EP0983085A2 - Compositions et moyens de traitement de brulures et autres lesions cutanees - Google Patents

Compositions et moyens de traitement de brulures et autres lesions cutanees

Info

Publication number
EP0983085A2
EP0983085A2 EP98921713A EP98921713A EP0983085A2 EP 0983085 A2 EP0983085 A2 EP 0983085A2 EP 98921713 A EP98921713 A EP 98921713A EP 98921713 A EP98921713 A EP 98921713A EP 0983085 A2 EP0983085 A2 EP 0983085A2
Authority
EP
European Patent Office
Prior art keywords
debriding
wound
skin
debrided
agent
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP98921713A
Other languages
German (de)
English (en)
Inventor
Lior Rosenberg
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
L R R and D Ltd
Original Assignee
L R R and D Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by L R R and D Ltd filed Critical L R R and D Ltd
Publication of EP0983085A2 publication Critical patent/EP0983085A2/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/43—Enzymes; Proenzymes; Derivatives thereof
    • A61K38/46—Hydrolases (3)
    • A61K38/48—Hydrolases (3) acting on peptide bonds (3.4)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L15/00—Chemical aspects of, or use of materials for, bandages, dressings or absorbent pads
    • A61L15/16—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons
    • A61L15/38—Bandages, dressings or absorbent pads for physiological fluids such as urine or blood, e.g. sanitary towels, tampons containing enzymes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F15/00—Auxiliary appliances for wound dressings; Dispensing containers for dressings or bandages
    • A61F15/001—Packages or dispensers for bandages, cotton balls, drapes, dressings, gauze, gowns, sheets, sponges, swabsticks or towels
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/43—Enzymes; Proenzymes; Derivatives thereof
    • A61K38/46—Hydrolases (3)
    • A61K38/48—Hydrolases (3) acting on peptide bonds (3.4)
    • A61K38/482—Serine endopeptidases (3.4.21)
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K38/00—Medicinal preparations containing peptides
    • A61K38/16—Peptides having more than 20 amino acids; Gastrins; Somatostatins; Melanotropins; Derivatives thereof
    • A61K38/43—Enzymes; Proenzymes; Derivatives thereof
    • A61K38/46—Hydrolases (3)
    • A61K38/48—Hydrolases (3) acting on peptide bonds (3.4)
    • A61K38/4873—Cysteine endopeptidases (3.4.22), e.g. stem bromelain, papain, ficin, cathepsin H
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00—Drugs for dermatological disorders
    • A61P17/02—Drugs for dermatological disorders for treating wounds, ulcers, burns, scars, keloids, or the like
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F13/00—Bandages or dressings; Absorbent pads
    • A61F2013/00089—Wound bandages
    • A61F2013/00157—Wound bandages for burns or skin transplants

