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When preoperative infection control was insufficient, plastic or reconstructive closure of limb soft-tissue defects could fail, leading in some cases to amputation. This clinical investigative study evaluates hyperbaric oxygenation delivered via an ozone-containing steam-water mixture as an antibacterial treatment. Eighteen male patients (20–60 years) were grouped by time since injury, and all received the method, demonstrating high effectiveness and improved conditions for soft-tissue closure with limb preservation.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/hyperbaric-oxygenation-of-an-ozone-containing-steam-water-mixture-as-treatment-of-infected-combat-wounds-of-the-limbs-with-antibiotic-resistant-microflora/460462/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/hyperbaric-oxygenation-of-an-ozone-containing-steam-water-mixture-as-treatment-of-infected-combat-wounds-of-the-limbs-with-antibiotic-resistant-microflora/460462.png","ImageObject",300,407,{"name":92,"@type":93},"moss~","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What condition does this study target in combat casualties?","Question",{"text":113,"@type":114},"The study targets infected and purulent limb wounds with antibiotic-resistant microflora, including extensive soft-tissue defects.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What treatment method is proposed?",{"text":118,"@type":114},"It proposes hyperbaric oxygenation using an ozone-containing steam-water mixture as an antibacterial agent.",{"name":120,"@type":111,"acceptedAnswer":121},"How were patients organized for the clinical investigation?",{"text":122,"@type":114},"Eighteen male patients aged 20–60 were categorized into three groups based on the time elapsed since the injury, and all received the proposed method.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},460462,1790994728,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":44,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962090895452,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","International Wound Journal  \nCLINICAL INVESTIGATIVE STUDY  OPEN ACCESS   \nHyperbaric Oxygenation of an Ozone-Containing Steam–Water Mixture as Treatment of Infected Combat Wounds ofthe Limbs With Antibiotic-Resistant Microflora  \nM. V. Kostyliev1  | H. V. Terekhov1  | O. Yu. Furmanov1  | N. Yu. Hryhorieva2  | I. M. Savytska1  | Ye. V. Symulyk1  | L. A. Smitiukh1   \n1O.O. Shalimov National Institute of Surgery and Transplantology, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine | 2Scientific-Methodic  \nCenter “Medical Innovative Technologies” LLC, Kyiv, Ukraine Correspondence: N. Yu. Hryhorieva ([nmc.medintex@gmail.com](nmc.medintex@gmail.com))  \nReceived: 26 May 2025 | Revised: 1 October 2025 | Accepted: 26 December 2025  \nKeywords: anti-bacterial agent | combat trauma | hyperbaric oxygenation | ozone | wound infection  \nABSTRACT  \nPatients with combat wounds and injuries, presented as extensive infected and purulent defects with antibiotic-resistant microflora, were treated in a surgical inpatient setting. Closure of extensive soft tissue defects of the limbs is possible using methods of plastic and reconstructive surgery and requires preoperative infection control. The lack of effect from preoperative treatment for purulent limb defects with antibiotic-resistant microflora leads to limb amputation. This clinical study proposes a method of treatment by hyperbaric oxygenation with an ozone-containing steam–water mixture as an anti-bacterial agent. Eighteen male patients, aged between 20 and 60 years, were categorised into three groups based on the time elapsed since the injury. All patients were treated using the proposed method. The high effectiveness of the proposed method was demonstrated in all groups and resulted in saving limbs from amputation, establishing suitable conditions for closing the soft tissue defects of the limbs and achieving significant progress in the recovery.  \n1 | Introduction  \nTraumatic limb injuries account for 65%–70% of the overall structure of combat surgical trauma. In some cases, extensive soft tissue defects of the limbs need the use of plastic and reconstructive surgery techniques for their closure. Restoring limb function and enabling the return to duty for this category of wounded individuals represents a challenging task due to the length and complexity of treatment.  \nIn this process, antibiotic-resistant microflora in the wound prevents timely surgical intervention and its outcome.  \nDuring the ongoing military operations, the majority of observed cases involve the consequences of mine-explosive injuries, which result from the use of modern weaponry possessing  \nmassive damaging potential. As a result, primary wound infection occurs at the moment of injury and progresses rapidly, even with the timely provision of staged medical care [1] . Difficulties in transporting the wounded to specialised medical facilities, delays in performing initial bacteriological examinations, and the administration of inadequate antibiotic therapy contribute to the generalisation of infectious processes during evacuation stages, making the performing of the restorative surgical interventions impossible [1] .  \nInvestigation of the infected wounds microflora comprises associations of the following microorganisms: Staphylococcus aureus + Pseudomonas aeruginosa, St. aureus + Escherichia coli, Staphylococcus capitis + Ps. aeruginosa, St. aureus + Staphylococcus simulans, St. aureus + Streptococcus pyogenes, Staphylococcus lentus + St. simulans + Bacillus subtilis, St.  \nThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.  \n© 2026 The Author(s). International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.  \nInternational Wound Journal, 2026;","cbCaieNxxVnC8rRD","https://ap.wps.com/l/cbCaieNxxVnC8rRD","pdf",1134885,"English","# Abstract\n# Introduction\n## Combat wound burden and treatment challenges\n## Infection dynamics and diagnostic/therapy delays\n## Microflora associations and implications\n## Standard diagnostic and treatment protocol","[{\"question\":\"What condition does this study target in combat casualties?\",\"answer\":\"The study targets infected and purulent limb wounds with antibiotic-resistant microflora, including extensive soft-tissue defects.\"},{\"question\":\"What treatment method is proposed?\",\"answer\":\"It proposes hyperbaric oxygenation using an ozone-containing steam-water mixture as an antibacterial agent.\"},{\"question\":\"How were patients organized for the clinical investigation?\",\"answer\":\"Eighteen male patients aged 20–60 were categorized into three groups based on the time elapsed since the injury, and all received the proposed method.\"}]","Hyperbaric Oxygenation of an Ozone-Containing Steam-Water Mixture as Treatment of Infected Combat Wounds of the Limbs With Antibiotic-Resistant Microflora | PDF",1790758525,23]