ULRASONIC CAVITATION IN TREATMENT OF TROPHIC UICERS
Authors: Bitska І. V. , Vasilyuk S. M. , Gudyvok V. І. , Dmytruk О. М. , Osadets V. S. , Kozan Ya. І. , Slyusar V. T. 
Published: July 2021

The aim: improvement of trophic ulcer by surgical treatment with ultrasound cavitation combination.
Materials and methods. The analysis of complex surgical treatment of trophic ulcers was conducted. Patients were divided into 2 groups, depending on the strategy of treatment. In the first (main) group (n=43) the combination of surgical treatment with ultrasonic cavitation was applied. By comparison, in the second group (n=43) only surgical treatment was applied. The method of treatment of trophic ulcers with the Sonoca 300 device is based on the effect of ultrasonic cavitation, which is a process of mechanical cleaning of the wound from necrotic tissues, while healthy tissue and vessels are not injured. Ultrasound machine SONOCA 300 is intended exclusively for use in human ultrasound surgery and is intended for the following applications: selective tissue dissection, mechanical grinding and cutting of bone tissue, debridement and cleaning of wounds, tissue cutting, tissue coagulation. The exact purpose of the application is determined by which tool is connected. In our case, this is a Macro ultrasonic tip designed for debridement and wound cleansing. Ultrasound is supplied at an operating frequency of 25 kHz, when you press the foot pedal, and simultaneously with the power of ultrasound, the irrigation and aspiration systems are activated. The irrigation solution from the container with the irrigation fluid passes through the tool, at the same time the aspiration of necrotic tissues and fluid, and their direction into the container for aspirate collection.
Results and discussions. The ultrasonic cavitation in treatment of trophic ulcers different localization and etiological factors, achieve partial incarnation of ulcer surface on the average in (14,2±0,5) days in the first group and in (16,9±0.6) days in the second group.
The level of bacterial titer of ulcer secretion by (16,5±0,6) days was not higher than the commonly accepted critical one in comparison to the classic situation, in the second group it was on the (27,2±0,9) days. Terms of inpatient treatment were: (21,2± 0,9) days in the first group and (27,2±0,9) days in the second group accordingly. The biological properties of ultrasound are due to bactericidal and bacteriostatic action on various microorganisms. In addition to its own bactericidal effect, low-frequency ultrasound significantly enhances the action of many antibiotics and antiseptics, promotes the deposition of drugs in the surface layers of the wound. Under the action of ultrasound increases the phagocytic activity of leukocytes, there is a stimulation of cellular and humeral parts of the immune system, which accelerates the wound process.
Conclusion. The usage of ultrasonic cavitation in the complex surgical treatment of trophic ulcers different localization and etiological factors, significantly increases the time of trophic ulcer cleaning, accelerates incarnation by 1.2, reduce the time of treatment of patients with trophic ulcers by 1.8 times in comparison to the classical approach of cleaning, by means of mechanical cleaning of the ulcers from purulence and necrotic tissue by ultrasound of low frequency.