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The principles of active surgical treatment of purulent wounds made it possible to perform reconstructive operations on 5,422 patients with large purulent wounds and tissue defects. In 3,887 patients the wounds were closed with sutures and drained, in 1,535 patients the wound surfaces were closed and tissue defects repaired by various methods of cutaneo- and osteoplasty, in 1,261 of these patients free skin graft was carried out. In 274 patients wounds in the region of important anatomical structures and functionally active surfaces were closed by transposed vascularized tissues with good cosmetic and functional results. Defects in long tubular bones were repaired in 107 patients in the early stages by variants of compression--distraction osteosynthesis. Healing by first intention occurred in 89.8% of cases in which the wounds were closed with sutures and in 91.9% in plastics with local tissues and transposed grafts. After free skin graft plastics had to be repeated until complete healing in 11.1% of patients. The defects in bones were replaced in all cases, osteomyelitis developed at the site of pin introduction in 4% of cases.

The article discusses the results of treatment of 7,092 patients with purulent wounds and septic surgical diseases by means of a suggested method of active surgical management. The main principles of the method are as follows: preoperative examination and preparation of the patients for operation for 12-36 hours; radical excision of all purulent and nonviable tissues followed by active drainage and treatment under conditions of controlled abacterial medium or by ointments on a water-soluble base; use of auxiliary methods for the treatment of the wound surface (pulsed stream of antiseptics, ultrasonic cavitation, vacuum treatment); performance of laboratory tests (microbial dissemination per 1 g tissue, cytologic and morphologic studies, values of tissue hemostasis) as an objective criterion of the course of the wound process and for determining whether the wound surface is ready for closure; accomplishment of intensive therapy; early closure of the wound surface with sutures or by plastic operations. Analysis of the data allows the conclusions that active surgical treatment may be accepted as an optimal and universal method for the management of purulent wounds of any etiology and septic surgical diseases. With its application, the terms of treatment are shortened due to most economical mechanisms of healing by first intention, and good functional and cosmetic results are produced. Such an effect is due to the pathogenetic character of all components of the method.