RU149063U1 - ANTI-MICROBIAL ACTION BAND FOR HEALING - Google Patents

Abstract

1. Dressing for wound healing with antimicrobial action, characterized in that it has the form of a multilayer product and contains a contact layer (K), one or more absorption layers (A) and a surface layer (R), and all layers are arranged in the following order in the direction from the wound: a contact layer (K), which contains on one side in contact with the wound, a coating (P) from a mixture of physiologically acceptable salt of gualuronic acid and octenidine dihydrochloride in a mass ratio of 500: 1; one or more absorption layers (A) and a surface layer (R). 2. The dressing according to claim 1, characterized in that the contact layer is made of woven or knitted fabric from monofilament polyamide (PAD), from staple fibers; from a non-woven fabric or porous membrane, polyurethane, polyester, viscose, a mixture of these fibers or other materials, for example synthetic fibers such as polypropylene. 3. The dressing according to claim 1 or 2, characterized in that the coating (P) is made in the form of a lyophilisate or a dried coating. Dressing according to any one of paragraphs. 1 and 2, characterized in that the absorption layers (A) made of materials that are selected from the group consisting of polyester, viscose, polyamide, polyethylene, polypropylene, polysaccharide, for example, xanthan or a derivative of cellulose, super absorbent material, a combination of woven or unwoven textile fibers and superabsorbents or a mixture of these materials. 5. Dressing according to any one of paragraphs. 1 and 2, characterized in that it includes several absorption layers (A) arranged in such a way that the gradient of the absorption capacity increases in the direction from the wound. 6. The dressing according to claim 5, characterized in that including

Description

Technical field

The technical solution relates to a dressing that promotes wound healing, having an antimicrobial effect, containing a physiologically acceptable salt of hyaluronic acid and octenidine dihydrochloride as an antimicrobial substance that can be used to heal surface wounds, especially chronic wounds, for example, varicose ulcers, as well as a dressing, containing the specified mixture.

State of the art

Wound healing, especially the healing of abnormal wounds, is a complex process that can be promoted with a dressing that creates adequate conditions for healing and / or contains active substances. Abnormal wound healing includes conditions for excessive wound healing (such as fibrosis, adhesion and contracture) or more often insufficient wound healing (such as varicose or diabetic ulcers). Despite recent significant advances in this area, abnormal wound healing remains an expensive painful treatment with high mortality. All this points to the importance of creating an optimal environment for wound healing that would positively influence the healing process (Stephanie R. Goldberg, Robert F. Diegelmann: Wound Healing Primer, Surgical Clinics of North America, Volume 90, Issue 6, December 2010, p . 1133-1146).

A brief review of literature related to wound healing is provided, for example, in James R. Hanna, Joseph A. Giacopelli: A review of wound healing and wound dressing products, The Journal of Foot and Ankle Surgery, Volume 36, Issue 1, January-February 1997, p. 2-14. The authors especially discuss the importance of a suitable wound dressing that would create an optimal environment for wound healing. It has been shown that modern dressings are usually multi-layered and the contact layer has the greatest effect on the healing process.

Currently, the market offers many industrial products, which, however, do not fully meet the important requirements for dressings for wound healing, or are very expensive, which limits their mass application. Usually, various natural or synthetic substances are used that form gels that are able to regulate humidity. But these substances in most cases only regulate the moisture of the wound and do not support the body's ability to self-regenerate. Moreover, the use of such substances reduces gas permeability and therefore they block wound ventilation. They fight infections by using disinfectant reagents before bandaging, which reduces the effect of disinfection. These dressings for wounds cannot be applied to chronic wounds, since there is a risk that a moist environment will contribute to the spread of infection and, therefore, significantly worsen the patient's condition.

Many patents and publications describe the use of hyaluronan as the main component of a dressing for wounds, but due to the high cost of these dressings are not very widely used in industry. Therefore, in practice, hyaluronan is used only for intra-somatic (intra-articular) injections and not necessarily for special applications (ophthalmology, eye drops to moisten the surface of the eyes in patients with contact lenses).

