RU2228763C1 - Method for treating the cases of purulent wounds - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves carrying out wound pretreatment with antiseptic preparations and introducing Superlymph preparation next to it. Thymogen is administered concurrently with the Superlymph into the wound. The preparations are taken in known proportion of 1:10 once a day at the first, the second, the third, the seventh, the fourteenth and the twenty first day by making a series of injection around the internal surface of wound at a dose of 0.1 ml per 1 sq.cm of the wound. EFFECT: enhanced effectiveness of treatment.

Description

The invention relates to medicine and can be used in purulent surgery, in traumatology.

In medical practice, it is known to use a wide class of antiseptic agents for the treatment of purulent wounds, for example, such as chloramine B, iodoform, iodinol iodopyron, a solution of hydrogen peroxide, crimeal, various detergents, etc. (M.D. Mashkovsky. Medicines M, 2001. )

Known methods of treating purulent wounds by washing them with solutions of various antiseptics (US Pat. RF 2068263) and antibiotics (US Pat. RF 2008917).

A known method of treating purulent wounds by surgical treatment of the wound surface and application of powder pepsin to areas with necrotic tissue. (US Pat. RF 2131255). In addition, a dressing is applied to the wound with an electrochemically activated EChAR analyte solution obtained by activation of a 0.3% potassium chloride solution on a standard ECHAR-30 apparatus.

A known method of treating infected wounds, which consists in the surgical and mechanical treatment of wounds, drainage and washing, conducting reconstructive surgery, local drug therapy (US Pat. RF 2128518). In this case, washing is carried out once with an aqueous solution of pilastine-cholerogen-toxoid for 3-5 days, and local drug therapy is carried out by applying dressings to the wound with an aqueous solution of pylastine of the same concentration for 24-48 hours for 5-8 days.

A known method of treating infected wounds by external use of drugs containing proteolytic enzymes (US Pat. RF 2036658). Moreover, at the stage of development of the wound process in the hydration phase, treatment is carried out with a proteolytic complex of pancreatic organs of aquatic organisms with an activity of 0.1-0.5 PE in 1 mg of the drug in a dose of 4-6 mg per 1 cm ^{2 of the} wound surface, and at the dehydration stage, treatment carried out by the preparation of low molecular weight DNA with a DNA content of 45-86% in pure form.

A known method of treating purulent wounds by applying silver preparations to it (US Pat. RF 2063232), a trypsin proteolytic enzyme immobilized on a highly porous polyurethane foam composition (US Pat. RF 2026686).

A known method of treating purulent wounds by surgical treatment and subsequent application of a dressing with drugs (US Pat. RF 2185781). In the first phase of the wound process, before and after surgery, a multilayer dressing is applied to the wound surface, the first layer of which is impregnated with a proteolytic enzyme dissolved in a 30% aqueous solution of urea, the second layer is a multicomponent ointment on a water-soluble basis, which has antibacterial and dehydration properties, the third layer they are hydrophobized with naphthalan ointment, and in the second phase, free skin grafting is performed or secondary sutures are applied with irrigation drainage of the residual cavity.

A common drawback of all these methods is the low efficiency of treatment of soft-bone wounds, the duration of wound healing, the need for surgical intervention.

A known method of treating bone-soft tissue wounds in patients with chronic osteomyelitis, including the introduction of antibacterial and desensitizing agents, vitamins, anabols. In this case, before and after the operation, Xymedon is administered at 0.5 g 4 times a day for 20 days, then the course of treatment with the drug is carried out after 6 months for 1.5 years (US Pat. RF 2073514). The disadvantage of this method is the use of antibiotics, the need for preoperative treatment, multiple daily use of drugs.

The known drug superlymph, which is a natural heterologous complex of natural cytokines, obtained from cultures of stimulated peripheral blood leukocytes. Cytokines are low molecular weight mediators of intercellular interactions with high biological activity. Superlimph is a complex of natural cytokines (Kovalchuk L.V., Gankovskaya L.V. J. Immunology, 1995, No. 1, pp. 4-7).

Superlimf can be used to treat cancer patients (US Pat. RF 2149643). By means of a superlymph (cytokines), the nature, depth and duration of inflammation and the immune response in case of inflammation of the eye tissue are regulated (US Pat. RF 2180853).

A known method of immunotherapy of acute lung abscesses by introducing into the cavity of the drug superlymph, which is administered daily in an amount of 100 μg in a solution of 0.5% methylcellulose for 7-10 days (US Pat. RF 2170583).

The closest way to the claimed method is a method of treating purulent wounds, including pre-treatment of the wound with an antiseptic followed by the introduction of Superlimph into the wound (L. Kovalchuk et al. Bulletin of Experimental Biological Medicine, 1997, No. 6, pp. 680-683). The disadvantage of this method of treatment is the need to remove necrotic tissue. Superlymph affects the cytokine system of the body, excluding the effect on other parts of the immune system.