Definitions

  • the present invention relates to the treatment of traumatized skin. More
  • the invention relates to compositions and means for promoting
  • cutaneous burn trauma onset, severity, complexity, short and long term implications the cutaneous burn trauma will be used here as an example to other cutaneous traumas.
  • the traumatized skin (burned tissue) the eschar may be of different depths
  • the eschar characteristics may depend on the traumatizing agent
  • burn's depth is changing from point to point and the eschar' color
  • debridement This removing of the dead tissue is termed "debridement".
  • the concept of debridement is as old as
  • bleeding tissues is the procedure of choice. In the case of burns, because of
  • the severed blood vessels are the ones that will grow
  • debrided tissue is typical and made of healthy dermal collagen, subdermal
  • Fibrinolysin-desoxyribonuclease (Elase) compounds were or still are in
  • microbacterial, vegetable or even animal origin were tested and some even
  • Bacillus subtilis Sutilains (Travase), Streptococci:
  • Streptokinase-streptodornase plants such as the Papaya (Papain) or
  • tissue could not support an autogenous or non autogenous living graft
  • burn treatment the following choices of burn treatment protocols may be
  • the area that needs to be grafted is
  • raw debrided tissue dictates usually an autograft with an additional
  • the new treatment means are based on the discovery that both the above
  • the first is an undertreatment, leaving the dead eschar
  • the second is an overtreatment, debriding aggressively the
  • necrotic tissue prevents secondary germ's contamination and sepsis. Its
  • neo-vascularization does not proceed as readily in the interface layer as in
  • the graft with their host/graft direct anasthomosis or budding potential.
  • epithelial remnants in the skin adnexae are given the right conditions for
  • epithelialization prevents the formation of the granulation tissue
  • these areas may be grafted by
  • the present invention provides, inter alia, a skin pre-heahng
  • composition for the pre-treatment of traumatized skin, comprising an
  • the debriding agent is present in an amount and nature
  • the debriding agent comprises:
  • the debriding agent is derived from pineapple. Typical debriding
  • agents of this kind include, e.g., Bromelain or a derivative or fraction
  • the invention is directed to an early coverage set for the
  • the Keratocyte described above and promotion of its heahng, comprising a protective dressing that may be provided with Keratocyte growth promoting agent(s).
  • the Keratocyte may be provided with Keratocyte growth promoting agent(s).
  • growth promoting agent comprises an artificial dermis.
  • agent comprises one or more growth hormones.
  • the invention further provides a method for treating a patient suffering from trauma of the skin, said method comprising the steps of:
  • the debridement procedure is carried out
  • Keratocyte propagation in
  • Figure 1 is a photography of a fresh, mixed depth, scaled burn of the
  • white-gray area 2 is deeper and is of a second-deep (deep-dermal)
  • Figure 2 is a photography of the same burn of Fig. 1 after an enzymatic
  • Figure 3 is a photography of a deep (nominal third degree) burn of the
  • the thickness dermal eschar is present.
  • the whitish areas marked 7 shows clearly a very thin LL. with its typical granular pinkish aspect and
  • area marked 8 is a full
  • Figure 4 is a photography of a wider field and general appearance of
  • Figure 5 is a photography of a deep mixed flame burn (similar in
  • Figure 6 is a drawing of a soaking dressing whereas 12 represents the
  • absorbent material that moisturizes the wound's surface by capillary
  • Container 13 represents the germ-free soaking liquids that
  • a draining tube 15 drains the access fluids from the wounds site into a collecting
  • Figure 7 is a schematic drawing representing the piglet bioassay site
  • numbered 19 is the deep, full thickness burn.
  • excision 20 represents all the different areas (17, 18 and 19) of the
  • FIG 8 is a drawing representing the biopsy (Fig 7 no. 20) where the
  • Zone 21 is the
  • Fig. 9 is a drawing of a unit dose debriding matrix carrier saturated with lyophihzed enzyme, with an optional rigid frame 125 made of
  • inert matrrials such as plastic as in figs. 10 and 11.
  • Fig. 10 iUustrates a placing device for the matrix carrier, with or
  • debriding matrix carrier, 40 is released.
  • Fig. 11 is a drawing of a placing device for the matrix carrier in cross
  • Said device comprises a cartridge, 43, which contains one or more unit dose debriding matrix carriers, 44, may be separated one
  • debriding agent's solvent may be a part of the matrix carrier itself
  • a matrix carrier can be any suitable matrix carrier.
  • Fig. 12 is a drawing of a unit dose, uniform, dispersal device in cross section.
  • Said device comprises a cartridge, 30, which contains
  • peeling blade 36, is moved from close to side 37 to close to side 38, and back to close to side 37. At the first half of each cycle, i.e. when
  • the "peehng blade” 36 may be in the form of a "peeling
  • Figs. 13a and 13b are drawings of an example of a disposable, unit
