Background.  One of the characteristics of a combat injury is the penetration of pathogenic microorganisms, pieces of dirty skin, clothes, dust, etc. into the depth of the wound. The combination of significant defects of bones and soft tissues, vessels and nerves of the affected segment of the limb (musculoskeletal system) causes a high percentage of unsatisfactory treatment results, as well as the development of infectious complications. Objective: to evaluate the nature of combat wounds in patients who had  infectious complications in the musculoskeletal system during the war in Ukraine  since  2014;  to determine the features of the occurrence and development of such infectious complications. Materials and Methods. An analysis of case reports of patients with combat wounds with infectious complications (osteomyelitis, septic arthritis, surgical site infection (SSI), purulent- necrotic infection of soft tissues and wounds) who were treated at the Department of Bone- Purulent Surgery of the State Institution “Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine” for the period from 2014 to mid-2022 was carried out. Results and Conclusions. Infectious complications in combat wounds mostly arise primarily as a result of the wound itself, taking into account the severity, extent of damage to structures and tissues, the type of weapon used to inflict the injury, and a wide spectrum of microorganisms, among  which  Staphylococcus  aureus  plays  a  leading role. In the control group, infectious complications occurred more often than SSI with further progression.

Summary. Despite the improvement in the quality of implants, the number of complications in traumatology and orthopedics, which lead to infection, remains high. It is proved that untimely prescription of adequate antibiotic therapy for implant-associated infections can cause progression of the septic process until the development of shock and multiorgan failure and on practics leads to the development of resistance microorganisms to antibacterial drugs. An important point is to study the pathological microbial communities (bacterial film) in traumatology and orthopedics. All "classic" tests and markers of the infectious processhave low specificity and are not reliable enough for accurate diagnosis. These features are forced to development of additional microbiological diagnostics: the study of the destruction of the biofilm, which is removed from the implant surface with the help of ultrasound. The purpose of our study was to determine the effectiveness of the microbiological tests with sonication in patients with infectious process after osteosynthesis of long bones. Materials and Methods. Microbiological studies of the pathologically altered tissue biopsies directly at the implant and implant sonicates from the implant for osteosynthesis from 31 patients with chronic osteomyelitis or surgical site infection were performed. Results. As a result, the significant sonication efficiency was discovered: a 25.8% increase in positive results, 6.5% of E. aerogenes and E. faecalis cultures in association with S. aureus were isolated. Conclusions. Further improvement of the method and its application in specialized departments can give a positive diagnostic effect, which will subsequently improve the results of patient treatment.