Superlimph - lyophilized powder for topical application (FSP 42-0185-0573-00) - has antioxidant activity, reduces the development of inflammatory reactions, stimulates regeneration, prevents the formation of rough scars, has a direct antiviral and antibacterial effect. Designed to treat purulent wounds, apply 0.5-1 ml (0.05 = 0.1 mg) per wound. The drug is applied daily 1-2 times a day to a pre-treated wound for 5-10 days (instructions for the use of superlymph, approved by the State Sanitary Doctor of the Russian Federation, 2000).

The purpose of this invention is to reduce the healing time of infected bone-soft tissue wounds, reducing the dose of drugs used.

This goal is achieved through the use of a method for the treatment of purulent wounds, including pre-treatment of the wound with an antiseptic, followed by the introduction of Superlimf into the wound. Additionally, thymogen, taken in a volume ratio of 1:10, is injected into the wound with superlymph, once in the first, second, third, seventh, fourteenth and twenty-first days by chipping the inner surface of the wound with preparations at the rate of 0.1 ml of solution per 1 cm ^{2 of the} wound .

Timogen is a synthetically prepared dipeptide consisting of amino acid residues glutamine and tryptophan. The drug has an immunostimulating effect and enhances the nonspecific resistance of the body. It is used in complex therapy for acute and chronic diseases, accompanied by a decrease in cellular immunity. Release form - 0.01% solution in bottles, lyophilized powder of 0.0001 g in glass bottles (M.D. Mashkovsky. Medicines, M, 2001, p. 193).

It is known to use thymogen as an active compound in skin care compositions (US Pat. RF 2008894) in the treatment of dermatitis in children by administering the drug intranasally 4 times a day at a dose of 20-100 μg / day (US Pat. RF 2068696).

It is known to use thymogen as an immunostimulant in compositions for treating diseases caused by a microbial infection by external use (US Pat. RF 2116790). In the absence of thymogen, the composition is effective, but does not have a prolonged effect, an overestimation of its amount can lead to increased efficiency and can lead to undesirable side effects.

The simultaneous administration of a superlymph with thymogen provides an effect on different parts of the immune system, which leads to the restoration of normal metabolism of soft tissues, promotes faster resorption of decay products and enhances the functional activity of growth factors, which leads to faster self-healing of the wound, control of the wound process and accelerate its healing .

Timogen and superlymph are neutral with respect to each other and dissolve well in each other.

As a result of experimental studies, it was found that the simultaneous administration of superlymph with thymogen does not cause toxic reactions, and also does not have an allergenic, locally irritating and carcinogenic effect.

As a result of using the proposed method of treatment, the body's resistance to damaging effects increases. Thus, in the model of experimental infected wounds in rabbits, topical application of a super lymph with thymogen accelerated complete wound healing. The activation of regeneration processes, the improvement of trophism and metabolic processes in the skin when using the claimed method is also due to the stimulating effect of thymogen with super lymph on immunity indices. External use of these agents helps to increase the number of lymphocytes, increase the functional activity of peripheral blood mononuclear cells and cellular indicators of local immunity compared to the control.

An example implementation of the proposed method (clinical trials)

Patient P., 26 years old, medical history No. 4585, was admitted to the 12th department of purulent bone pathology of Moscow City Clinical Hospital No. 59 with complaints of the presence of fistulous passage along the anterior surface of the left lower leg with a moderate compartment. According to the patient, it is known that 10.06.2000. when falling, she received a closed fracture of the bones of the left tibia at the border of the middle and lower third. In the 3rd hospital of the city of Zelenograd 06/29/2000. osteosynthesis of the left tibia was performed by a plate. The postoperative period was complicated by suppuration. In the same hospital 10/26/2000. the plate was removed and the Ilizarov apparatus was laid on, which was dismantled on 01/26/01. However, the fracture did not heal and fistula remained on the front surface of the left tibia in its middle third. The patient was sent to the department on 5.06.01. On the X-ray of the left lower leg upon admission to the hospital, a rarefaction band is traced, against which the areas of the increased bone cavity (sequestra) are determined.

After appropriate preparation on 06/18/01. she underwent surgery: sequestrnecrectomy, fragments are compared and fixed with a spoke. In the postoperative period, the patient showed a divergence of the edges of the wound. Initially, the wound was pretreated with antiseptic solutions. Immunotherapy was carried out using a complex of preparations Superlimf and thymogen taken at a ratio of 1:10, which was injected once a day into the wound by injection by chipping from the inside of the wound surface at the rate of 0.1 ml of solution per 1 cm ^{2 of the} wound. The complex of preparations was prepared as follows: thymogen solution (10 μg) was drawn into a syringe and injected into a vial with Superlimph preparation (dose 100 μg). The complex in the ampoule was thoroughly mixed and the resulting solution was filled into a syringe. After chipping, an aseptic dressing was applied. Similarly, the procedure was performed on the 2nd day, 3rd day, 7th day, 14th day, and 21st day. The sutures were removed, the wound healed.

Claims (1)

A method of treating purulent wounds, including pre-treatment of the wound with an antiseptic followed by the introduction of Superlimph into the wound, characterized in that a superlimph with thymogen taken in a volume ratio of 1:10, once in the first, second, third, seventh, fourteenth and the twenty first day by chipping the inner surface of the wound with drugs at the rate of 0.1 ml of solution per 1 cm ^{2 of the} wound.