  • Fig. 13c is a schematic partial cross-section of the round inlet 50 as herinafter described. Said system
  • Said container has an enlarged lower end 140 closed by a peel off film
  • a special plunger 142 is placed within the tubular container and
  • liquid vehicle liquid vehicle, solvent or activating medium gel.
  • solvent or activating medium gel On its top there is a
  • tubular container 39 and covered with a peel off film 51, and an inner ledge or a groove 52 in the inner surface of said port that engages the
  • the quantity of the debriding agent and the solvent vehicle may be any quantity of the debriding agent and the solvent vehicle.
  • the tubular container is
  • the pressing surface is releasing into a cross bar
  • container may be an integral part of the vehicle container (inside or outside) with the plunger system designed to open the communication
  • the invention can be carried out using a variety of systems and means,
  • This preparatory set is designed to provide specific means for the treatment
  • treatment is to preserve as much as possible of the living tissues in the harsh conditions of a traumatized skin with impaired local circulation at the
  • the set that provides the protective micro-environment may be composed of
  • An occlusive dressing such as
  • M.D.O.D. Multipurpose Dynamic Occlusive Dressing
  • 4132/96 may provide all the changing, dynamic needs of the wound but a combination of different occlusive and non occlusive dressings may also
  • the first needs are to
  • hydrating dressings gel, soaking dressing, ointments or creams may be
  • occlusive chamber increases the efficacy and the bioactivity of the various
  • the M.D.O.D allows a minute control of the occlusive chamber ambient and its continuing changes
  • a continuous irrigation/soaking dressing A thick gauze or fibrous
  • a traditional heavy gauze or knotted dressing that is soaked with desired liquids at the desired intervals.
  • the debridement process is designed to produce within few hours a wound
  • the debridement timing is important. The older the eschar is, more
  • the macroscopic representation is of a
  • the graft adheres to the debrided surface, protects it and serves as a matrix
  • epithelial (epidermal keratocytes) cells For the propagation of the remaining epithelial (epidermal keratocytes) cells
  • the LL. may also support the second stage of skin graft take: The neo-vascularization phase that is the anastomosis of some of the opened
  • the main objective of the treatment modality is to promote
  • bioassay test comprising the following steps:
  • centimeters mixed depth burns where the center of at least 2x2
  • centimeters are of a full thickness burn and the rest gradually bevels
  • the debriding agent should have the following
  • debriding composition may change from one debriding agent to
  • a saline soaking dressing (such as
  • the dry Debridase is apphed in unit dose of descending values.
  • the unit doses may be achieved by using a unit dose debriding matrix or by
  • the dry enzyme is sprinkled with 37 centigrade warm sahne (5 cc. for each
  • the air may be sucked out after closure of the film. Special care is taken to
  • the debrided areas are soaked as previously described for 2-4 hours. After
  • this post-treatment soaking the wound is reassessed for the presence of I.L., eschar, bleeding vessels, exposed fat or deeper tissues.
  • the reassessment is confirmed by a radial inscisional biopsy containing at
  • the goal of the early cover is to promote a fast, spontaneous
  • the early cover for the debrided wound should provide the following
  • adherent surfaces provide some of the necessary condition for the
  • epithelial cells will originate within the skin remnants and/or may be imported to the wound's site from other areas
  • hormone growth factors apphed in the right amount and sequence is essential for an optimal epithehahzation process.
  • hormone system This "hormone factory” is the epithehal cell
  • Keratocyte culture Keratocyte culture, cell suspension or combined biological dressing
  • the coverage set includes a biological cover with the above mentioned
  • omograft (a partial thickness skin graft of human donor) in the form of
  • the Ortec CCS is a semi synthetic "omograft"
  • the living cells the hormones and growing factors for the Keratocytes
  • Keratocytes propagation and wound healing enhancement may demand a dressing that will provide the adequate cover, support and
  • autograft autogeneous skin grafting
  • the late grafting set is designed to provide the means for grafting the areas that were not healed by the early debridement and enhanced heahng
  • wound bed is clean without dermal or epidermal remnants that could be used as healing foci.
  • the small skin grafts may be meshed and thus
  • Such a cover can be used as a carrier for the meshed autograft
  • a component of the late heahng process is the epithehahzation and the scar
  • the heahng enhancing covers (such as the
  • omograft and the Ortec CCS may serve as epithehahzation dressings but
  • Such a dressing may be of the film
  • medicated gauze such as the Omiderm or Opsite type
  • medicated gauze such as the Omiderm or Opsite type
  • debriding agents can be used, or different dressings and Keratocyte growth promoting agents can be employed, all without

