых клинических ситуациях её эффективность сопоставима с классическими методами лечения. А ввиду некоторых особенностей, применение в таких клинических случаях становится экономически необоснованным. Метод терапии отрицательным давлением широко применяется как в лечении повреждений покровных тканей и хронических ран, требующих кожно-пластических методов лечения, так и в составе комплексного лечения глубокой перипротезной инфекции, хронического остеомиелита,  а также открытых переломов конечностей. В настоящее время терапия отрицательным давлением нередко применяется в хирургической практике в области послеоперационной раны с целью профилактики инфекционных осложнений у лиц из групп риска. К группе риска относятся пациенты с метаболическими и эндокринными нарушениями, а также пациенты с заболеваниями сосудистого русла нижних конечностей, в контексте хирургического вмешательства на нижних конечностях. Применение терапии отрицательным давлением также нашло своё место в комплексе лечебных мероприятий при пролежнях различных локализаций.

The purpose of the study is to analyze the literature data on the use of negative pressure wound therapy in clinical practice, in particular in traumatology and orthopedics, to study the effectiveness  of the technique in a specific clinical situation, to assess its feasibility, as well as to summarize  the clinical experience of authors. Despite the universality of the method, in each specific clinical situation there are some subtleties in the use of negative pressure therapy systems. On the other hand, despite the seemingly indisputable absolute positive effect of negative pressure therapy, in some clinical situations its effectiveness is comparable to classical treatment methods, and due to some features, its use in such clinical cases becomes not economically justified. Negative pressure therapy is widely used both in the treatment of damage to integumentary tissues, wounds requiring skin-plastic treatment methods, and as part of the complex treatment of deep periprosthetic joint infection, chronic osteomyelitis, and open fractures of the extremities. Currently, negative pressure therapy is often used in surgical practice in the area of a postoperative wound in order to prevent infectious complications in individuals at risk. The use of negative pressure therapy has also found its place in the therapy measures of decubitation of various localizations.

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