RU2457810C1 - Method of membrane dialysis in case of purulent-inflammatory diseases of cattle - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of veterinary surgery. Method includes surgical treatment of purulent cavity, installation into cavity of drainage dialysing device for animals, provided with guide-pin for introduction of the device into cavity and plastic fixer, filling of membrane capsule on 1/2 volume with multi-component medicinal solution, which contains dextran solution with molecular weight 40±15 kDa, polyethylene oxide 400, imosimase, ethacridine lactate, antibiotic in 1/2 therapeutic dose, lidocaine. Dialysate is replaced 1 time per 48 hours.

EFFECT: method makes it possible to ensure uniform, deep and gradual supply of complex antiseptics into tissues of granulation barrier.

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Description

The invention relates to veterinary medicine, in particular to veterinary surgery, and can be used in the treatment of abscesses, phlegmon, infected wounds in cattle.

In veterinary medicine, there are known methods 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], since profusely falling fibrin during purulent-inflammatory processes in large horned animals livestock obstructs the wound outlet, and drainage itself becomes a source of infection.

A known method of treating purulent-inflammatory diseases of cattle, including prolonged irrigation of the purulent cavity with an antiseptic solution, followed by drainage with a gauze swab impregnated with a fibrinolytic enzyme solution or complex ointments [1, 2]. To maintain optimal conditions in the purulent cavity, regular drainage replacement is necessary, which is extremely traumatic for the animal and leads to disruption of reparative processes.

Closest to the claimed is a method of treating infected wounds using a device for drainage of wounds [3], 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 and an antibiotic in a maximum single therapeutic dose. The device is held in the wound with a bandage. The inlet and outlet tubes with cannulas for connecting a syringe are brought to the surface of the dressing, which are closed with rubber plugs during fractional replacement of the dialysis solution. Treatment of cattle in a known manner is ineffective, since the device used in this method is cumbersome and not suitable for farm animals. In addition, the composition of the dialysate does not match their species reactivity.

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

The objective is achieved by the fact that the method of membrane dialysis for purulent-inflammatory diseases of cattle, including surgical treatment of the purulent cavity, installation in a drainage cavity with a capsule from a semipermeable membrane and filling the capsule with a dialysate solution, according to the invention, is carried out using a drainage dialysis device for animals equipped with a guide pin to insert the device into the cavity and a plastic retainer. Diaphragm capsule is filled with _^1/2 volumes of dialysate solution that contains 10% solution of dextran having a molecular weight of 40 ± 15 kDa, polyethylene 400, imozimazu, ethacridine lactate, antibiotic _^half the therapeutic dose and lidocaine at a certain component ratio. Dialysate is replaced once every 48 hours.

The use of a 10% dextran solution with a molecular weight of 40 ± 15 kDa is due to its ability to create an osmotic pressure in the membrane capsule of 2.5 mOsmol. In animals with moderate hydration of perivular tissues, such pressure is sufficient to ensure a gradual and deep delivery of drugs to the granulation barrier tissue on the one hand, and on the other hand, to collect and hold toxic compounds in the cavity of the membrane capsule.

Polyethylene oxide-400 with a low molecular weight (0.4 kDa) provides a gradual and deep penetration of the medicinal components of dialysate into the tissue of the granulation barrier and fibrinous masses of pus. Polyethylene oxide-400 has a pronounced dehydrating effect, due to its ability to form complex unstable compounds with water, which break down when they enter the membrane cavity with an osmotic stream and are retained by large dextran molecules there.

The enzyme selective action of imosimase in the dialysate ensures the lysis of necrotic tissues while maintaining healthy ones. The enzyme dissolves the fibrin film, "opens" the microabscesses and microflegmon scattered in the area of inflammation, and paves the way for the drugs used, which increases the effectiveness of their use. The fibrinized masses of pus dissolved by imimazase partially fall into the cavity of the membrane capsule, partially out, flowing down its outer surface.

