RU2351320C2 - Method of preventing development of wound infection in animals - Google Patents

Abstract

FIELD: veterinary.

SUBSTANCE: invention relates to field of veterinary surgery. Method includes application of photocatalitic air purifier-decontaminator "Aerolife" and composite preparation, consisting of following components wt %: placenta active essence - 49.0; gentamicin sulphate 4% - 0.1; sodium chloride solution 0.9 - the remaining part.

EFFECT: method allows to increase efficiency of wound surface sanitisation and activate regenerative processes in wound.

2 tbl, 1 ex

Description

The invention relates to veterinary surgery, for the prevention of the development of wound infections in animals.

The main objective of the surgical intervention is the radical rehabilitation of the wound, reducing the microbial contamination of the tissue and dissemination of the infectious agent / 1, 2 /. However, this is often impossible because of the risk of obtaining an excessive increase in the wound defect and damage to the most important anatomical structures (main vessels and nerves, tendons, joint bags, serous membranes of the cavities).

At the present stage of the development of surgery, there is a tendency to increase the frequency of purulent-inflammatory processes that complicate the treatment of the postoperative period in surgical patients / 3 /, the reason for this is pathogenic microorganisms (staphylococci, streptococci, Escherichia coli and Pseudomonas aeruginosa, etc.), which have a negative the effect, especially with mild general non-specific resistance in animals against the background of impaired vitamin-mineral metabolism in the autumn-winter-spring period. To prevent the development of wound infection, antibiotics are most often used, in the form of solutions for irrigation of wounds and wetting of drains / 4 /.

The increase in the number of patients with acute purulent diseases of the soft tissues is associated with a decrease in the effectiveness of antibiotic therapy, a change in the nature of microflora, an increase in its antibiotic resistance as a result of wide unsystematic use of antimicrobial agents and the administration of too small doses, as well as with a change in the immunobiological resistance of the body / 4 /; the practically unfulfilled desire to devastate poorly studied populations, the periodic release of niches through poorly substantiated disinfection measures, and other direct or indirect human actions that perform a selective role, provide abnormal outbreaks of the number of various pathogenic and conditionally pathogenic microorganisms.

On the other hand, the concentration of a large number of animals in limited areas, their year-round stay in enclosed areas with easel or cage content, the use of industrial feeds and other processes began to cause animals to weaken their health and constitution, deep metabolic disorders, decreased productivity, the emergence of new diseases / 5 /.

Air is a natural aerosol. More than 60 types of pathogenic microorganisms can exist in the air of medical facilities, including pathogens of the most dangerous diseases - tuberculosis, influenza, fever, meningitis, etc. In case of violation of sanitary standards (insufficient ventilation, solar insolation, poor-quality disinfection), molds, fungi, etc. can develop in the premises, thus stable colonies are artificially created, which are constantly in contact with animals and humans, which leads to repeated or chronic contamination. The vast majority of microorganisms are in a dusty environment and tend to accumulate in it (in this case, the pathogen is in an organic substrate, the amount of which is much larger in comparison with the mass of the microbe, which makes it difficult to disinfect with chemicals), and disperse in hard-to-reach places, are moved by air currents, creating potential foci of infection.

Many methods for neutralizing and disinfecting air in treatment rooms to prevent the development of wound infections, such as the use of carbon filters, aerosols, quartz lamps and laser radiation, have significant drawbacks, for example, in the first case, microorganisms are not deactivated and not all toxic substances are disinfected, household air purifiers using this technology have high operating costs, and with an untimely change of filters, the air purifier itself becomes the source of Ikom harmful substances.

In the second case, harmful substances are not detoxified, in the third - not high antibacterial effectiveness, lack of detoxification and harmful effects on humans and animals (nitrogen oxides, ozone, etc. are generated) / 6, 7, 8 /.

Currently, one of the main problems of surgery is the prevention of purulent-inflammatory diseases in animals.

The main tasks that should be addressed in the prevention of wound infection are: the fight against aerobic and anaerobic infections; nonspecific stimulating therapy and detoxification of the patient's body; restoration of the function of a damaged organ or tissue.

The solution to these problems is possible only with a combination of physical and conservative methods of prevention.

