PATHOGENETIC ASPECTS OF TREATMENT OF CHRONIC PURULENT WOUNDS WITH CONSIDERATION OF PROTEASE AND PROTEASE INHIBITOR MECHANISMS

Chronic purulent wounds remain a major clinical challenge due to persistent inflammation, microbial colonization, and impaired tissue regeneration. A key pathogenic mechanism underlying delayed healing is the imbalance between proteolytic enzymes and their endogenous inhibitors. Excessive activity of proteases, including matrix metalloproteinases and serine proteases, leads to degradation of extracellular matrix components, inactivation of growth factors, and disruption of cellular signaling pathways essential for tissue repair. This study aims to analyze the pathogenetic mechanisms of chronic purulent wounds with a focus on protease–antiprotease imbalance and to evaluate therapeutic strategies targeting these pathways. The analysis is based on contemporary scientific literature, clinical observations, and reported statistical outcomes. Findings indicate that targeted modulation of protease activity, combined with antimicrobial and regenerative therapies, significantly improves wound healing outcomes. The integration of protease inhibitors, advanced wound dressings, and biologically active agents contributes to restoring tissue homeostasis and accelerating repair processes. Understanding the molecular basis of proteolytic dysregulation provides a foundation for developing personalized and pathogenetically justified treatment strategies.