RU2331441C1 - Hyper-gassed and hyper-osmotic antiseptic mixture - Google Patents

Abstract

FIELD: medicine, surgery.

SUBSTANCE: invention can be applied to septic wounds, cavities, and fistulas sanitation. The means comprise aqueous antiseptic solution, including 2.7-3.3% hydrogen peroxide, 0.9-10.0% sodium chloride, and carbon dioxide giving positive pressure 0.2 atm at +8°C.

EFFECT: invention provides safe and effective sanitation conditions, facilitates biological masses elimination, renders expressed geyser-like, dehydrating and antiseptic action.

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Description

The invention relates to medicine, in particular to pharmacy and surgery, and can be used for the repair of purulent wounds, cavities, fistulas.

An antiseptic agent is known, which is a cool aqueous solution containing 2.7-3.3% hydrogen peroxide and 0.05% antifebrin, prepared by diluting perhydrol or a solution of hydrogen peroxide with water (State Pharmacopoeia of the USSR. Xth ed., M .: Medicine, 1968, p. 630-631).

The specified antiseptic agent has low efficiency and safety when washing purulent cavities and fistulas. The fact is that in the presence of 2.7-3.3% hydrogen peroxide in the solution, it decomposes with insufficient formation of molecular oxygen in the form of gas bubbles, so the solution has insufficient carbonation. When the solution is introduced into the cavity, gas bubbles are formed with low intensity and small size; therefore, when they ascend, they do not provide effective mechanical upward movement of viscous and dense biological masses (pus, exudate, blood, bone sequestration) due to insufficient intensity of their flow. In this case, molecular oxygen does not have a sufficient antiseptic effect, so the tool is not able to provide a pronounced anti-infection activity in purulent cavities.

The presence of antifebrin reduces the safety of the solution due to the high toxicity of this aniline derivative. At the same time, the cool state of the product lowers the temperature regime in biological tissues, which also reduces its effectiveness and safety, since hypothermia increases the viscosity of colloidal fluids, complicates their removal, and contributes to infection.

In addition, the disadvantage of the tool is pronounced hypoosmoticity, since the osmotic activity of the specified solution of hydrogen peroxide is about 4 mOsm / l of water, which is significantly lower than the corresponding level of isoosmosis (280-290 mOsm / l of water). Washing purulent cavities and fistulas with such a hypoosmotic solution does not contribute to the anti-inflammatory effect, since the hypoosmotic solution does not eliminate edema, but promotes hydration of tissues, that is, contributes to their swelling. Cells swell under the influence of a hypoosmotic solution, tissues swell. Therefore, the introduction of such a solution leads to aggravation of edema of inflamed tissues, enhances the diffusion of water from the cavity into the tissues, weakens their barrier function by increasing edema of the cells, and creates the prerequisites for the generalization of infection. In addition, the increase in swelling of inflamed tissues that fulfill the walls of the fistula can significantly reduce the lumen of the fistulous canal, which in the narrowest places can completely close due to an increase in the volume of swollen tissues, thereby eliminating the possibility of adequate drainage.

The objective of the invention is to increase efficiency and safety by increasing carbonation and osmosis.

This goal is achieved in that the antiseptic agent containing 3 ± 0.3% hydrogen peroxide and water additionally contains sodium chloride and is carbonated with carbon dioxide in the following ratios of components, wt.%:

Hydrogen peroxide 2.7-3.3 Sodium chloride 2.0-10.0 Carbon dioxide before creation overpressure 0.2 atm at 8 ° C Water Rest.

The use of hydrogen peroxide in a concentration of 3 ± 0.3% provides a rather effective deodorizing effect due to the release of molecular oxygen. The introduction of additional sodium chloride in a concentration range of 2.0-10% allows you to give the solution hyperosmotic properties, since the presence of sodium chloride in the indicated concentration range provides an increase in the osmotic activity of the solution by 560-3110 mOsm / l of water, respectively, which gives the solution dehydrating properties without the threat of necrosis washed tissues. The appearance of a dehydrating activity in a solution gives it an anti-inflammatory effect, helps to reduce the swelling of inflamed tissues and enhances the antiseptic activity of the solution.

Increasing the carbonation of the solution through the use of carbon dioxide gas ensures the safety of the carbonated solution, since carbon dioxide is a biologically inert gas. The introduction of carbon dioxide to create an excess pressure of 0.2 atm (atmospheres) in the solution at 8 ° C allows increasing the potential aeration of the solution (when introduced into the purulent cavity) to the maximum effective values that ensure the realization of a pronounced geyser-like action and do not threaten excessively intense gas formation and do not damage the tissue. Storage and use of a solution with a pressure of 0.2 atm at 8 ° C provides sufficient safety for medical personnel.