Known photocatalytic method for the prevention of animal diseases using the device "Aerolife" / 9, 10 /.

When injuring animals, there is a violation of the integrity of the skin and underlying tissues, and due to contamination, pathogenic microorganisms located on the traumatic object (nail, glass, wood chips, etc.) or on the surface of the skin, wool or litter get into the wound defect. The wound is filled with capillary (venous, arterial) blood, lymph, and after a certain time, the fibrinogen contained in the blood (a protein that ensures blood coagulation) forms a blood clot - a biological plug that prevents the wound from contacting the environment, thus, due to the scab, air (and those contained in bacteria, viruses, fungi, etc.) in the wound ceases, however, the scab itself already contains microorganisms that have fallen into the wound, for which in this case optimal conditions for life are created.

Thus, the use of only a photocatalytic air disinfectant purifier in the prevention of the development of wound infection does not ensure the effective destruction of microorganisms in the wound, and the effect of preventing the development of wound infection in animals is not achieved.

Local reactions to trauma in almost all cases are due to the interaction of two damaging factors: the presence of a lesion of tissue destruction and a microbial pathogen. The local effect of the injury itself is manifested primarily in direct damage to the injured area of cells, blood vessels and nerves, as a result of which microcirculation is disrupted, chemical mediators are released, and the metabolism and cellular composition of the wound change. In any wound, there are dying tissues, hemorrhages and lymphorrhages.

The wound healing process begins from the moment the bleeding stops. In the first phase of healing, the most pronounced bio-physico-colloid-chemical changes occur. They are characterized by an increase in potassium content and a rapidly increasing level of acidity in the wound environment; this reaction often becomes stable and causes de-compensated acidosis at the site of injury.

Increased acidity in the wound occurs quite quickly due to trauma to blood stasis vessels, local asphyxiation of CO 3 accumulation, decreased oxygen supply and changes in tissue metabolism. Incomplete oxidation of the breakdown products of tissue protein and fats in the wound canal and traumatic necrosis leads to the formation of organic acids - lactic, butyric, nucleic, paraaminobenzoic, adenylphosphoric amino acids, various fatty acids, carbon dioxide, etc.

The more acids accumulate in the inflammatory focus, and the less the body is able to free itself from them, the sooner and stronger the shift of the active reaction of the medium to the acid side occurs. The disturbance of acid-base balance is so permanent that tissue buffer systems are not able to alkalize the wound medium, resulting in local decompensated acidosis. The increased concentration of hydrogen ions, causing the development of acidosis, has a huge impact on the vital functions of cells.

The acidic reaction of the wound environment entails an increase in the permeability of the vascular walls, swelling of tissue colloids, an increase in surface tension and an increase in osmotic pressure, it contributes to the development of hyperemia, causes a sharp violation of tissue metabolism, a change in the activity of enzymatic processes, the development of degenerative changes, necrosis of cells and tissues and poisoning of the body with poisonous tissue protein breakdown products.

Inhibition of immunological reactions of the body is also observed, the sum of all the above factors leads to the development of a chronic pathological process, because the use of only a photocatalytic air purifier-disinfectant in the prevention of wound infection does not provide an early cleaning effect, and the effect of preventing the development of wound infection in animals is not achieved.

The technical result of the invention is to increase the efficiency of sanitation of the wound surface and the activation of regenerative processes in the wound.

This goal is achieved by the use of the Aerolife photocatalytic air purifier-disinfectant and a composite agent containing the active principle placenta preparation, 4% gentamicin sulfate and 0.9% sodium chloride solution, in the following ratio, wt.%:

Placenta active principle - 49.9

Gentamicin sulfate 4% - 0.1

0.9% Sodium Chloride Solution - Rest

The drug PAN contains a complex of biologically active substances:

amino acids, nucleic and hexuronic acids, proteins - peptides, nitrogen, polysaccharides, vitamins, trace elements, hormones. It is known that many of these substances are actively involved in the construction of the main substance of connective tissue. It was established that after the use of the PAN preparation, general stimulation of the body occurs due to the presence of the natural components of the placenta in the preparation. The anti-inflammatory effect of the drug is determined by the presence of uronic acids in it, and the general strengthening effect due to stimulation of the enzyme system and metabolism in the body / 11 /.

