Experimental evaluation of clinical and microbiological efficacy of systemic antibiotic therapy and local phage therapy in surgical treatment of burn wound infection

• Tulupov A.A.
• Beschastnov V.V.
• Shirokova I.Yu.
• Tyumenkov Yu.O.

Abstract

Aim – was to evaluate the clinical and microbiological efficacy of systemic antibiotic therapy and local phage therapy of burn wound infection after radical and partial necrectomy.

Material and methods. The experimental study was performed on rats (n=90). Animals of the first group (n=30) were simulated contact skin burn of 5% of the body surface, after which radical necrectomy was performed. In the second group (n=30), after modeling a contact burn of 5% of the body surface and performing radical necrectomy, a ring made of medical steel was sewn into the edges of the post-necrectomy wound. Animals of the third group (n=30) were simulated contact skin burn of 20% of the body surface, partial fascial necrectomy was performed, a ring made of medical steel was sewn into the edges of the post-necrectomy wound. At the stage of necrectomy, the wounds were contaminated with P. aeruginosa. Three days after the moment of contamination, all animals underwent a seven-day course of antimicrobial therapy for the treatment of wound infection. Ten animals from each group received as etiotropic antimicrobial therapy: systemic antibiotic therapy (therapy “A”), local phage therapy (therapy “F”) and their combination (therapy “AF”).

Results. In addition to the lack of clinical efficacy from antimicrobial therapy, we have not achieved the elimination of P. aeruginosa from the wound surface in any animal. When analyzing the results of microbiological examination of wound discharge obtained on the fourth and seventh days of antimicrobial therapy, it was recorded that the formation of mixed infection was statistically significantly more frequent in animals receiving therapy “A” and “AF” (p<0.01).

Conclusion. As a result of the conducted experimental study, data were obtained indicating that the local use of polyvalent pyobacteriophage in a single mode in the treatment of burn wound infection reduces the risk of infection of wounds with nosocomial pathogens and the formation of mixed infection even in the presence of necrotic tissues and foreign bodies in the wound.

Keywords:burn wound; necrectomy; wound infection; antibiotic therapy; phage therapy

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