RU2450794C1 - Method of treating pyoinflammatory diseases in horses - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to veterinary science, particularly to a method of treating pus pockets in soft tissues. The method of treating pyoinflammatory diseases in horses involves surgical treatment of a pus pocket, insertion of drainage with a capsule made of a semi-permeable membrane in the socket, filling of the capsule with high osmolar polycomponent medicinal solution. Dialysis is ensured by a drainage dialysis system for animals, supplied with a guide wire used to introduce the device introduction into the socket and a plastic clamp. Before the surgical treatment 5-10 minutes earlier, the iodine-polymer antiseptic monoklavit-1 is introduced in the pus pocket, while the membrane capsule after being inserted is 1/2 filled with a dialysate solution containing: 33 % dextrane of molecular weight 70±15 kDa, 1,2-propiylene glycol, an antibiotic in 1/2 therapeutic dose and an anaesthetic with the dialysate changed once a day.

EFFECT: using the declared invention shall enable higher clinical effectiveness in pyoinflammatory diseases in horses.

2 cl, 1 tbl

Description

The invention relates to veterinary medicine, in particular to veterinary surgery, and can be used in the treatment of infected wounds and purulent-necrotic processes in horses with the formation of purulent cavities in the tissues.

In veterinary medicine, methods are known for draining purulent cavities of soft tissues using various devices (rubber and PVC tubes of various sizes and diameters, gauze swabs), a significant drawback of which is low efficiency [1].

There is a method of treating purulent-inflammatory diseases of animals, based on capillary diffusion and including prolonged irrigation of the purulent cavity with its subsequent drainage with a gauze swab saturated with solutions of salts, antiseptics or proteolytic enzymes [1, 2]. However, the drainage lasts for 2-4 hours, then it should be removed, as it interferes with the excretion and becomes a source of intoxication [2]. To maintain optimal conditions in the wound or purulent cavity, regular drainage replacement is necessary, which is extremely traumatic for the animal and leads to disruption of reparative processes in the wound.

The known method of wound dialysis using drainage from a semipermeable membrane that provides, on the one hand, stable diffusion of drugs in the body tissue, and on the other, the removal of toxic products from the wound cavity [3]. The method is widely used in various fields of surgery, but is practically not used in veterinary medicine.

Closest to the claimed is a method of treating infected wounds using a device for drainage of wounds containing laid on the bottom of the wound membrane of a semipermeable membrane filled with a medicinal solution. Multicomponent dialysate contains a 6% solution of dextran with a molecular weight of 70,000, which provides an osmotic pressure level of 0.85 mOsmol and an antibiotic at the maximum single therapeutic dose [4]. The known method is ineffective for dialysis of purulent cavities of horses, since it does not create sufficient osmotic pressure for active dehydration of the perivular tissue of horses and does not reduce resorption from the purulent focus.

The objective of the invention is to provide a reliable method for the treatment of purulent-inflammatory diseases of horses using membrane dialysis.

The task is achieved in that for membrane dialysis use a special drainage device for animals, equipped with a spoke-guide for inserting the device into the purulent cavity of the horse and a plastic retainer. 5-10 minutes before the surgical treatment, iodine-polymer antiseptic monclavit-1 is introduced into the purulent cavity. After installation, the membrane capsule is filled into ½ volume with a highly osmolar dialysate solution containing: 33% dextran solution with a molecular weight of 70 ± 15 kDa, 1,2-propylene glycol, ½ therapeutic antibiotic, anesthetic. Dialysate is replaced once a day. Clindaspectin is used as an antibiotic.