The choice of antiseptic was carried out taking into account species tolerance, interaction with dialysate components, the ability to penetrate the pores of the cellulose membrane and effectively destroy the mixed aerobic infection characteristic of purulent-inflammatory processes in cattle. The best test results were shown by a broad-spectrum antiseptic of ethacridine lactate.

The combination of the components used in the dialysate can increase the effectiveness of antibiotic therapy, avoid obstruction of the wound opening with fibro-tissue masses and proliferate until the infection is completely destroyed in the depth of the wound, and ensure uniform tissue regeneration of the cavity.

Membrane dialysis is carried out using a drainage dialysis device for animals, developed by the author of the proposed method [4].

The method is as follows.

Surgical treatment is performed on sick animals with purulent-inflammatory diseases, during which pus, fibrinous tissue masses and dead tissues are removed from the pathological cavity. Then the cavity is sanitized with an antiseptic solution, for example, furatsillinom 0.5%. Then, using a guide needle, a membrane capsule with a retainer is installed in the pathological cavity.

The membrane capsule is mounted so that it fits congruently to the surface of the cavity. Diaphragm capsule is filled through a delivery pipe by _^1/2 volume of dialysate solution.

The approximate composition of the dialysate solution:

10% dextran solution with a molecular weight of 40 ± 15 kDa - 100 ml;

polyethylene oxide 400-20 ml;

imosimase - 10 ml;

ethacridine lactate - 0.2 g;

antibiotic - ½ single therapeutic dose;

lidocaine 10% - 1 ml.

Dialysate is replaced once every 48 hours. The duration of treatment is 8-10 days.

Example. The claimed method was treated 15 cows with various forms of purulent-inflammatory pathologies in the stage of abscess formation, including abscesses and phlegmon of various localization and genesis, purulent paraplegitis of the jugular vein, deep infected wounds.

Surgical treatment of purulent wounds was carried out under local infiltration or conduction anesthesia. The purulent necrotic cavity was opened with contraperture incisions, and the size of the lower contraperture corresponded to the size of the extracted sequestration. Upon completion of necrotomy and sanitation of the purulent cavity with antiseptic solutions, a drainage dialysis device was intravularnically installed [4]. Dialysate solution was replaced as the capsule was filled with the membrane once every 48 hours. Dialysis was stopped with: stable positive dynamics of laboratory blood parameters, improvement of the general condition of animals, absence of exudate, disappearance of functional disorders, scarring of the skin wound. Membrane dialysis was carried out for 8-10 days. A mandatory daily study of dairy products for the presence of inhibitory substances was carried out. During treatment, all animals on the 1-5-10th day determined the clinical and biochemical parameters of blood, presented in the table.

Table Clinical and laboratory blood parameters of cows on the background of membrane dialysis Indicators (units) Normal values 1 day 5 days 10 days ESR (mm / h) 0.5-1.5 3.0 ± 0.09 1.5 ± 0.05 1.2 ± 0.04 White blood cells (10 ⁹ / L) 5.5-10.0 14.9 ± 0.02 11.3 ± 0.03 7.5 ± 1.06 Red blood cells (10 ¹² / L) 5.0-7.5 2.9 ± 0.61 4.2 ± 0.27 4.9 ± 2.35 Hemoglobin (g / l) 90-120 58.0 ± 13.6 77.8 ± 9.56 92.1 ± 15.21 Total protein (g / l) 60-85 54.7 ± 4.2 69.2 ± 2.9 83.0 ± 2.3 Albumin (%) 30-50 17.1 ± 2.36 28.4 ± 2.9 34.56 ± 4.35 Alpha globulins (%) 12-20 24.11 ± 0.05 21.9 ± 2.65 15.3 ± 4.59

In all animals, before the operation, significant deviations from the norm of hematological parameters and clinical condition were observed. 5 cows (33.2%) had low-grade fever and loss of appetite. There was a decrease in milk yield in 15 (100%) animals. When conducting wound dialysis in all operated animals, an improvement in the general condition was noted already by 2 days. Subfebrile fever, anxiety and depression disappeared, appetite improved. Liquid pus without fibrin impurities was abundantly separated from the contrapertural sections. Significant changes in clinical and laboratory blood parameters during this treatment period were not noted. A study of milk in milk processing enterprises did not reveal inhibitory substances.

