WO2005009448A1 - Treatment of lesions of the soft tissues - Google Patents

Treatment of lesions of the soft tissues Download PDF

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Publication number
WO2005009448A1
WO2005009448A1 PCT/IB2004/002358 IB2004002358W WO2005009448A1 WO 2005009448 A1 WO2005009448 A1 WO 2005009448A1 IB 2004002358 W IB2004002358 W IB 2004002358W WO 2005009448 A1 WO2005009448 A1 WO 2005009448A1
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WO
WIPO (PCT)
Prior art keywords
granules
combination
weight percent
range
amount
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/IB2004/002358
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English (en)
French (fr)
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WO2005009448A8 (en
Inventor
Alexander D. Vilesov
Marina S. Vilesova
Viktor N. Balin
Nataila I. Eisenstadt
Vasily V. Mikhailov
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Delsi OOO
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Delsi OOO
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Delsi OOO filed Critical Delsi OOO
Priority to EP04744018A priority Critical patent/EP1648419A1/en
Priority to JP2006520930A priority patent/JP4729488B2/ja
Priority to AU2004258736A priority patent/AU2004258736A1/en
Priority to CA002533707A priority patent/CA2533707A1/en
Publication of WO2005009448A1 publication Critical patent/WO2005009448A1/en
Publication of WO2005009448A8 publication Critical patent/WO2005009448A8/en
Priority to US11/337,433 priority patent/US20060120993A1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L26/00Chemical aspects of, or use of materials for, wound dressings or bandages in liquid, gel or powder form
    • A61L26/0061Use of materials characterised by their function or physical properties
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00Drugs for dermatological disorders
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P17/00Drugs for dermatological disorders
    • A61P17/02Drugs for dermatological disorders for treating wounds, ulcers, burns, scars, keloids, or the like
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P29/00Non-central analgesic, antipyretic or antiinflammatory agents, e.g. antirheumatic agents; Non-steroidal antiinflammatory drugs [NSAID]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P31/00Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
    • A61P31/02Local antiseptics