A high osmolarity dextran solution with a molecular weight of 70 ± 15 kDa provides a high (4.7 mOsmol) osmotic pressure in the membrane capsule, causing massive dehydration of the pathological focus while simultaneously eliminating low molecular weight toxic compounds, while maintaining high molecular weight proteins necessary for building a cell barrier and regeneration . 1,2 propylene glycol introduced into the dialysate solution ensures its stability, enhances the adsorbing properties, provides uniform release of antibacterial and painkillers, and also has a potentiating effect on the components of the dialysate. This allows you to increase the performance of the membrane capsule and reduce the amount of antibiotic in the dialysate solution to 1/2 a single therapeutic dose. The choice of antibiotic is due to the sensitivity of microorganisms to it, the absence of its local irritant effect, its tolerance by animals, and the ability to penetrate through the pores of the cellulose membrane. The best test results were shown by the complex antimicrobial drug clindaspectin, which includes clindamycin and an antibiotic from the aminoglycoside group.

Membrane dialysis is carried out using a drainage dialysis device for animals, developed by the author of the proposed method [5].

The method is as follows.

Pre-prepare the purulent cavity of the horse for dialysis. To do this, using an injection needle, a cavity is deposited once with a iodine-polymer antiseptic of a wide spectrum of action of monclavit-1, which helps to suppress the activity of infect and reduce resorption. After 5-10 minutes, surgical treatment is performed, including infiltration or conduction anesthesia, performing counter-percutaneous incisions, necrectomy, evacuation of pus and spent monclavite-1. The membrane capsule is selected in accordance with the configuration and size of the pathological cavity. For membrane dialysis, a drainage dialysis device for animals is used [5]. After the device is installed in the cavity, the membrane capsule is filled into ½ volume of the drug solution. A device with a filled membrane capsule should fit snugly against the walls of the purulent focus, while ensuring maximum contact of the membrane with the surface of the wound. The approximate composition of the dialysate solution:

33% dextran solution with a molecular weight of 70 ± 15 kDa - 100 ml;

1,2 - propylene glycol - 20 ml;

novocaine - 0.5 g;

clindaspectin in the amount of ½ single therapeutic dose.

Dialysate is replaced once a day. The duration of treatment is 5-7 days.

Example. According to the claimed method, 11 horses were treated with various forms of purulent-inflammatory pathologies at the stage of abscess formation, including phlegmon of the withers, lateral chest and abdominal walls, suppuration of random infected wounds of the shoulder-shoulder region, croup, forearm, thigh, suppuration of hematomas. In all animals, during the initial examination, external signs of intoxication and purulent-resorptive fever were observed: refusal to feed, fibrillar muscle twitching, sweating, and fever.

The operations were performed against a background of local anesthesia. 5-10 minutes after depositing the purulent cavity with iodine-polymer antiseptic Monclavit-1, surgical treatment was performed, including opening the purulent cavity with contrapertural incisions, revision of the cavity, elimination of inflows, and necrectomy. During wound dialysis, dialysate replacement was carried out 1 time per day as the membrane was filled.

The reason for stopping dialysis was a decrease in signs of purulent inflammation and intoxication, an improvement in the general condition of the animal, a decrease in swelling, the appearance of healthy granulations, the disappearance of functional disorders, and normalization of laboratory parameters. Removal of the membranes was technically simple, without causing pain to the animals and without causing resistance from them.

The duration of dialysis was 5-7 days. In all animals, the clinical and biochemical parameters of blood, presented in the table, were determined on the 1-5-7th day.

                                                         Table Clinical and laboratory blood counts of horses in the treatment of membrane dialysis Indicators, (units) norm 1 day M ± m 5 days M ± m 7 days M ± m ESR (mm / h) 10-50 75 ± 0.09 47.5 ± 0.05 22.2 ± 0.04 White blood cells (10 ⁹ / L) 6.0-10.0 20.9 ± 0.02 11.3 ± 0.03 7.5 ± 1.06 Red blood cells (10 ¹² / L) 6.0-11.0 4.3 ± 0.61 5.8 ± 2.03 5.8 ± 1.51 Hemoglobin (g / l) 100-160 148.0 ± 13.6 148.1 ± 3.12 150.6 ± 10.2 Potassium (mol / L) 2.9-4.5 5.2 ± 1.56 4.4 ± 0.15 3.2 ± 0.6 Calcium (mmol / L) 2.6-3.6 2.1 ± 0.4 2.6 ± 0.22 3.7 ± 0.51 Total protein (g / l) 57-75 49.7 ± 4.2 56.1 ± 2.9 59.0 ± 2.3 Alkaline phosphatase (u / l) 70-250 580.3 ± 13.6 359.6 ± 10.6 243.2 ± 5.18