The practical use of hyaluronan is illustrated by a hyaluronan-based product in combination with other active compounds described in US Pat. No. 4,736,024. The product is specifically designed for ophthalmology and pharmaceutically active substances used include, for example, kanamycin, neomycin, tetracycline, chloramphenicol, and combinations thereof.

US Pat. No. 5,218,136 describes a dressing used to prevent wound dehydration and infection, i.e. for the same purposes as the proposed product. However, unlike the dressing in this utility model, it contains soluble collagen as the main component, which does not affect wound healing and does not contain hyaluronic acid or its salts. The disadvantage of US Pat. No. 5,218,136 is that collagen can cause unwanted reactions such as inflammation. Another disadvantage is that after application, the phase state of the liquid changes with the formation of a solid gel that blocks the permeability of the eye.

Utility Model Essence

The disadvantages of existing dressings for maintaining wound healing are overcome with dressings in the form of a multilayer formation. One of the advantages of the claimed utility model is a positive effect on the rate of wound closure and a decrease in the content of bacteria in the wound. The multilayer formation includes layers arranged in the following order away from the wound: the proposed contact layer (K) on one side that will be in contact with the wound, and a coating (P) of polysaccharides with an antimicrobial substance, i.e. made from the mixture discussed above (chemical or mechanical mixture), then one or more absorption layers (A) and surface layer (R). Thus, the lower contact layer (K) contains on one (lower) side intended for contact with the wound, a coating (P) consisting of a mixture of a salt of hyaluronic acid and octenidine dihydrochloride in a mass ratio of 500: 1, and the other (upper) side in contact with one or more absorption layers (A or A-1, A-2, etc.). The upper side of the last absorption layer farthest from the wound is in contact with the surface layer (R). All layers can be joined together along the edges to form a so-called tea bag with dimensions, for example, 10 × 10 cm. A single-layer dressing consists only of a contact layer (K) with a coating (P) of a mixture of a salt of hyaluronic acid and octenidine dihydrochloride, with the contact layer (K) may consist of tissue with a large absorption capacity (it may also be superabsorbent).

Preferably, the contact layer consists of woven or knitted fabric made from polyamide (PAD) monofilaments, optionally staple fibers; from an unwoven fabric or porous membrane, polyurethane, polyester, viscose, a mixture of these fibers or other materials, for example, synthetic fibers such as polypropylene. Preferably, the coating (P) is in the form of a lyophilisate or a dry coating, more particularly in the form of a lyophilized or dry layer of a chemical mixture or a layer of a mechanical mixture. Preferably, the absorption layer or absorption layers (A) are made of materials that are selected from the group consisting of polyester, rayon, polyamide, polyethylene, polypropylene, polysaccharide, for example, xanthan or a cellulose derivative, a super absorbent material, a combination of woven or non-woven textile fibers and superabsorbents or mixtures of these materials. In the case of several absorption layers (A), it is preferable to arrange them so that the gradient of the absorption capacity increases in the direction from the wound, for example, the absorption layer (A-1) closest to the wound consists of 100% polyester and the absorption layer (A -2), the next from the wound, from a mixture of polyester and viscose 1: 1. The surface layer (R), preferably made from a non-woven polyester fabric, may optionally have an antimicrobial modification due to the impregnation with a suitable antimicrobial substance or due to the presence of antimicrobial fibers, for example obtained from bamboo, or the presence of silver microparticles.

Coating (P) may consist of a layer of precipitated gualuronan fibers coated with a layer of a solution of octenidine dichloride, wherein the amount of gualuron coating is at least 0.1 mg / m ² and the amount of coating of octenidine dichloride is at least 0.0001 mg / m ² . Preferably, the amount of the gualuronic coating is in the range of 1-50 g / m ² and the amount of the coating of octenidine dihydrochloride is in the range of 0.001-0.5 g / m ² . Most preferably, the amount of the gualuronic coating is in the range of 5-20 g / m ² and the amount of the coating of octenidine dihydrochloride is in the range of 10-40 mg / m ² .

