RU2384338C2 - Composition for healing septic wounds and trophic ulcers - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention presents a composition for local healing of septic wounds and trophic ulcers, including application of the medicines appropriate to the sensitivity of microorganisms in a wound, differing that it contains an antiseptic, high-purity beet pectin and water with all of components taken in a certain mass ratio.

EFFECT: invention provides intensification of antiseptic properties that is ensured by application of high-purity beet pectin which provides cleaning of a wound or a trophic ulcer in a relatively short time owing to bactericidal action; beet pectin provides accelerated regeneration of wound surface; the offered composition is absolutely nontoxic that eliminates the collateral action, besides introduction of pectin reduces a dosage of the antiseptic, and as a whole accelerates medical and social rehabilitation of the patient.

1 ex, 1 tbl, 6 dwg

Description

The present invention relates to medicine and pharmacology, and can be used in the treatment of purulent wounds and trophic ulcers.

As you know, [Kuzin M.I. Wounds and wound infections. - M., 1990. - P.223-297; Surgical Infections: A Guide / Ed. I.A. Eryukhina, B.R. Gelfand, S.A. Shlyapnikov. - SPb., 2003] for each phase of the wound healing process, the corresponding drug is used. So, in the first (exudative phase), drugs are used whose action is aimed not only at suppressing infection in the wound, but also to enhance the outflow of wound exudate. In the second phase of the wound healing process, drugs are used that protect and stimulate granulation and promote epithelization. However, the existing numerous known methods of treating purulent wounds and trophic ulcers often do not give satisfactory results. One of the reasons for the low therapeutic effect is the underestimation of the significant overall inhibition of tissue regeneration in the area of tissue defect. Therefore, recently, researchers have focused on studying the mechanism of action of bioregulators of recovery processes.

A known tool for the treatment of purulent wounds in the first phase of the wound healing process - ointments on a water-soluble basis (Levosin, Levomekol) [Datsenko V.M., Tamm T.I. The study of multicomponent ointments on a water-soluble basis with dioxidine // Klin. hir., 1981, No. 1, pp. 43-45], contributing to the formation of rough scars, often with long-lasting autoimmune processes. In addition, the terms of cleansing wounds from pus and necrosis, as well as the processes of granulation and epithelization of wounds are long.

For the closest analogue, the well-known drug - Xymedon [RF patent No. 2063752 "A tool for the treatment of senile, diabetic and radiation long-healing wounds"] is taken. " Xymedon is a pyrimidine derivative, has low toxicity, rarely causes side effects, improves microcirculation in tissues. Xymedon is an odorless, crystalline white powder with a bitter taste with a melting point of 139-143 ° C, soluble in water, 95% alcohol, chloroform, diluted hydrochloric acid, sodium hydroxide solution and isotonic sodium chloride solution. Xymedon is used as a means to accelerate wound healing regardless of genesis and location: with extensive wound surfaces, with trophic ulcers, anal fissures, etc., in the form of a 5-10% ointment on a lanolin-vaseline base, suppositories, 5 -10% talcum powder, 5-10% aqueous solution.

Disadvantages:

- has some toxicity;

- the terms of cleansing wounds from pus and necrosis, as well as the processes of granulation and epithelialization of wounds are quite long;

- in patients with diabetes mellitus, glucose tolerance should be more often determined;

- use is contraindicated in acute and chronic forms of leukemia, erythremia.

Tasks:

1) reduce the healing time of wounds and ulcers;

2) to develop a tool for the treatment of wounds and ulcers is absolutely non-toxic and has no restrictions on the use;

3) reduce the dosage of antiseptics due to the prolonged action of pectin;

4) to provide the possibility of using the drug at different stages of the treatment of wounds and ulcers.

Pectin has attracted the attention of doctors since its discovery. The study of its useful properties and implementation in medical practice is carried out constantly, and as information on the nature of pectin and its properties accumulates, the scope of pectin use in medicine expands, and this process is far from complete.

Despite the successful use of pectin in various fields of medicine, it must be recognized that the capabilities of this substance have not been fully studied, and pectin continues to be a drug promising for new aspects of use.

The essence of the invention is that the following components are included in the composition for the treatment of purulent wounds and trophic ulcers, in%:

antiseptic 0.05 highly purified beet pectin 17-20 the rest is water 82.95-79.95

The technical result of the invention is to enhance the properties of an antiseptic due to the presence of beet highly purified pectin, which provides a shorter time for cleaning a wound or trophic ulcer due to bactericidal action. In addition, beet pectin helps to accelerate the regeneration of the wound surface. The proposed composition is absolutely non-toxic, which eliminates the side effect. The introduction of pectin reduces the dosage of an antiseptic, thereby reducing economic costs, and in general - accelerates the medical and social rehabilitation of the patient.

The method is as follows. Dry beet pulp is subjected to washing-swelling with water at a temperature of 30-60 ° C for 20-30 minutes. Prepared raw materials are subjected to hydrolysis-extraction at a temperature of 74-75 ° C for 2 hours at a ratio of raw materials and a solution of hydrochloric acid with a concentration of 1.3-1.5%, respectively 1:15.