Abstract

On décrit une composition de pré-cicatrisation destinée au prétraitement d'une lésion cutanée, qui comprend une quantité efficace d'un agent de débridement formant une couche d'interface.
EP98921713A 1997-05-26 1998-05-25 Compositions et moyens de traitement de brulures et autres lesions cutanees Withdrawn EP0983085A2 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
IL12090997 1997-05-26
IL12090997A IL120909A0 (en) 1997-05-26 1997-05-26 Compositions and means for the treatment of burns and other cutaneous traumas
PCT/IL1998/000237 WO1998053850A2 (fr) 1997-05-26 1998-05-25 Compositions et moyens de traitement de brulures et autres lesions cutanees

Publications (1)

Publication Number Publication Date
EP0983085A2 true EP0983085A2 (fr) 2000-03-08

Family

ID=11070172

Family Applications (1)

Application Number Title Priority Date Filing Date
EP98921713A Withdrawn EP0983085A2 (fr) 1997-05-26 1998-05-25 Compositions et moyens de traitement de brulures et autres lesions cutanees

Country Status (6)

Country Link
EP (1) EP0983085A2 (fr)
JP (1) JP2002501525A (fr)
KR (1) KR20010012952A (fr)
AU (1) AU7448198A (fr)
IL (1) IL120909A0 (fr)
WO (1) WO1998053850A2 (fr)

Families Citing this family (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
IL137689A0 (en) 2000-08-03 2001-10-31 L R Res & Dev Ltd System for enhanced chemical debridement
AUPR298901A0 (en) 2001-02-07 2001-03-08 McComb Foundation, Inc., The Cell suspension preparation technique and device
WO2003090598A2 (fr) * 2002-04-23 2003-11-06 Mediwound, Ltd. Appareil et procedes d'incision de decharge enzymatique dans le syndrome de compartiment induit par une brulure
WO2004069147A2 (fr) * 2003-02-03 2004-08-19 Mediwound Ltd. Systeme de parage chimique ameliore
US20060233783A1 (en) * 2003-04-09 2006-10-19 Gomez Torres Harold A Topical composition in the form of a gel for treating skin burns
AU2005261276A1 (en) * 2004-07-13 2006-01-19 Mediwound Ltd. Compositions and methods for dermatological wound healing
ES2829956T3 (es) 2008-10-02 2021-06-02 Lrr & D Ltd Apósito para heridas en capa de interfaz
AU2013205148B2 (en) 2013-03-14 2014-10-30 AVITA Medical Americas, LLC Systems and methods for tissue processing and preparation of cell suspension therefrom
IL256675A (en) * 2017-12-31 2018-02-28 Technion Res & Development Found Ltd Methods and preparations for the prevention and treatment of pressure sores
KR20210089659A (ko) 2018-10-05 2021-07-16 제노세라퓨틱스, 인코포레이티드 이종이식 생성물 및 방법
US10883084B2 (en) 2018-10-05 2021-01-05 Xenotherapeutics, Inc. Personalized cells, tissues, and organs for transplantation from a humanized, bespoke, designated-pathogen free, (non-human) donor and methods and products relating to same
BR112021018788A2 (pt) 2019-03-25 2021-11-23 Xenotherapeutics Corp Células, tecidos e órgãos personalizados para transplante de um doador (não humano) humanizado, indivi-dualizado, designado livre de patógenos e métodos e produtos relacionados aos mesmos

Family Cites Families (7)

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Publication number Priority date Publication date Assignee Title
EP0040862A1 (fr) * 1979-01-11 1981-12-02 Key Pharmaceuticals, Inc. Matrice pour brûlures, procédé pour sa préparation et appareil de dosage comprenant cette matrice
US4668228A (en) * 1985-03-12 1987-05-26 Johnson & Johnson Products, Inc. Debriding tape
US4784653A (en) * 1987-06-22 1988-11-15 Johnson & Johnson Patient Care, Inc. Absorbent adhesive dressing
US5296222A (en) * 1989-02-23 1994-03-22 University Of Utah Percutaneous drug delivery system
EP0498532A1 (fr) * 1991-01-10 1992-08-12 E.R. SQUIBB & SONS, INC. Poudre pour le débridement des tissus nécropés contenant une enzyme protéolytique
AU4104093A (en) * 1992-04-20 1993-11-18 Rufeld, Inc. Method and compositions for treatment of pyonecrotic processes
AU1939895A (en) * 1994-03-01 1995-09-18 E.R. Squibb & Sons, Inc. Enzymatic debridement compositions and methods

Non-Patent Citations (1)

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Title
See references of WO9853850A2 *

Also Published As

Publication number Publication date
WO1998053850A2 (fr) 1998-12-03
WO1998053850A3 (fr) 1999-08-12
IL120909A0 (en) 1997-09-30
AU7448198A (en) 1998-12-30
JP2002501525A (ja) 2002-01-15
KR20010012952A (ko) 2001-02-26

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