Definitions

  • An invention is related to the field of medicine, particularly, to surgery, and can be used for treatment of the suppurative inflammation lesions of the soft tissues.
  • a wound coating and method for its preparation (RU N-> 2091082, A61 L 15/30, 1997).
  • the coating is a multi-layer film made of the fluorinated rubber and water-soluble polysaccharides of the plant origin, combined in certain ratio.
  • the coating is obtained by mixing of the fluorinated rubber latex and water solution of the polysaccharide to homogeneity, and then spreading out the resulting mass on the flat surface and drying.
  • a remedy for wound healing (RU N° 2115436, A61L 15/24, 1995).
  • the remedy is made of the co-polymer of the vinyl alcohol, vinyl acetate and vinyl glutarate as a dry powder with the particle size 10-1500 ⁇ M also containing a drug selected from the following group: anitimicrobial, proteolytic enzymes or local anesthetic.
  • a drug selected from the following group: anitimicrobial, proteolytic enzymes or local anesthetic.
  • RU application Ns 94033866/14, A61K 39/106, 1994 The method consists in a surgical and mechanical treatment of the wound, then drainage and washing, and carrying out a restoration surgery and local drug therapy.
  • Washing is accomplished by a single daily treatment with a pilastin solution, 0.25-0.8 dose/mL over 3-5 days, whereas a local therapy is conducted by applying a bandage soaked in the water solution of pilastin of the same concentration for a period of 24-48 h, over 5-8 days. It is known that for healing of the local festering wounds during the exudative phase, the compounds with hyper-osmolar properties can be used in order to facilitate an outflow of the wound discharge from the wound to the bandage. (Wounds and Wound Infections. Manual for Doctors. Eds. M. I. Kuzin, B. M. Kostyuchenok, Moscow, Medicine, 1990, p. 281).
  • the tasks which solutions the inventions are targeting consist in reducing timeframes of the main stages of the wound healing process and decreasing duration of the inpatient treatment for the patients with suppurative inflammation lesions of the soft tissues by virtue of prolonged maintenance of the required drug concentrations in the wound.
  • the formulated problems have been addressed in the following manner.
  • the remedy for healing of the suppurative inflammation lesions of the soft tissues contains a polymer and has an appearance of the micro-granules which matrix is composed of at least one cross-linked polymer selected from the group containing sodium alginate, gelatin, pectin, carraginan, agar-agar, sodium salt of carboxymethylcellulose, copolymer of the acrylic acid and butyl acrylate, and their mixture, and additives, that are hyper-osmolar, antiseptic, anesthetic, and, if necessary, antioxidants, in the following ratios, weight %: Matrix: Indicated cross-linked polymer 11.0 - 29.0, Additive: hyper-osmolar 70.0 - 80.0, antiseptic 0.5 - 5.5, anesthetic 0.5 - 2.5, antioxidant 0.05 - 1.0,
  • the remedy contains sodium chloride (NaCI) or magnesium chloride (MgCI 2 ), or the sea salt.
  • NaCI sodium chloride
  • MgCI 2 magnesium chloride
  • the remedy contains lidocaine or nitazole.
  • the remedy contains lidocaine, or trimecaine, or pyromecaine hydrochloride.
  • antioxidant the remedy contains olifen, or carnasine, or emoxipine.
  • the method of treatment of the suppurative inflammation lesions of the soft tissues using the above-mentioned remedy along with antibacterial, anti- inflammatory, desensitizing and disintoxication therapy that is different by placing the micro-granules via post-surgical or fresh wound into the suppurative inflammation lesion and filling not more than half the volume of the wound cavity followed by the wound drainage and applying an aseptic bandage that is replaced along with the granules once a day over 2-3 days.
  • the proposed remedy MIKPOL has an appearance of loose powder consisting of micro-granules.
  • the micro-granules are composed of the polymer matrix and functional additives, that are primarily salts creating a local hyper-osmolar effect in the suppurative inflammation lesion, and also anesthetic and antiseptic compounds, both in combination, and separately.
  • the granules are obtained by granulation of the proposed compositions followed by drying and sterilization.
  • the application of the above-mentioned components in granulated form rather than in native state provides a general effect of the prolonged action of the encapsulated active components, salts, first of all.
  • anesthetic compounds as a component of the micro-granules reduces pain threshhold and even relieve pain syndrome.
  • MIKPOL is introduced via surgical opening or fresh wound directly into the suppurative inflammation nidus or wound.
  • a mixture of the micro-granule components gets diffused into the lesion thus maintaining an increased osmotic pressure as compared to the interstitial liquid and blood plasma.