At the end of the hydrolysis-extraction, the hydrolysis mixture is separated by one of the known methods: pressing, centrifuging, on a stacker, etc., with the isolation of pectin extract. The extract is purified from raw material particles by known methods: filtration, separation, sedimentation, etc. Pectin extract with a pH of 0.7-0.8 and a temperature of 40-50 ° C is treated with a KU-2-8 hC cation exchange resin in an H ⁺ form at a rate 6-8 cm ³ / min. H ⁺ - kationirovanny pectin extract EDE treated with anion exchange resin in the OH-10P ^- - form. Pectin isolated from extracts treated with ion exchange resins has a purity of 70-72%. To ensure the possibility of use in medicine, alcohol purification of dry pectin powder is performed, which allows to obtain pectin with a purity of 75-77% and a complexing ability of 500-600 mg Pb ²⁺ / g. The obtained beet pectin, highly purified and finely ground, is dissolved in an aqueous solution of an antiseptic at a temperature of 20-30 ° C and mixed until smooth for 20-30 minutes.

The proposed composition is used:

- 1-1.5% solution for washing the wound;

- 17-20% gel - for the treatment of wounds; as the main healing agent for the entire period of treatment of the wound by repeatedly applying to the surface of the wound.

The solution or gel is prepared as follows.

A portion of highly purified and finely ground beet pectin in an amount of 1 ... 20 g is mixed with 100 ml of a solution of furatsilin (chlorhexidine) with a temperature of 20 ... 30 ° C and stirred until smooth for 20 ... 30 minutes. The finished gel is pasteurized to release random microflora by keeping it in a low-boiling water bath for 20 minutes and is recommended to be used later for washing wounds or for treating wounds with a gel. The prepared pectin solution is a cloudy, grayish-white liquid of varying degrees of viscosity (depending on the concentration of the solution). When stored for more than a day, an amorphous precipitate forms, which easily passes into the solution with agitation. Provided that it is kept in the refrigerator at a temperature of 5 ... 7 ° C, the pectin solution retains its properties for a long time (3 ... 4 months).

Comparative analysis table of the results of using various pectins and an antiseptic in the treatment of purulent wounds and trophic ulcers Name of funds Pathogens of purulent-inflammatory diseases (clinical strains of microorganisms) E.coli P.aeruginosa E.faecalis P.vulgaris Apple pectin 1-20% in distill. water solid growth solid growth solid growth solid growth Beet pectin 1-20% in distill. water moderate growth moderate growth moderate growth moderate growth Beet pectin 1-20% in a solution of an antiseptic (chlorhexidine) no growth no growth no growth no growth

The choice of chlorhexidine antiseptic is due to the fact that in the study of clinical strains of microorganisms [Khvorik D.F. Characterization of the microbial flora in patients with urethritis / Honey. panorama, - 2003. - No. 5. - S.30-32] noted their high sensitivity to chlorhexidine bigluconate (97.9%). Chlorhexidine-bigluconate showed high activity in the prevention of infections in neurosurgical patients [Le TA, Dibley MJ, Vo VN, Archibald L, Jarvis WR, Sohn AH. Reduction in surgical site infections in neurosurgical patients associated with a bedside hand hygiene program in Vietnam // Infect Control Hosp Edemiol. 2007, May; 8 (5): 583-8. Epub 2007 Apr], in the prevention of nosocomial infection [Segers P, Speekenbrink RG, Ubbink DT, van Ogtrop ML, de Mol BA. Prevention of nosocomial infection in cardiac surgery by decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate: a randomized controlled trial // JAMA. 2006 Nov 22; 296 (20): 2460-6].

Clinical example. Patient G., 81 years old, diagnosis: post-thrombophophlebitis syndrome, CVI VI art. according to CEAR, trophic ulcer of the left leg. From the anamnesis: the patient suffers from CVI for 20 years. A trophic ulcer in a patient appeared about 2 years ago. For a long time was treated on an outpatient basis. He entered the hospital for inpatient treatment. To treat a trophic ulcer (Photo 1 - the type of trophic ulcer of the left tibia before treatment), 20% pectin gel was used (Photo 2 - a napkin on the ulcer soaked in 20% pectin gel). On the 2nd day from the start of treatment, marked cleansing of the trophic ulcer was noted, consisting in cleansing the ulcer from the edges and the appearance of granulations (Photo 3).

The results of cytological studies. Prior to the start of local treatment of chronic lower leg ulcers with 20% pectin gel, smears obtained from its surface and stained according to Romanovsky-Giemsa (Microphoto 1 and 2 — cytological picture before treatment) revealed the presence of numerous neutrophilic granulocytes in the discharge, of which there were clear signs of degeneration, single lymphocytes with nuclei containing compact, coarsely dispersed chromatin, fibroblast-like cells and a moderate number of filaments and clots of fibrin. The described picture corresponds to an active ulcerative process with elements of purulent inflammation.

A day later, a certain decrease in the number of cellular elements and a pronounced monocyte-macrophage reaction, characterized by the presence of a significant number of monocyte-like cells and typical macrophages, were observed in smear prints of the wound discharge, the number of lymphocytes also increased significantly (Microphoto 3 and 4 - cytological picture of an ulcer after treatment in a day) .

After 2 days, the morphological pattern found on the smears (fingerprints 5 and 6), changed significantly - the cellular elements disappeared almost completely (only single lymphocytes are detected), the presence of individual fibrin clots that are finely dispersed is noted.

Claims (1)

Composition for topical treatment of purulent wounds and trophic ulcers, including the use of medicines corresponding to the sensitivity of microorganisms in the wound, characterized in that it includes the following components,%:
antiseptic 0.05 highly purified beet pectin 17-20 water 82.95-79.95

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