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Shiryaev A.A.

Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Ivankov M.P.

Vishnevsky Central Military Clinical Hospital

Kalyagina N.A.

Prokhorov General Physics Institute;
National Research Nuclear University

Voitova A.V.

BIOSPEC LLC

Efendiev K.T.

Prokhorov General Physics Institute;
National Research Nuclear University

Kuznetsov M.R.

Sechenov First Moscow State Medical University

Reshetov I.V.

I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Health of Russia

Udeneev A.M.

National Research Nuclear University MEPhI (Moscow Engineering Physics Institute)

Loshchenov V.B.

Prokhorov General Physics Institute;
National Research Nuclear University

Photodynamic inactivation of antibiotic-resistant microflora of gunshot wounds under fluorescence control

Authors:

Shiryaev A.A., Ivankov M.P., Kalyagina N.A., Voitova A.V., Efendiev K.T., Kuznetsov M.R., Reshetov I.V., Udeneev A.M., Loshchenov V.B.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2025;(2): 50‑59

DOI: 10.17116/hirurgia202502150

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Table of contents

PHOTODYNAMIC INACTIVATION OF ANTIBIOTIC-RESISTANT MICROFLORA OF GUNSHOT WOUNDS UNDER FLUORESCENCE CONTROL
PHOTODYNAMIC INACTIVATION OF ANTIBIOTIC-RESISTANT MICROFLORA OF GUNSHOT WOUNDS UNDER FLUORESCENCE CONTROL

To cite this article:

Shiryaev AA, Ivankov MP, Kalyagina NA, et al. . Photodynamic inactivation of antibiotic-resistant microflora of gunshot wounds under fluorescence control. Pirogov Russian Journal of Surgery. 2025;(2):50‑59. (In Russ.)
https://doi.org/10.17116/hirurgia202502150

Подписка 2025-2 (Pirogov Russian Journal of Surgery)
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OBJECTIVE

Antimicrobial photodynamic therapy or photodynamic inactivation (PDI) of antibiotic-resistant microflora seems to be a very promising alternative, including for the treatment of long-term non-healing wounds, due to its potential and extremely low possibility of resistance.

MATERIAL AND METHODS

The authors describe an effective approach to preparing the wounds for delayed surgical treatment (secondary suturing, split-flap autodermoplasty, wound defect closure with local tissues), as well as healing by secondary intention of wounds using PDI of antibiotic-resistant microflora under spectroscopic control of fluorescence intensity in tissues. For this purpose, laser and LED radiation with wavelengths 660—680 nm was used. Various photosensitizers (methylene blue, aluminum phthalocyanine, chlorin e6 and their emulsion forms) were used. The study included 90 patients with various wounds.

RESULTS

Positive treatment outcomes were obtained in most patients. The first PDI procedure decreased concentration of microflora by 3—4 times. There was significant or complete inactivation of bacteria by the end of the treatment. In all patients, concentration of photosensitizers significantly decreased by more than 75% after PDI. Surgical treatment was successful in 100% of cases (n=56; 62%).

CONCLUSION

PDI is a promising method for inactivating antibiotic-resistant microflora, including patients with long-term non-healing wounds. This method contributes to safe and high-quality surgical treatment. A great advantage of PDI is its multi-purpose mechanism and no resistance of microorganisms.

Keywords:

photodynamic therapy
surgical treatment of wounds
fluorescence spectral diagnosis
infected wound
antibiotic-resistant microflora
decontamination

Authors:

Shiryaev A.A.

Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Ivankov M.P.

Vishnevsky Central Military Clinical Hospital

Kalyagina N.A.

Prokhorov General Physics Institute;
National Research Nuclear University

Voitova A.V.

BIOSPEC LLC

Efendiev K.T.

Prokhorov General Physics Institute;
National Research Nuclear University

Kuznetsov M.R.

Sechenov First Moscow State Medical University

Reshetov I.V.

I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Health of Russia

Udeneev A.M.

National Research Nuclear University MEPhI (Moscow Engineering Physics Institute)

Loshchenov V.B.

Prokhorov General Physics Institute;
National Research Nuclear University

Received:

20.10.2024

Accepted:

07.11.2024

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