Investigation of the microflora and the principles of treatment of infected open tissue defects.

Treatment of chronic defects of the body remains a difficult problem. Despite the achievements in reconstructive surgery, the failure incidence is high. Infection in the chronic defect region plays the leading role in the pathogenesis. Therefore the outcome of the disease highly depends on the study of the microflora of chronic defects and the choice of optimal methods of infection control. There are data testifying to the fact that the schemes of empirical antibiotherapy which have proved their effectiveness in one country, may turn out to be ineffective in another country. 176 cases of chronic tissue defects of various duration (up to 4 and more years) were analyzed. Changes of the microflora and microbe resistance were traced. High incidence of strains resistant to most antibiotics is observed in chronic defects. The microflora formation is in many respects associated with an inadequate administration of antibiotics. On the basis of the obtained results, practical recommendations are given on the use of antibacterial preparations. One-stage operations and the transplantation of well-vascularized tissues are the principal methods of treatment against the infection in a tissue defect, which are no less important than the methods of choice in treating large infected chronic defects of the body.