The contact layer (K) and the surface layer (R) can be connected to each other along their borders so as to close the absorption layer or absorption layers (A) between the contact layer (K) and the surface layer (R), for example, the edges of the contact layer (K) and the surface layer (R) can be soldered.

Brief Description of Drawings

Figure 1 is a cross-sectional view of the dressing, the lower side being the contact layer K , consisting of 100% polyamide, coated with P from a mixture of polysaccharides and an antimicrobial substance, then the first absorption layer A-1 , consisting of 100% polyester, the second absorption layer A-2 , consisting of a mixture of 50% polyester and 50% viscose, and on top of it a surface layer R , consisting of 100% polyester. Layers K and R are sealed in the form of a “tea bag”, inside of which there are absorption layers instead of tea.

Figure 2 is a surface view of the dressing in the direction away from the polysaccharide coating. The boundary S is formed by connecting the layers (the layers indicated by K and R in figure 1 are connected), and part N is a coating consisting of a mixture of polysaccharides and an antimicrobial substance.

Figure 3 is a graph showing the effectiveness of wound healing in a healthy rat model, where the area of the wound's healed surface is plotted against the time of wound healing using the dressing of Example 1 and a bandage consisting of gauze without dressing (i.e. without polysaccharides and an antimicrobial agent )

Figure 4 is a graph showing the effectiveness of wound healing on a dwarf pig model, where the area of the wound’s healed surface is plotted against the healing time using the dressing of Example 1 and a control bandage with the same structure made from the same tissue materials, but without coating ( i.e. without polysaccharides and antimicrobial agents).

Figure 5 is a graph showing the effectiveness of the total antimicrobial effect of the dressing of example 1 and the control bandage (see description of figure 4) on a dwarf pig model.

Figure 6 is a graph showing the antimicrobial effect on the "G" sticks from the dressing of Example 1 and the control bandage (see description of Figure 4) for a model dwarf pig.

Examples

Example 1

Dressing with hyaluron, octenidine dihydrochloride and two different absorption layers, lyophilized

Octenidine dihydrochloride (10 mg) is dissolved in 1 ml of absolute ethanol, then 30 μl of this solution is diluted to 10 ml with sterile water for injection. Sodium hyaluronan (150 mg) with a molecular weight of 1650000 g / mol is gradually added to this solution with stirring and stirred for 12 hours. The resulting viscous solution is uniformly applied to a template with a width of 1 mm and a hole of 10 × 10 cm from a fabric base (contact layer) of 13 × 13 cm, the fabric being a knitted base of 40 g / m ² of 22 decitex polyamide "M" monofilaments. The coated contact layer on a suitable carrier is immediately frozen to -70 ° C and then transferred to a lyophilizer (the coating must remain frozen) and lyophilized. The obtained spongy porous elastic lyophilisate of white color firmly adheres to the contact layer partially inside the fabric material, but the main part of the applied material is on one side of the fabric. The contact layer is placed in such a way that the lyophilizate is in contact with the base on which it lies, for example, with a table or frame on which the fabric is stretched (i.e. the main part of the coating is directed towards the base), and a 10 × 10 square is placed on it cm non-woven polyester fabric 140 g / m ² (first absorption layer). A second absorption layer is applied to the first absorption layer (a square of 10 × 10 cm of non-woven fabric 140 g / m ² of polyester and viscose 1: 1). A surface layer made of non-woven polyester 30 g / m ² with dimensions of 13 × 13 cm is placed on the second absorption layer. The dressing is completed by joining the contact and surface layers at the desired distance from the absorption layers to prevent them from being damaged by heating. Then the final product is prepared - a square of approximately 11 × 11 cm, cutting off excess tissue along the edges of the surface and contact layers.