To eliminate the negative impact of surgical infections on the wound, the aminoglycoside antibiotic gentamicin sulfate was added to the PAN preparation. The main advantage of gentamicin over other similar antibiotics is its high activity against most G + and G-microorganisms. In addition, the resistance of microorganisms to gentamicin develops relatively slowly. Aminoglycosides are not metabolized in the body and only slightly bind to serum proteins, therefore, they cannot contribute to the development of an allergic reaction of an immediate type, and even more so, of a delayed one / 3 /. The placenta active principle and gentamicin sulfate are diluted in 0.9% sodium chloride solution.

Air is a natural aerosol. More than 60 types of pathogenic microorganisms can exist in the air of medical facilities, including pathogens of the most dangerous diseases - tuberculosis, influenza, fever, meningitis, etc. The vast majority of microorganisms are in a dusty environment and tend to accumulate in it (in this case, the pathogen is in an organic substrate, the amount of which is much larger in comparison with the mass of the microbe, which makes it difficult to disinfect with chemicals), and disperse in hard-to-reach places, are moved by air currents, creating potential foci of infection. In case of violation of sanitary standards (insufficient ventilation, solar insolation, poor-quality disinfection), molds, fungi, etc. can develop in the premises, thus stable colonies are artificially created, which are constantly in contact with animals and humans, which leads to repeated or chronic contamination (seeding, infection), therefore, on a wound defect, and the above remedy will constantly precipitate microorganisms that may not be sensitive to the antibiotic gentamicin sul Fat, so the effect of preventing the development of wound infection in animals will not be achieved.

With the combined use of a photocatalytic cleaner-disinfectant and a composite agent, on the one hand, highly effective utilization of formaldehyde, carbon monoxide, ozone, nitrogen oxides, bacteria, viruses and fungal spores from the air occurs, and on the other hand, the composite preparation will facilitate the fastest sterilizing, regenerative process and improving trophism of the pathological focus.

Thus, the combined use of these two agents helps to accelerate the cleansing of wounds from dead tissues, stop the necrotization of healthy tissues, alkalize the wound zone (as a result of which the inflammatory reaction normalizes and phagocytosis is activated), it will prevent the accumulation of tissue decomposition products and microorganism metabolism in the wound, and photocatalysis will ensure lack of undesirable chemical compounds in the air (formaldehyde, oxides, phenols, etc.), which are irritating to at the wound, thereby reducing the local resistance, photocatalysis prevents re-microbial wound assimilation.

The method is implemented as follows: a wound toilet is carried out, a composite agent is placed in the wound 2-3 times a day (depending on the condition and complexity of the wound). The animal is placed in a closed enclosure (room), in which there is a photocatalytic cleaner-disinfector. Indicated feeding.

Example.

In order to determine the effectiveness of the claimed method in the conditions of the Department of Surgery of the Voronezh State Agrarian University. KD Glinka on 9 outbred dogs of both sexes, selected according to the principle of paired analogues at the age of 4-5 years, grouped into 3 experimental groups, incised wounds of the same size and shape were modeled.

Experimental wounds were inflicted in the lumbar region, departing from the spinous processes of the lumbar vertebrae by 1.5-2 cm to the right.

Before applying the wound, the surgical field was prepared according to the Pirogov method: the hair was cut off, the skin was shaved, degreased with alcohol-ether, and lubricated with a 5% alcohol solution of iodine for disinfection while tanning. Hands were prepared according to the method of Kiyashev. The operation was performed after premedication under general anesthesia performed with xylosin in a dose of 1 ml per 10 kg of animal body weight. A simultaneous horizontal linear incision was made of the skin, subcutaneous tissue, superficial two-leaf fascia, subcutaneous muscle enclosed in a deep two-leaf fascia, the longest muscle of the back and lower back 5 cm long and 1.5 cm deep according to the template. Bleeding was stopped mechanically using sterile cotton-gauze swabs.

The first group was used photocatalytic cleaner-disinfectant / 9, 10 /, the second group of animals was processed by the claimed method. The drugs were used after the application of experimental wounds. The development of wound infection was prevented only by one of the methods described above. Dogs did not receive other medical care.

The results of the clinical examination are presented in table No. 1.