On the 5th day of treatment, 100% of the animals showed a noticeable improvement in all hematological parameters compared with the initial level: ESR decreased by 2.1 times; the number of leukocytes decreased by 1.3 times; the content of red blood cells and hemoglobin increased by 1.4 and 1.3 times, respectively. There was a decrease in the level of alpha globulins by 1.1 times, an increase in the total protein and albumin - by 1.2 and 1.6 times, respectively. A moderate discharge of jelly-like pus from the wound was noted. Granulations at the edges of the wound are bright pink, dense, shiny, covered with a moderate amount of wound contents. On palpation, perivular tissue is painless. The size of the purulent cavity decreased uniformly.

On the 8th day of dialysis in 8 cows with optimal clinical and laboratory parameters and the absence of signs of purulent inflammation in the wound, the membrane capsules were removed. In 5 cows, membrane capsules were removed on the 9th day, in 2 - on the tenth day. The dimensions of the cavity were uniformly filled with healthy granulation tissue.

On the 10th day of membrane dialysis, hematological parameters completely normalized in 15 (100%) animals. The changes compared with the initial data were: ESR decreased by 2.5 times, the level of leukocytes decreased by 1.9 times, the number of red blood cells and hemoglobin increased by 1.6 and 1.5 times, respectively, the total protein and albumin increased by 1.5 and 2.0 times, the number of alpha globulins decreased by 1.5 times.

All animals showed an improvement in clinical status. Signs of subfebrile fever disappeared on the second day. Throughout the treatment period, a steady positive dynamics of hematological parameters was observed: the ESR level was optimized on the 3rd day, leukocytosis significantly decreased by the 5th day and completely eliminated by 10. The purulent cavity was reduced uniformly, across the entire surface. Complications in the form of accumulation of caseous masses, obliteration of the wound canal, pathological granulations for the entire treatment period were not detected in any animal. This indicates an effective relief of the infectious process. The process of membrane dialysis took 8.5 ± 0.4 days, a full recovery occurred in 20.5 ± 0.9 days. Subsequent monitoring within 60 days of relapse and complications in the studied cows was not detected.

The technical result from the application of the method.

- simplicity and painlessness of medical manipulations during dialysis;

- optimization of membrane dialysis by taking into account the specific features of the course of purulent-necrotic pathologies;

- ensuring a uniform, deep and gradual flow of complex antiseptics into the tissue of the granulation barrier;

- quick relief of infection;

- reduction in the treatment of purulent-inflammatory processes in cattle;

- the absence of complications characteristic of purulent-inflammatory diseases of cattle;

- the absence of repeated recurrence and metastasis of the purulent process;

- lack of loss of dairy products due to the lack of drugs in the circulating blood and milk of animals.

The method allows you to quickly and effectively stop the infection with purulent-inflammatory diseases of cattle, does not cause stress in animals and ensures the safe operation of a veterinarian.

Information sources

1. Plahotin M.V. Handbook of Veterinary Surgery. - M .: Kolos, 1977 - p. 43-46.

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

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

4. Bezruk E.L. Utility Model Patent No. 100396 RU. Application No. 20102828661 dated July 9, 2010. Registered on December 20, 2010.

Claims (1)

A method of membrane dialysis in the treatment of purulent-inflammatory diseases of cattle, including surgical treatment of a purulent cavity, installation in a drainage cavity with a capsule from a semipermeable membrane, filling the capsule with a dialysate 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, the membrane capsule is filled into ½ volume with a dialysate solution containing: 10% solution p dextran with a molecular weight of 40 ± 15 kDa, polyethylene oxide 400, imosimase, ethacridine lactate, ½ therapeutic dose of antibiotic, lidocaine at a certain ratio of components, while dialysate is replaced once every 48 hours.