The resulting square dressing is applied to the wound with a contact layer to the wound and then fixed with a secondary dressing. Dry wounds are applied to severely exudative wounds. On slightly exudative wounds, the contact layer is moistened with 5-10 ml of physiological saline, sterile water or drinking water before application. On dry wounds, it is always necessary to moisten the dressing with 10 ml of a suitable liquid (examples are given above). This dressing can be left on the wound for 3 or 4 days and then it is changed. In the case of massive exudation, only the secondary dressing is changed as often as necessary, and the primary dressing is changed. The absorption capacity of the secondary dressing can be increased using any commercially available superabsorbent or other suitable system.

Example 2

Dressing with hyaluron, octenidine dihydrochloride and two different absorption layers, dried

Octenidine dihydrochloride (10 mg) is dissolved in 1 ml of absolute ethanol and then 30 μl of this solution is diluted to 10 ml with sterile water for injection and 1: 1 isopropyl alcohol (i.e. 50% isopropyl alcohol solution). Sodium hyaluronan (150 mg) with a molecular weight of 1650000 g / mol is gradually added to this solution with stirring and stirred for 30 minutes. The resulting viscous solution is uniformly applied to a template with a width of 1 mm and a hole of 10 × 10 cm on a fabric substrate (contact layer) with dimensions of 13 × 13 cm, the fabric being a knitted base of 40 g / m ² of 22 decitex polyamide M monofilaments. The coated contact layer on a suitable carrier is dried in an oven at 40 ° C for 2.5 hours or in a suitable drying mode (e.g. drying at 40 ° C for 60 minutes, heating to 70 ° C for 30 minutes, holding at 70 ° C for 15 minutes and then cooling to 40 °). The obtained glassy elastic transparent (colorless) film adheres firmly to the contact layer, partially inside the fabric material, but the main part of the applied material is on one side of the fabric and has the same structure as the surface of the substrate on which the fabric is fixed; if the substrate is smooth, then the film will also be smooth; it is more preferable to have a relief with minor depressions. The contact layer is placed so that the coating is in contact with the substrate (i.e. the main part of the coating is directed towards the substrate), and a square of 10 × 10 cm of non-woven polyester fabric 140 g / m ² is placed on it (first absorption layer). The second absorption layer is placed on the second absorption layer in the form of a square of 10 × 10 cm from non-woven fabric 140 g / m ² of polyester and viscose 1: 1. A surface layer of non-woven polyester 30 g / m ² measuring 13 × 13 cm is placed on the second absorption layer. The dressing is completed by joining the contact and surface layers at the desired distance from the absorption layers in order to prevent them from being damaged by heating. Then the final product is prepared (a square of approximately 11 × 11 cm), cutting off excess tissue along the edges of the surface and contact layers.

The resulting dressing is applied to the wound with a contact layer to the body, as in example 1. The difference between the film and the lyophilizate is that the film is less permeable to gases and dissolves faster. Therefore, it is preferable to use a film, especially in the first stage of the healing process, when a chronic wound needs to be transferred to a standard healing process. When the second phase begins, i.e. extensive granular tissue begins to form; lyophilized or other dressings can be used instead if the granular tissue penetrates deep into the dressing.

Example 3

Dressing with hyaluron, octenidine dihydrochloride and two different absorption layers, fibrous

