RU2227742C1 - Agent for prophylaxis of postoperative commissural process - Google Patents

Abstract

FIELD: medicine, surgery. SUBSTANCE: invention proposes a novel agent for prophylaxis of postoperative commissural process. Agent represents zinc hyaluronate known early as a wound-healing agent. Invention expands assortment of agents used for prophylaxis of postoperative commissural process. EFFECT: valuable medicinal property of agent. 1 tbl, 1 ex

Description

The invention relates to medicine, in particular to surgery, and can be used to prevent adhesions of the abdominal cavity after various operations.

In surgery, various agents are used to prevent the adhesive process of the abdominal cavity after various surgical interventions.

It is known that for the prevention of postoperative adhesions, intraperitoneal administration of a 0.8% solution of methyluracil in a 0.25% solution of novocaine, which have an anti-inflammatory effect, is used [Dontsov BS Drug prevention of adhesive disease. / Abstract for the degree of candidate of medical sciences. - Rostov-on-Don: 1982, p.18-19]. The disadvantage of this tool is the low anti-adhesive effect in relation to the occurrence of peritoneal adhesions.

It is widely known a means for preventing the process of adhesion formation of the abdominal cavity, such as spermaceti oil, administered intraperitoneally [Tarbaev D.S. Prevention of adhesive disease. / Bulletin of Surgery. Grekova, 1982, vol. 128, No. 6, pp. 41-44]. The use of this tool is based on the fact that the introduction of an oil solution into the abdominal cavity ensures that sections of damaged tissue slip against each other, which prevents them from sticking together during the formation of fibrinous adhesions between the abdominal organs. The disadvantage of using this tool is that with the introduction of an oil solution into the abdominal cavity, the formation of oleogranulomas is often observed.

It is known that vinylin (Shostakovsky's balm, polyvinox) is also used as a prophylaxis for adhesion formation, introduced into the abdominal cavity after performing the main stages of abdominal surgery [Vorobyov AA, Beburishvili AG, Ishankulov VI, Ivanov A .I., Sigaev S.M. Experimental modeling of intra-abdominal adhesion and its drug prophylaxis. Macro and micromorphology. / Interuniversity collection of scientific papers. Vol. Number 4. - Saratov: 1999, p.205-208]. This drug has an antiseptic, uncoupling and anti-inflammatory effect. The disadvantage of using vinylin is its relatively low anti-adhesion activity.

The closest analogue to the claimed agent is hyaluronic acid, used to prevent the process of adhesion of the abdominal organs [Kulakov V.I., Adamyan L.V., Mynbaev O.A. Postoperative adhesions. - M .: Medicine, 1998, p.181-182].

Hyaluronic acid is a natural glycosaminoglycan. It has been established that this agent is involved in physiological processes, such as tissue hydration, protein homeostasis, cell growth and differentiation. In a model of adhesion formation on the rabbit uterine horns, a solution of hyaluronic acid helps to reduce adhesions. In this case, an increase in the concentration of a solution of hyaluronic acid increases its anti-adhesion effectiveness. The disadvantage of the closest analogue of the claimed drug is the lack of a complex effect on the main pathogenetic links in the development of the adhesive process, due to which it has a relatively low anti-adhesive activity.

The aim of the invention is to identify new properties of the tool "Curiosin" for use in preventing the formation of postoperative adhesions.

The essence of the invention lies in the fact that for the prevention of postoperative adhesions after the main stage of an operation is completed before the surgical wound is sutured, “Curiosin” is introduced into the abdominal cavity, which reduces the level of postoperative adhesions.

"Curiosin" is 20.5 mg of zinc hyaluronate (10 ml) in a viscous sterile solution. According to the literature, "Curiosin" is used to treat trophic ulcers, wounds of the skin and soft tissues of the face, sluggish and infected skin defects, bedsores, fistulas [Gideon Richter in the CIS. Scientific Information Medical Journal, 2001, No. 2 (6), p.16-32]. In the available literature, we have not found that the Kuriozin agent was previously used to prevent the postoperative adhesive process, although its properties suggest a possible anti-adhesive effect.

Curiosin enhances phagocytosis processes, enhances macrophage activity, improves local circulation and oxygen supply to tissues, affects the proliferation process, has an antimicrobial effect on a number of microorganisms, while reducing the risk of superinfection inhibiting regenerative processes.

Examples

Means "Curiosin" was tested in an experiment on 30 outbred cats. Animals were randomly assigned to the control and experimental groups of 15 animals each. The animals were modeled standard surgical injury [Vorobev A.A., Beburishvili A.G. Surgical anatomy of the operated abdomen and laparoscopic adhesion surgery. - Volgograd: 2001, p. 32-33]. In animals of the control group, adhesion formation prophylaxis was not carried out. The animals of the experimental group after modeling the standard operating injury in the abdominal cavity before its closure was injected with the drug “Curiosin” in a dose of 5 ml.

One month after the application of a standard operating injury, a relaparotomy and revision of the abdominal organs were performed, and a postoperative adhesion process was evaluated.

In the group of animals in which prophylaxis of prophylaxis was not carried out, the following fusions were revealed: omentum with laparotomic scar in 20 cases, omentum with terminal ileum in 9 cases, omentum with defects in the parietal peritoneum in 5 cases, omentum with deserted sections of the cecum in 2 cases. In total, 36 adhesions were formed in the group.

In the group of animals in which adhesion formation was prevented using the Kuriozin agent, the following fusions were revealed: an omentum with a laparotomic scar in 9 cases, an omentum with a terminal ileum in 1 case, an omentum with defects in the parietal peritoneum in 3 cases, an omentum with deserted areas of the cecum in 2 cases. In total, 15 adhesions were formed in the group. It should also be noted that the adhesions in the experimental group were loose, easily separated by a blunt path, were absent in three experiments.

The table shows data on the number of adhesions in experimental animals after prophylaxis with Curiosin and in animals that have not been prevented.

Thus, after the use of the claimed means for the prevention of adhesions in the experiment, the number of formed adhesions decreased by 2.4 times.

Claims (1)

The use of kuriosin as a means for the prevention of postoperative adhesions.