  • This provides a centripetal flow of the tissue liquid from the perifocal area directly to the suppurative cavity and further down to the bandage via drainage, facilitating an accelerated excretion of the excess of fluids and metabolites from the inflamed tissues and swollen adjacent tissues and reducing oedema.
  • the micro-granules improves the conditions for restoration of the microcirculation in the area of inflammation, the inflow of the fresh components of the humoral and cell system of immuno-protection is stimulated, and also the concentration of the drugs delivered perenteral and supplied from the vasculature is increased.
  • the activity of the micro-granules in time is regulated through cross-polymerization in the preformed granules that affords possessing a stable diffusion of the microelements over the period of time not less than 24 h.
  • the micro-granules have an ability to absorb a significant amount of the exo- and endo-toxins from the wound exudates and also to assert a hemo-static, anesthetic, and antiseptic effects.
  • the treatment with MIKPOL is conducted in the first phase of the inflammation process till complete termination of the pronounced exudation events in the festering wound.
  • the method of treatment with MIKPOL is conducted along with general line of antibacterial, anti-inflammation, desensitizing and disintoxication therapy.
  • Microgranules are introduced into fresh wound or suppurative necrotic nidus so that about half of the volume of the wound or suppurative nidus is filled. The cavity is then drainaged by any know method, and aseptic bandage is applied.
  • the bandage and granules are replaced once a day over next 2-4 days. In the cases with particularly abundant exudation, which is determined by soaking of the bandage, the bandage could be replaced twice a day.
  • the breadth of therapeutic applications may be extended by complimentary incorporation into the granules of any drug substances.
  • the remedy can be used both in clinical and field setting. Of particular importance, is possible application in the emergency situation and for terrorist attacks victims in the medical units of the Ministry of Defense and Ministry of the Extreme Situations, and also by the Ministry of Health for inpatient and outpatient treatment of the suppurative inflammation complications of the trauma of different localization.
  • MIKPOL allows qualitatively improve treatment of the patients, decrease the number of suppurative septic complications in the cases of mechanical and gun- inflicted trauma, shorten the rehabilitation time, and also reduce the labor allocation for the medical personnel involved in patient care in the surgical departments of the Ministry of Health and Ministry of the Extreme Situations.
  • the proposed inventions are illustrated by examples.
  • the Table lists the compositions of MIKPOL that were used for treatment of the patients with suppurative inflammation lesions. Table
  • Example 1 The patient N., 34 years old, was hospitalized with an acute odontogenic localized osteomyelitis of the lower jaw adjacent to the 36 th tooth, complicated by the flegmon of the mouth floor, in overall fair conditions. After lancing and drainage on the day of hospitalization under general anesthesia of the left submaxillary and lower chin areas, MIKPOL No.1 was introduced into the suppurative necrotic nidus to fill half the volume of the cavity. A post-surgical wound was drainaged with two tubular double gap drainages. The bandaging that was done twice a day and the fractional wound wash was also completed via drainages using 0.02 % chlorohexedine.
  • Example 2 Patient C, 33 years old, admitted with acute adenoflegmon of the right submaxillary area. Upon admission, a lancing and drainage of the adenoflegmon were conducted. Local treatment was carried out using MIKPOL No.2 that was administered to the post-surgical wound once a day to fill approximately half the volume of the suppurative cavity. Besides that, a general anti-bacterial and anti- inflammatory treatment was carried out. By the second day, a termination of the exudates processes and cleaning of the cavity from necrotic tissues were registered. The cytology study recorded a transition to the regenerative stage by the day 4 of the treatment, and then the traditional local wound healing remedies were commenced. The double reduction of the wound size to 5.99 cm 3 as determined by the planimetrical study, occurred by the day 5 of treatment. The secondary stitches were applied on the day 6 of the treatment.