Octenidine dihydrochloride (6 g) was dissolved in 100 ml of sterile water, and then 8 g of gualuron sodium with a molecular weight of 1650000 g / mol was gradually added with stirring and the solution was stirred for 12 hours. The resulting viscous solution was taken with a syringe and squeezed into a precipitation bath, which contains 400 ml of concentrated acetic acid (about 98%) and 100 ml of isopropyl alcohol (about 99%). The resulting fiber is left in the bath and its length is controlled, for example, using rapidly rotating knives (for example, in a machine similar to a conventional mixer). The solution with shorter fibers is then filtered through contact tissue and a suitable porous diaphragm (for example, a solid plate with holes on which the fabric is placed) to form a layer of fibers having a capacity of about 15 g / m ² . Optionally, the fiber coating can be prepared on a porous diaphragm and then transferred (for example, by “reprinting” to the contact layer). The layer of fibers on the contact tissue is washed with a suitable liquid, for example, a mixture of isopropyl alcohol and water (the concentration should be above 60% so that the fibers do not dissolve). The washed layer is then pressed so as to press the fibers to the base and to each other without disturbing the porous structure. The size of the substrate or contact tissue and fiber layer is adjusted so as to obtain a square of the contact layer 13 × 13 cm with a 10 × 10 cm fiber coating. Octenidine dihydrochloride (10 mg) is dissolved in 1 ml of absolute ethanol and then 30 μl of this solution is transferred to 2 ml of a mixture of sterile water for injection and 1: 1 isopropyl alcohol (i.e. 50% isopropyl alcohol). Then, the octenidine dihydrochloride solution is uniformly applied to the entire surface of the fiber coating, for example by spraying, and optionally the fibers are compressed (this causes some dissolution of the fibers, which improves the bond strength between the fibers and the contact tissue). Thus, octenidine dichloride, i.e. antimicrobial substance penetrates the structure of polysaccharide fibers and a mechanical mixture of polysaccharides and antimicrobial substances is formed. The contact layer of coated fibers on a suitable substrate is dried in an oven at 40 ° C for 2.5 hours or in a different drying mode (for example, drying at 40 ° C for 60 minutes, heating to 70 ° C for 30 minutes, holding at 70 ° C for 15 minutes and then cooling to 40 ° C). Further processing to obtain a dressing for wounds and its use is carried out in the same way as in example 1. The coating of the fibers is more porous than the film made in example 2, but at the same time, the pore structure is different from the structure of the lyophilisate described in example 1. The properties of the coated fiber dressing are much closer to the properties of the lyophilisate than to the properties of the film.

Example 4

Replacing a portion of gualuronan with another substance or mixture of substances

A method similar to that used in examples 1, 2 or 3 was used, but 0.1-99.9% of gualuronan was replaced with another polysaccharide, for example, a cellulose derivative, xanthan, alginate, schizophyllan, chitosan, glucan, or a saccharide, for example, glucose, fructose, sucrose, or an electrolyte, for example, sodium chloride, potassium chloride, potassium iodide, magnesium chloride, sodium hydrogen phosphate, sodium dihydrogen phosphate, zinc sulfate, or a plant extract or similar natural product, for example propolis, olive oil, tea tree oil, oak extract, calendula, mint and whether citrus, or a mixture of any combination of these substances. The dressing can be modified using 0.1-99.9% of the initial amount of gualuronan and a larger amount of another substance or mixture of substances compared to the initial amount of gualuronan. For example, in the dressing of Example 1, only 10 mg of gauluronan was used instead of 150 mg of gualuronan and 150 mg of xanthan was added, so that the total amount of polysaccharides was higher than the initial amount of gualuronan (160 mg of the mixture compared to the original 150 mg). You can use other substances or a mixture of substances up to concentrations corresponding to their saturated solutions. The purpose of this modification is to achieve a hypertonic environment that is favorable for certain phases of the healing of specific wounds, mainly chronic wounds (especially with necrotic decay).

Example 5

Substitution of octenidine dihydrochloride with another substance or mixture of substances

A method similar to that used in examples 1,2,3 or 4 was used, but octenidine dihydrochloride was replaced with another suitable antimicrobial substance in the appropriate concentration (here calculated on a surface area of 10 × 10 cm). For example, 1.5 mg of benzalkonium chloride can be used; 3.5 mg chlorhexidine; 0.5 mg of PHMB or a mixture in any combination of various amounts of these substances with octenidine dihydrochloride, optionally without octenidine dihydrochloride.