Table number 1 Changing the clinical signs of the course of the wound process when using various methods of prevention Clinical signs Control n = 4 Experienced n = 5 Edema +++ + Hyperemia of the skin ++ + Necrolysis +++ + Fibrinolysis +++ + Decreased discharge to lean + +++ pH of the wound after 3 hours 6.8 6.9

Table number 2 The influence of various methods of preventing the development of wound infection on the further healing of wounds Wound healing processes Control n = 4 Experienced n = 5 The appearance of granulations 2.8 ± 0.5 1.6 ± 0.2 Filling granulation of the entire wound 8.0 ± 0.6 * 5.0 ± 0.3 * Beginning of marginal epithelization 7.1 ± 0.3 * 5.8 ± 0.4 * Complete wound epithelization 23.2 ± 0.4 * 16.1 ± 0.4 * Relief of soreness 6.1 ± 0.3 * 4.1 ± 0.25 * Normalization of body temperature 11.4 ± 0.4 * 6.4 ± 0.4 * * - P <0.05 - the difference is statistically significant

When analyzing the data presented in the tables, it is clear that the development of inflammatory phenomena (table 1) and wound healing (table 2) occurs more actively in the experimental group where the claimed method was used.

Comparison of the studied clinical signs showed that in the experimental group statistically significant compared with the control group normalization of body temperature, stopping of edema and hyperemia of the skin in the wound area, the disappearance of fibrin, a decrease in the amount of discharge from the wound from profuse to scanty. Pretty quickly changing his character for the better. There is a fairly rapid complete filling of the wound with high-quality granulation tissue, the disappearance of soreness during dressings.

Thus, the clinical data presented in tables 1 and 2 show that the subsidence of inflammatory phenomena occurs more actively in the experimental group to which the claimed method was applied.

The conducted studies convincingly prove that when applying the proposed method in operating and procedural boxes for the effective treatment of surgical diseases, it leads to pronounced sterilizing activity against any aerogenic microflora, all odors were removed, thus ensuring the necessary hygiene and sterility of the premises.

The inventive method of preventing the development of wound infection during use does not cause complications and has no contraindications.

Information sources

1. Struchkov V.I., Gostishchev V.K., Struchkov Yu.V. Surgical infection // Guide for doctors. - 2nd ed., Prererab. and add. - M.: Medicine, 1991 .-- 450 p.

2. Svetukhin A.M. The evolution of the method of surgical treatment of wounds for 20 years (1973 - 1993) // International. conf. "Wounds and wound infection." - M., 1993. - P.40-44.

3. Struchkov V.I. Errors, complications and issues of the rational use of antibiotics in surgery / V.I. Struchkov, V.K.Gostishchev // Bulletin of Surgery. I.I. Grekova. - 1973. - No. 9. - C.3-8.

4. Kurbangaliev S.M. Purulent infection in surgery. - M.: Medicine, 1985 .-- 272 p.

5. Shakhov A.G. Ecological problems of animal health and ways to solve them / A.G. Shakhov, M.N. Argunov, B.C. Buzlama. // Veterinary medicine. - 2003. - No. 5. - C.3-6.

6. Akatov V.A. Ultrasound and its use in veterinary medicine / V.A. Akatov. - M .: Kolos, 1970.

7. Aerosols for disinfection of livestock buildings. Guidelines. Makhachkala. 1983.

8. Mikhailov N.V. The mechanism of the treatment-stimulating effect of the laser beam on the animal organism and increase their productivity. / N.V. Mikhailov. - Kazan, 1985.

9. RU 8634 U1, 06/30/98.

10. Methodological recommendations on the use of the Aerolife photocatalytic air purifier-disinfectant for the prevention of animal diseases / Ed. ed. prof. M.N. Argunova. - Voronezh, 2004 .-- 11 p.

11. Mashkovsky M.D. Medicines - 12th ed., Revised. and add. - M .: Medicine, 1993.

Claims (1)

A method for preventing the development of wound infection in animals, including the use of the Aerolife photocatalytic air purifier-disinfectant, characterized in that it additionally uses a composite agent consisting of the following components, wt.%:
placenta active principle 49.9 gentamicin sulfate 4% 0.1 0.9% sodium chloride solution rest