  • Example 3 The patient Sh., 41 years old, was treated for an acute odontogenic localized osteomyelitis of the lower jaw, complicated by the flegmon of the left submaxillary area. After a surgery with lancing and drainage, the local treatment was conducted with MIKPOL No.3. During bandaging that was conducted once a day, the pussy cavity was washed out with antiseptics via tubular drainage and the micro- granules were introduced to fill half the volume. By the next bandaging, the granules became swollen by absorbing the wound discharge. They were easily removed from the wound during bandaging when washing the wound with antiseptic via tubular drainage, after that a new portion of the MIKPOL was applied.
  • Example 4 Patient Z, 30 years old. Admitted with a double-sided non-consolidate fracture of the lower jaw in the area of 36 th and 44th teeth complicated by the flegmon of the left submaxillary area. The lancing and drainage surgery were performed; the lower jaw was immobilized using Vasiliev's splints with inter-jaw rubber tug. The local treatment of the post-surgical wound was done using MIKPOL No.4, by filling half the volume of the suppurative cavity and applying an aseptic bandage. A bandage replacement frequency was once a day. As a result of the treatment, the exudative processes were suppressed by the day 3, whereas an infiltration of the soft tissues disappeared by the day 5.
  • Example 5 The patient L, 30 years old, was treated for the acute odontogenic osteomielitis of the lower jaw adjacent to the 48 th tooth, complicated by the phlegmon of the moth floor. An excision surgery and drainage was conducted at the left and right submaxillary, sublingual and lower chin areas. During surgery the patient had an abundant malodorous gray pussy discharge. The soft tissues of the moth floor had necrotic alterations; there were indications of myocitis and fasciitis. With a background of general therapy, MIKPOL No.5 was applied locally by filling necrotic pussy cavities during bandaging that were performed twice a day after wound dialysis using antiseptics.
  • the volume of the pussy cavity was determined planimetrically to be 41.6 cm 3 .
  • the necrotic processes went into a recession, the wound has cleaned, and exudation processes halted.
  • the tubular drainage was removed and the ointment bandages began to be applied locally.
  • a cytology picture by the day 5 commenced to display the traits of regenerative process manifested by the macroscopic granulation.
  • the volume of the cavities was 23.5 cm 3 .
  • the early secondary stitches bringing together edges of the wound were applied. The patient was released for the outpatient treatment on the day 10 after the surgery.
  • the invented remedy allows cleaning up the area from necrotic tissues and facilitating reduced perifocal oedema and infiltration as well as lessening pain syndrome during suppurative inflammation diseases.
  • the remedy can be applied both in the hospital and field settings. FORMULA OF THE INVENTION 1.
  • a remedy for treatment of the suppurative inflammation lesions of the soft tissues containing polymer that is different by the fact that it is a micro-granules which matrix is composed from at least one cross-linked polymers selected from the group including sodium alginate, gelatin, pectin, carraginan, agar-agar, sodium salt of carboxymethylcellulose, copolymer of the acrylic acid and butyl acrylate, and their mixture, and additives, that are hyper-osmolar, antiseptic, anesthetic, and, if necessary, antioxidants, in the following ratio, weight %: Matrix: Indicated cross-linked polymer 11.0 - 29.0, Additive: hyper-osmolar 70.0 - 80.0, antiseptic 0.5 - 5.5, anesthetic 0.5 - 2.5, antioxidant 0.05 - 1.0, while the granules that have the size of 500-3000 ⁇ M are shaped spherically or close to the spherical form.
  • the remedy described in claim 1 different by that in contains a hyper- osmolar compounds sodium chloride (NaCI), or magnesium chloride (MgCI 2 ), or sea salt.
  • NaCI sodium chloride
  • MgCI 2 magnesium chloride
  • the remedy described in the claim 1 different by that it contains lidocaine , or trimecaine, or pyromecaine hydrochloride as anesthetic compounds.
  • the remedy described in claim 1 different by that it contains olifen, or carnasine, or emoxipine as antioxidant compounds.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Chemical & Material Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Medicinal Chemistry (AREA)
  • Engineering & Computer Science (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • General Chemical & Material Sciences (AREA)
  • Chemical Kinetics & Catalysis (AREA)
  • Organic Chemistry (AREA)
  • Materials Engineering (AREA)
  • Bioinformatics & Cheminformatics (AREA)
  • Dermatology (AREA)
  • Epidemiology (AREA)
  • Communicable Diseases (AREA)
  • Oncology (AREA)
  • Pain & Pain Management (AREA)
  • Rheumatology (AREA)
  • Medicinal Preparation (AREA)
  • Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
  • Materials For Medical Uses (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
PCT/IB2004/002358 2003-07-24 2004-07-22 Treatment of lesions of the soft tissues Ceased WO2005009448A1 (en)

