| Summary: | Chronic wounds treatment is a huge problem for the health care of all countries both in the economic aspect (annual costs reach $ 9 billion) and in the time spent by medical personnel to organize adequate long-term monitoring of this category of patients. A variety of etiological, systemic, and local factors may be involved in the pathogenesis of a chronic wound. The situation is aggravated by the fact that with every year the resistance of microorganisms to the widest range of antibiotics is growing. The desire to reduce healthcare costs while improving outcomes drives search for new methods to replace traditional antibiotics. In recent decades, the effectiveness of the use of adsorbents of various nature, biopolymers, cationic surfactants, and various forms of silver for the treatment of wounds has been reassessed. The objective of this review is to summarize the accumulated data of clinical and preclinical studies of substances widely used in medical devices for wound healing: silver, chlorhexidine, hyaluronic acid, and kaolin. The search for alternative medicines for wound healing showed that the most encouraging results regarding multidirectional antimicrobial activity and high safety of use were shown by medicines based on silver, chlorhexidine, hyaluronic acid, and kaolin ions. Combinations of these compounds in one medical device allowed to achieve the optimal effect, which was confirmed by clinical trials of Kadermin (Kadefort).
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