RU41613U1 - DEVICE FOR TREATMENT OF TROPHIC ULCERS AND LONGLY HEALING FUSAL RAS - Google Patents

Abstract

The technical solution relates to medicine, namely to therapeutic methods of treatment, and can be used in the clinical and outpatient treatment of trophic ulcers and long-term non-healing purulent wounds.

Description

The technical solution relates to medicine, namely to therapeutic methods of treatment, and can be used in the clinical and outpatient treatment of trophic ulcers and long-term non-healing purulent wounds.

It is known (RU, patent 2049491 A 61 M 35/00, 1995) a device for treating purulent wounds, comprising a channel for supplying a washing solution, a discharge channel connected to a rarefaction source, an elastic skirt covering the wound area, and also a hollow body with a lid on the upper end, on the lower end of which the specified elastic skirt is fixed, while in the cavity of the body there is a centrifugal nozzle connected to the inlet channel and a filter cup connected to the outlet channel.

It is known (RU, patent 2042362 A 61 M 35/00, 1995) a device for applying to the skin of medicines containing a container filled with a porous capillary material combined with a capillary rod mounted with linear movement.

It is known (RU, patent 2197287 A 61 M 35/00, 2003) a device for treating ulcers, which is a porous carrier - a napkin based on dialdehyde cellulose, on which the trypsin-copper complex is immobilized.

The disadvantages of the above devices should be recognized as low antibacterial and necrolytic activity.

The technical problem solved by the proposed device is to provide effective treatment of trophic ulcers and long-term non-healing purulent wounds.

The technical result obtained by the implementation of the proposed device consists in accelerating the rejection of necrotic tissues, inhibiting the growth of microbes, including those resistant to antibiotics, while reducing the risk of generalization of infection, which leads to a significant acceleration of tissue regeneration and, as a result, a reduction in treatment time by 1 , 5-2 times and the prevention of relapse in the long term.

To achieve the technical result, it is proposed to use a device for the treatment of trophic ulcers and long-term non-healing purulent wounds, containing the first layer of a gauze dressing of 8-10 layers, abundantly moistened in a medicinal product containing (g / 100 ml of solution): methyluracil 0.9-1 , 1, pepsin 3.6-4.4, betaine hydrochloride 3.6-4.4, sodium chloride 9.0-11.0, distilled water - up to 100.0, the specified moistened dressing contains crushed collagen-containing dressings with a layer 2.0-5.0 mm thick, the napkin is located on a multi-hole mikroirrigatore atom, which can be closed by an additional layer 8-10 sterile dry cloth.

All ingredients included in the product are approved for use by the Ministry of Health and Social Development of the Russian Federation.

Pepsin is a gastric enzyme with the highest proteolytic activity among all other enzymes in the body.

This enzyme belongs to one of the most numerous groups of enzymes - proteolytic enzymes (proteases). They are

belong to the class of hydrolases, to a subclass of peptide hydrolases and catalyze the cleavage of proteins and polypeptides. Pepsin hydrolyzes peptide bonds and breaks down almost all natural proteins.

As an ingredient of the proposed funds, it is preferable to use the most affordable and cheapest pork pepsin - abomin.

In the literature, data on the possibility of an overdose of pepsin are not known.

Betaine (N-trimethylglycine, oxyneurin, lycine, betafin) is a natural nitrogenous lipotropic substance of plant origin, a derivative of the natural amino acid glycine. It is a readily soluble powder in water. The molecular formula of betaine is C ₅ H ₅ NO ₂ , the chemical formula is (CH ₃ ) ₃ N ⁺ -CH ₂ COO ^- (amphoteren preparation).

Betaine molecule contains active methyl groups (CH ^3- ), which are necessary for normal metabolism. The addition of a methyl group (methylation) is an obligatory stage of the most important biochemical reactions.

The human body cannot synthesize methyl groups, but extracts them from food. Due to its direct participation in the methylation reaction, betaine has a great influence, in particular, on lipid metabolism, having a lipotropic effect, since it is close in composition to choline and lecithin. Betaine is involved in the metabolism of methionine.

In addition, betaine acts as an osmoprotector, that is, it helps maintain water balance in cells and tissues and reduces platelet aggregation.

Betaine is used in pharmacology for the treatment of liver pathology, the treatment of alcoholism in toxic poisoning, in the form of nutritional supplements as part of nutraceuticals.

Betaine hydrochloride (or hydrochloride) chemically 1-carboxy-N, N, N-trimethylmethanaminium chloride. Pure 5% betaine hydrochloride solution has a pH of 1.

Betaine hydrochloride, which dissociates in solution into free betaine and diluted hydrochloric acid with a pH of 2-2.5, is used as part of Acidin-Pepsin tablets for oral administration in order to treat hypacid gastritis in combination with pepsin.

In the literature, data are not known about the possibility of an overdose of betaine and betaine hydrochloride.

Metiuratsil (2,4-dioxo-6-methyl-1,2,3,4-tetrahydropyrimidine). Flavourless white crystalline powder, slightly soluble in water (up to 0.9%) at a temperature of 20 ° C and alcohol. By the chemical structure, methyluracil is a pyrimidine derivative. According to experimental data, a number of drugs of this group (methyluracil, pentoxyl, etc.) have anabolic and anti-catabolic activity. These drugs accelerate cell regeneration processes; accelerate wound healing, stimulate cellular and humoral defense factors. They also have anti-inflammatory effects.