Example 6

Product performance evaluation (antimicrobial activity tests, preclinical studies) Models used, brief description

Antimicrobial activity was studied in vitro. Samples were examined periodically for several days. Samples were transferred with sterile forceps into sterile glass tubes (in the case of hard dressings), and liquid mixtures were transferred into tubes with a pipette. 15 ml of BHI culture medium (Brain Heart Infusion Broth; Hi-Media) was added to each tube and the samples were inoculated with the following microorganisms: Staphylococcus aureus subsp. aureus CCM 4516 (gram-positive cocci), Escherichia coli CCM 4517 (gram-negative bacillus), Pseudomonas aeruginosa CCM 1961 (gram-negative non-fermentative bacillus), Bacillus subtilis subsp. spizizenii SSM 1999 (sporulating gram-positive bacillus), Aspergillus niger SSM 8222 (mushrooms). The growth properties of the culture medium were tested. The tubes were placed in a metal sheath and introduced into a thermostatic chamber for cultivation. Liquid samples were cultured for 24 and 48 hours, samples of solid dressings were cultured for a week in the temperature range of 30-35 ° C and the next week at 20-25 ° C. After this period, the presence or absence of turbidity was investigated. To control the cultivation of the present microorganisms, turbid samples were introduced using a sterile inoculation loop into Petri dishes with KA blood agar (Merck). Incubation was carried out for 5 days at 30-35 ° C.

The healing effect was studied using an excised wound model in healthy rats (male ZDF). Wounds of 2 × 2 cm were prepared and healing was determined twice a week by wound reduction using computer processing of wound photos.

The healing effect was also studied on a Minnesota dwarf pig model with 5 deep excisions of 25 × 25 mm on each side, made under anesthesia in the manner described by Van Dorp Verhoeven MC, Koerten NK, Van Der Nat-Van Der Meij TH, Van Blitterswijk CA, Ponec M: Dermal regeneration in full-thickness wounds in Yucatan miniature pigs using a biodegradable copolymer, Wound Repair Regen, 1998; 6 (6): 556-68. Then, the wounds were covered with a control and experimental dressing until healing is complete. Regular dressings, photo documentation and scrapings for microbiological studies were performed twice a week. Based on the analysis of the photographs, the rate of wound healing (compression, epithelization) was determined, and on the basis of cultivation tests, the effect of the dressing on colonization of microbes on the wound was evaluated.

Antimicrobial efficacy of the active mixture (liquid according to example 1)

The sample of the liquid mixture (viscous solution) used for the coating according to Example 1 showed complete (i.e. 100%) inhibition of the growth of E. coli strains (initial suspension of 20,000 CFU / ml), S.ureus (20,000 CFU / ml ), P.aeruginosa (40,000 CFU / ml) and B. subtilis (1000 CFU / ml) with 4 mg octenidine dihydrochloride. When using 1 mg of octenidine dihydrochloride, inhibition was 100% only for B. subtilis and S. Aureus strains, inhibition for E. coli strains was 99.95% and for P.aeruginosa strains 90%.

An inhibition zone around the contact layer was established on the sample of the final dressing, however, at a greater distance from the dressing, the growth of microorganisms was not inhibited. On the other hand, this fact shows that the antimicrobial substance is not released from the dressing into the environment and therefore does not harm the patient.

Antimicrobial efficacy of the active mixture (liquid according to example 5)

The sample of the liquid mixture (viscous solution) used for the coating according to Example 5 showed complete (i.e. 100%) inhibition of the growth of E. coli strains (initial suspension of 1800 CFU / ml), S.aureus (600 CFU / ml ) and A. niger (65 CFU / ml) with a content of 16 mg of benzalkonium chloride (BAC) or 40 mg of chlorhexidine or 40 mg of PHMB. When using 1.6 mg of BAC, the inhibition was 100% only for S.aureus strains, the inhibition of E. coli strain was 16% and the inhibition of A.niger strain was 89%. When using 4 mg of chlorhexidine, the growth inhibition of E. coli was 61%, S.aureus 95% and A.niger 32%. When using 4 mg of polyhexamethylene biguanide (PHMB), the growth inhibition of E. coli was 44% and A. niger 57%.