When the solution is introduced into the purulent cavity or into the fistulous canal, the agent provides the simultaneous formation of molecular oxygen and carbon dioxide. Since carbon dioxide is released by lowering the pressure in the solution, the process of gas generation occurs with the same intensity regardless of the presence of biological tissues in the cavity, and is also much more intense than the release of molecular oxygen from hydrogen peroxide, which depends on the activity of catalases. Therefore, the introduction of this solution into the cavity or fistula canal is immediately accompanied by intensive formation of carbon dioxide bubbles and highly effective “ejection” of liquid, viscous and dense biological masses from all parts of the cavity. That is, this solution creates better conditions for the mechanical purification of purulent cavities without swelling of cells and tissues, moreover, providing a dehydrating (decongestant) and more pronounced antiseptic effect. Only after mechanical cleansing of the cavity from excess purulent masses, molecular oxygen begins to be released, which under these conditions is rationally used to deodorize and inactivate those biological tissues that could not be removed to the outside. Therefore, this tool improves the treatment of local purulent-inflammatory processes, reduces the likelihood of developing septic complications, reduces the frequency of surgical interventions, and reduces the duration and cost of treatment.

In model conditions, we reproduced the process of sanitizing the fistulous canal with a carbonated antiseptic. As a model of the fistulous canal, 2 glass tubes of 20 ml each were used, which were half filled with serous-purulent contents taken from the pleural cavity of a patient with destructive pneumonia, and placed vertically in a laboratory tripod. Then, the end of a standard subclavian catheter was inserted into the bottom area of each tube. Then, through a catheter, 5 ml of an aqueous solution containing 3% hydrogen peroxide and 0.05% antifebrin was injected into the bottom of the first tube. Through the transparent walls of the tube, it was seen that immediately after the introduction, small (with a diameter of not more than 1 mm) gas bubbles appeared, rising up to the surface of the contents of the tube, where the bubbles burst and disappeared. The process of bubbling up was accompanied by a slight mixing of serous-purulent contents. Moreover, the most “thick” part of the latter did not change its location at the bottom of the tube.

The introduction through the catheter into the bottom of the second tube of 5 ml of an aqueous solution containing 3% hydrogen peroxide, 2% sodium chloride and carbon dioxide to create an overpressure of 0.2 atm led to the foaming of serous-purulent contents with the formation of large gas bubbles with a diameter of up to 4-5 mm and the ejection of almost the entire contents of the tube out together with its thick fragments from the bottom of the tube. After that, only a small amount of diluted serous-purulent contents remained in the test tube at its very bottom. In the remaining content of steel with smaller intensity, small bubbles with a diameter of about 1 mm are formed, which rise up and burst on the surface of the solution. The bubbling up was accompanied by mixing of the diluted contents.

Example. Patient I., 61 years old and weighing 63 kg, admitted to the surgical department with a diagnosis of “Mixed pancreonecrosis with a predominant lesion of the pancreatic tail,” on the day of admission, a laparotomy was performed, which ended with the formation of omentopancreatobursostomy, which opens on the front wall of the abdomen, and then into complex therapy daily sanitation of the formed fistulous canal with a standard solution of 3% hydrogen peroxide in the dressing room was included. For this, the patient was injected 100 ml of a standard solution of 3% room temperature hydrogen peroxide at a temperature of 100 ml into the depth of the fistula channel daily for 3 days in a row using a catheter. However, despite the treatment, the signs of intoxication remained at the same level. An ultrasound scan revealed a cavity with a diameter of about 2.5 cm with heterogeneous contents in the region of the tail of the gland. In addition, an ultrasound examination revealed the presence between the head and the tail of the gland, the presence of an additional narrow fistulous channel connecting the formed omentopancreatobursostomy with the specified cavity located in the region of the tail of the gland. In this regard, the tool was canceled. From the next day, into the caudal pancreas, using a catheter connected to a syringe, 100 ml of a room temperature solution at 8 ° C containing 3% hydrogen peroxide, 10% sodium chloride and carbon dioxide was introduced under ultrasound control to create excess pressure 0.2 atm. At the first use of this solution in the washings, the remains of the crushed pancreatic sequestration were found. The next day, the symptoms of intoxication began to decrease, in particular, the patient's body temperature in the evening decreased from 39 to 37.5 ° C. The specified solution was used for sanitation every day for 3 days in a row. On the 3rd day, the pain syndrome completely disappeared, the body temperature returned to normal, the functional and laboratory health indicators returned to normal, on the 9th day the fistula closed. The patient was discharged in satisfactory condition, avoiding surgical treatment.

Claims (1)

An antiseptic agent containing 3 ± 0.3% hydrogen peroxide and water, characterized in that it additionally contains sodium chloride and is carbonated with carbon dioxide in the following ratios of components, wt.%: Hydrogen peroxide 2.7 - 3.3 Sodium chloride 2.0-10.0 Carbon dioxide to create an overpressure of 0.2 atm at + 8 ° C Water  rest