The table shows that the animals treated by the claimed method, significantly improved clinical and laboratory parameters compared with their initial level. On the 5th day, there was a slowdown and normalization of ESR level (1.5 times), a decrease in the number of leukocytes (1.8 times), a decrease in alkaline phosphatase level (1.6 times). At the same time, an increase in the content of red blood cells (1.3) times and the total protein (1.1 times) was observed. On day 7, the hematological parameters of horses were optimized.

Anesthetic effect was observed during the first hours after surgery and the start of dialysis. All animals showed an improvement in clinical status. By the end of the first day, sweating and fibrillar muscle twitching disappeared, and appetite appeared. On day 2, puffiness significantly decreased and finally disappeared by the end of 2-3 days. By 4-7 days, in 100% of the animals, the purulent cavity was cleaned of necrotic tissues and covered with normal bright pink dense granulations. A complication in the form of tendogenic contracture of the superficial flexor of the finger was observed in 1 mare (9.09%) and was associated with profound changes in the tendon structure at the time of treatment initiation. The healing of animal wounds took 14.6 ± 1.8 days. When performing the procedures, additional fixation and drug-calming animals were not performed.

The technical result from the application of the method.

- simplicity and painlessness of medical manipulations during dialysis;

- reduction in the number of medical procedures (dialysate replacement 1 time once a day);

- optimization of transmembrane dialysis for horses by taking into account the specific features of the biology of the wound process;

- reduction of treatment time;

- prevention of trauma to granulations and the development of complications during surgical treatment of the purulent cavity due to the preliminary treatment of the purulent cavity with the antiseptic monclavit-1;

- reducing the therapeutic dose of the antibiotic in the dialysate by 2 times due to the potentiating action of 1,2-propylene glycol;

- ensuring the safe work of a veterinarian under any conditions of keeping and operating horses.

The method allows for effective local treatment of purulent-inflammatory diseases of horses, taking into account the physiological and behavioral characteristics of horses and can be used in a veterinary clinic, at horse farms, hippodromes and pastures.

Information sources

1. Shebits X., Brass V. Operative surgery of dogs and cats. - M .: Aquarium, 2005.-S. 91-92.

2. Timofeev S.V., Kontsevaya S.Yu. et al. General Veterinary Surgery. - M .: Zoomedlit, 2007 .-- S.119-128.

3. Gulman M.I., Vinnik Yu.S., Miller S.V. et al. Atlas of drainage in surgery. - Krasnoyarsk, 2004 .-- S.36-37.

4. Selezov EA, Sychev G.M. A method for treating infected wounds. Copyright certificate No. 1050679 SU. Publ. 10.30.83.

5. Bezruk E.L. Patent for utility model 100396 RU. Application No. 20102828661 dated July 9, 2010. Registered on December 20, 2010.

Claims (2)

1. A method for the treatment of purulent-inflammatory diseases of horses, including surgical treatment of the purulent cavity, insertion into the drainage cavity with a capsule of a semipermeable membrane, filling the capsule with a highly osmolar multicomponent drug solution, characterized in that the dialysis is carried out using a drainage dialysis device for animals equipped with a spoke a guide for introducing the device into the cavity and a plastic retainer, moreover, 5-10 minutes before the surgical treatment, the purulent cavity is introduced monclavit-1 od-polymer antiseptic, and the membrane capsule after its installation is filled into 1/2 volume with a dialysate solution containing: 33% dextran solution with a molecular weight of 70 ± 15 kDa, 1,2-propylene glycol, 1/2 antibiotic therapeutic dose and anesthetic, with dialysate replacement carried out 1 time per day. 2. The method according to claim 1, characterized in that clindaspectin is used as an antibiotic.