The inhibition zones were shown on the samples of the final dressings as described for the samples from Example 1. Therefore, when using the appropriate amount of antimicrobial substance, the dressings had similar microbial inhibition properties, due to the overall design and manufacturing method of the dressing, and not just the specific antimicrobial substance.

Dressing of Example 1, Healing Effect, Healthy Rat Model

When using the dressing of Example 1, a significant acceleration of wound closure was observed, which in the model used represents the scale of healing or healing efficiency. Compared with the untreated control wound (see figure 3), it is seen that the application of the dressing of example 1 shortens the healing time of the wound, especially since the healing process begins immediately after the injury. The intensity of subsequent wound healing is similar in both cases, as can be seen from the close slope of the curves for both functions in figure 3. Since they worked with healthy rats, the healing efficiency of chronic wounds was not investigated.

Dressing of Example 1, Healing Effect, Healthy Dwarf Pig Model

It was found that the dressing from example 1 positively affects the speed of wound closure (figure 4) and also reduces the total content of bacteria in the wounds (figure 5), of which gram-negative bacteria were especially monitored (figure 6).

Claims (10)

1. Dressing for wound healing with antimicrobial action, characterized in that it has the form of a multilayer product and contains a contact layer (K), one or more absorption layers (A) and a surface layer (R), with all layers in the following order in the direction from the wound: a contact layer (K), which contains on one side in contact with the wound, a coating (P) of a mixture of a physiologically acceptable salt of gualuronic acid and octenidine dihydrochloride in a mass ratio of 500: 1; one or more absorption layers (A) and a surface layer (R). 2. The dressing according to claim 1, characterized in that the contact layer is made of woven or knitted fabric from monofilament polyamide (PAD), from staple fibers; from a non-woven fabric or porous membrane, polyurethane, polyester, viscose, a mixture of these fibers or other materials, for example synthetic fibers such as polypropylene. 3. A dressing according to claim 1 or 2, characterized in that the coating (P) is in the form of a lyophilisate or a dried coating. 4. Dressing according to any one of paragraphs. 1 and 2, characterized in that the absorption layers (A) made of materials that are selected from the group consisting of polyester, viscose, polyamide, polyethylene, polypropylene, polysaccharide, for example, xanthan or a cellulose derivative, super absorbent material, a combination of woven or unwoven textile fibers and superabsorbents or mixtures of these materials. 5. Dressing according to any one of paragraphs. 1 and 2, characterized in that it includes several absorption layers (A) arranged in such a way that the gradient of the absorption capacity increases in the direction from the wound. 6. The dressing according to claim 5, characterized in that it includes absorption layers (A-1) and (A-2), the absorption layer (A-1) located closer to the wound, is 100% polyester, and the absorption layer (A-2), located further from the wound, is made of a 1: 1 mixture of polyester and viscose. 7. The dressing according to claim 1, characterized in that the coating (P) consists of a layer of precipitated gualuronic fibers, onto which a layer of a solution of octenidine dihydrochloride is applied, the amount of gualuronic coating being at least 0.1 mg / m ² and the amount of coating of octenidine dihydrochloride is at least 0.0001 mg / m ² . 8. The dressing according to claim 7, characterized in that the amount of gualuronic coating is in the range of 1-50 g / m ² and the amount of coating of octenidine dihydrochloride is in the range of 0.001-0.5 g / m ² . 9. The dressing according to claim 8, characterized in that the amount of the gualuronic coating is in the range of 5-20 g / m ² and the amount of the coating of octenidine dihydrochloride is in the range of 10-40 mg / m ² . 10. The dressing according to claim 1, characterized in that the contact layer (K) and the surface layer (R) are joined together at the edges, while the absorption layer or absorption layers (A) are closed between the contact layer (K) and the surface layer (R )

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