The hypertonic sodium chloride solution has long been used in 5% and 10% concentrations for topical treatment of purulent wounds due to its osmotic effect, which contributes to the separation of wound exudate. Hypertonic solutions have a local antimicrobial effect.

For the use of this mixture in clinical practice, permission was obtained from the Pharmacological Committee of the USSR No. 211-7032 / 24 dated 12.03.90.

For direct treatment, the drug is used in the form of a suspension, which is prepared ex tempore. In a preferred embodiment, the medicament comprises methyluracil 1.0; pepsin 4.0; betaine hydrochloride 4.0; sodium chloride 10.0; distilled water - up to 100.0 (pH 2.0).

In a freshly prepared mixture, gauze napkins are abundantly moistened, which are applied to the surface of trophic ulcers and long-term non-healing purulent wounds.

Separate use of the components of the mixture is ineffective. When using them in the proposed combinations, a pronounced clinical effect was obtained, which is explained by the synergy of the action.

The drawing shows a view of the proposed device, with the following notation used collagen-containing dressings 1, a porous carrier 2, the area of the carrier 2, impregnated with the drug 3, multi-hole microirrigator 4.

In the future, the application of the proposed device will be disclosed using examples of treatment of patients.

Examples of specific applications of the tool.

Example 1. Patient P., 67 years old, I. b. No. 735/35, was admitted to the clinic 01/14/96 with a diagnosis of: Primary: varicose veins of the saphenous veins of both lower extremities. Complications:

chronic venous insufficiency of the left leg of 2 degrees, the right - 3 degrees, circular dermatosclerosis and hyperpigmentation in the lower third of the right lower leg, trophic ulcer in the lower third of the right lower leg along the anteromedial surface of 114 cm ² .

Concomitant diseases - diffuse recurrent goiter, moderate thyrotoxicosis; coronary cardiosclerosis, atrial fibrillation, cardiovascular insufficiency 2A degree; chronic obstructive bronchitis with an asthmatic component; prolapse of the walls of the vagina, prolapse of the uterus;

condition after right-sided mastectomy for breast cancer in March 1995.

The patient initially received conventional therapy for 20 days using 150 mg of chymopsin per dressing. 02/06/97 produced plastic surgery of the surface of the trophic ulcer. The flap initially took root, the patient was discharged from the hospital, as she refused surgery on the venous system of the lower extremities.

During follow-up observation, it was noted that the flap began to be quickly rejected, the infection joined, and by March 1997 an ulcer surface was formed with an abundant purulent-necrotic discharge of 84 cm ² . Its edges are gentle, the skin around is hyperpigmented and sclerotic, eczematized. Staphylococcus aureus is seeded from the wound discharge.

The patient was again hospitalized in the hospital 03.03.97, I.b. No. 842/42. From 03.03.97 to 03.03.97, treatment was started using the proposed device.

During this period, the area of the wound surface was reduced to 35 cm ² . By April 3, 1997, the ulcer had completely healed on its own.

Subsequently, the patient produced a combined excision of the saphenous veins of the right n / limb. No ulcer recurrence was observed during the next 5 years of follow-up.

Example No. 2. Patient K., 39 years old, I.b. 988/188, entered 03.19.99 with a diagnosis of obliterating endarteritis of the left

n / extremities, gangrene of the first toe of the left foot. 03/27/99 an operation was performed - left-side lumbar sympathectomy, exarticulation of 1 finger of the left foot with resection of the head of the metatarsal bone. In the postoperative period, as a result of necrosis of the edges of the postoperative wound and the addition of suppuration, a wound 6 × 3.5 × 4 cm in size was formed with abundant purulent-necrotic discharge. Staphylococcus aureus is seeded.

From 1.04.99, for two weeks, the wound was treated with dressings with chymotrypsin and 10% sodium chloride solution, but without much effect - the abundant purulent-necrotic discharge from the wound persisted.

From 04/14/99 to 04/16/99, for three days, when dressing, after the appropriate toilet with 3% hydrogen peroxide, the proposed device was applied to the surface of the wound.

Complete wound healing after 12 days from the start of treatment using the proposed device.

The use of the proposed device can accelerate the rejection of necrotic tissues, inhibit the growth of microbes, including those resistant to antibiotics, while reducing the risk of generalization of infection, which leads to a significant acceleration of tissue regeneration and, as a result, a reduction in treatment time by 1.5-2 times and prevention long-term relapses.

Claims (2)

1. A device for the treatment of trophic ulcers and long-term non-healing purulent wounds, containing a drug deposited on a porous carrier, characterized in that the porous carrier is a gauze dressing of 8-10 layers, and the specified drug contains (g / 100 ml of solution) : methyluracil 0.9-1.1, pepsin 3.6-4.4, betaine hydrochloride 3.6-4.4, sodium chloride 9.0-11.0, distilled water - up to 100.0, moreover, on the specified gauze dressing placed crushed collagen-containing dressings with a layer thickness of 2.0-5.0 mm, while gauze dressing is located on a multi-hole microirrigator. 2. The device according to claim 1, characterized in that the microirrigator is closed with an additional 8-10-layer dry sterile towel.