Priority Applications (5)

Application Number Priority Date Filing Date Title
EP04744018A EP1648419A1 (en) 2003-07-24 2004-07-22 Treatment of lesions of soft tissues
JP2006520930A JP4729488B2 (ja) 2003-07-24 2004-07-22 軟組織の損傷の処置
AU2004258736A AU2004258736A1 (en) 2003-07-24 2004-07-22 Treatment of lesions of the soft tissues
CA002533707A CA2533707A1 (en) 2003-07-24 2004-07-22 Treatment of lesions of the soft tissues
US11/337,433 US20060120993A1 (en) 2003-07-24 2006-01-23 Treatment of lesions of the soft tissues

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
RU2003123513/15A RU2245723C1 (ru) 2003-07-24 2003-07-24 Средство и способ лечения гнойно-воспалительных заболеваний мягких тканей
RU2003123513 2003-07-24

Related Child Applications (1)

Application Number Title Priority Date Filing Date
US11/337,433 Continuation US20060120993A1 (en) 2003-07-24 2006-01-23 Treatment of lesions of the soft tissues

Publications (2)

Publication Number Publication Date
WO2005009448A1 true WO2005009448A1 (en) 2005-02-03
WO2005009448A8 WO2005009448A8 (en) 2005-05-06

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2004/002358 Ceased WO2005009448A1 (en) 2003-07-24 2004-07-22 Treatment of lesions of the soft tissues

Country Status (7)

Country Link
US (1) US20060120993A1 (https=)
EP (1) EP1648419A1 (https=)
JP (1) JP4729488B2 (https=)
AU (1) AU2004258736A1 (https=)
CA (1) CA2533707A1 (https=)
RU (1) RU2245723C1 (https=)
WO (1) WO2005009448A1 (https=)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1982694A1 (en) * 2007-04-20 2008-10-22 D.M.G. Italia Srl Anti-oedema composition
JP2008538558A (ja) * 2005-04-22 2008-10-30 アール アンド エイチ ミネラルズ ビー.ブイ. 無機塩ゲル組成物

Families Citing this family (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ES2399138T3 (es) * 2006-03-16 2013-03-26 Stellaris Pharmaceuticals Aps Tratamiento local con factor VII
CA2727432C (en) * 2008-06-12 2016-10-11 Medtronic Xomed, Inc. Method for treating chronic wounds with an extracellular polymeric substance solvating system
RU2646462C1 (ru) * 2017-04-11 2018-03-05 Федеральное государственное бюджетное образовательное учреждение высшего образования "Курский государственный медицинский университет" Министерства здравоохранения Российской Федерации Средство для лечения гнойно-воспалительных процессов мягких тканей и слизистых оболочек
RU2641095C1 (ru) * 2017-04-11 2018-01-15 Федеральное государственное бюджетное образовательное учреждение высшего образования "Курский государственный медицинский университет" Министерства здравоохранения Российской Федерации Средство для лечения гнойно-воспалительных процессов мягких тканей и слизистых оболочек
RU2697669C1 (ru) * 2019-01-17 2019-08-16 Федеральное государственное бюджетное образовательное учреждение высшего образования "Курская государственная сельскохозяйственная академия имени И.И. Иванова" Ранозаживляющий гель с липосомами и способ его получения

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DE3146841A1 (de) * 1981-11-26 1983-06-01 Beiersdorf Ag, 2000 Hamburg "neue wundbehandlungsmittel"
CA2323382A1 (en) * 2000-10-17 2002-04-17 Pharma Mag Inc. Wound dressing

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JPH05117158A (ja) * 1991-10-22 1993-05-14 Sasaki Kagaku Yakuhin Kk 皮膚外用剤組成物
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Patent Citations (2)

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Publication number Priority date Publication date Assignee Title
DE3146841A1 (de) * 1981-11-26 1983-06-01 Beiersdorf Ag, 2000 Hamburg "neue wundbehandlungsmittel"
CA2323382A1 (en) * 2000-10-17 2002-04-17 Pharma Mag Inc. Wound dressing

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2008538558A (ja) * 2005-04-22 2008-10-30 アール アンド エイチ ミネラルズ ビー.ブイ. 無機塩ゲル組成物
EP1982694A1 (en) * 2007-04-20 2008-10-22 D.M.G. Italia Srl Anti-oedema composition

Also Published As

Publication number Publication date
RU2003123513A (ru) 2005-01-27
WO2005009448A8 (en) 2005-05-06
AU2004258736A1 (en) 2005-02-03
CA2533707A1 (en) 2005-02-03
EP1648419A1 (en) 2006-04-26
JP4729488B2 (ja) 2011-07-20
US20060120993A1 (en) 2006-06-08
RU2245723C1 (ru) 2005-02-10
JP2006528622A (ja) 2006-12-21

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