The way to create funds for the treatment of wounds

 

(57) Abstract:

The invention relates to medicine, refers to medicines and can be used for the treatment of gunshot and infected wounds. The method of preparation tools for the treatment of wounds involves the use of polyvinylpyrrolidone containing as an antiseptic methenamine, and the composition further added vitamin E, benzoflavone in the form inclusion complexes with beta-cyclodextrin in the following ratio, wt.%: benzoflavone 2-20,0, vitamin E 2 - 20,0, polyvinylpyrrolidone 5 - 30,0, + 0,5 - 5,0, beta-cyclodextrin - rest, and the resulting complex wound healing preparation is carried out in a different dosage form aerosol, gel, sponge, tape, powder and ointment. The invention provides improved treatment of gunshot wounds and contributes to a more favorable course of the wound process. table 1.

The invention relates to medicine, refers to medicines and can be used for the treatment of wounds, particularly firearms and infected.

There are a large number of medicines used in the treatment of wounds. Widely used antiseptics and antibiotics for giving reparative processes [1 - 3].

In recent years found a significant effect on the structure formation of purulent and especially gunshot wounds, processes associated with activation of lipid peroxidation and impaired function of cell membranes. The use of antibiotics leads to a rapid adaptation of the microorganisms, the development of resistant forms, which significantly complicates the fight against infections. Created multi-component form, as a rule, affect the sorption or antimicrobial properties. Used high-molecular compounds as adsorbents - debrisan, eleven and others do not have antimicrobial and antioxidant properties, which is of fundamental importance.

The main disadvantage of these drugs is that in the treatment of gunshot wounds due to their specificity is not effective enough - a long time healing wounds, festering, etc. in Addition, these known drugs are not comfortable when using them in the field [4].

The closest to the essence and therapeutic result to the claimed remedy for treating wounds is selected as a prototype, is known wound-drug - 5% liniment dibunola that these steps in the treatment of infected wounds and trophic [5] . Experience of application of a 5% liniment dibunola showed its beneficial effect on the course of the wound process in the second phase of wound healing. The use of this drug in the early stages, severe wounds, complex wound channel, making it difficult to effectively draining wounds, which is a prerequisite for their successful treatment [6, 7].

The main disadvantage of therapeutic use of liniment dibunola is the fact that it covers the wound, creating a "greenhouse" effect, and degrades its drainage. In this regard, his ointment dosage form is mainly used in the second phase of wound process with the purpose of stimulation of reparative processes. In addition, this drug does not have an antioxidant effect that with regard to gunshot wounds is of fundamental importance, especially in the early weeks of treatment [6, 7].

The objective of the invention is to increase the effectiveness of treatment of gunshot wounds by applying a wound healing drug WHR-1.

This object is achieved in that a new comprehensive wound healing drug WHR-1 for local application in the treatment of infected and gunshot wounds. RA is a good draining properties. The combination in one product of these properties allows you to actively influence the formation of the structure of the RAS, reducing the area of secondary necrosis and contributing to a more favorable course of the wound healing process and reduce healing time.

The technical solution is that in polyvinylpyrrolidone (PVP) containing methenamine as an antiseptic, impose additional vitamin E, benzoflavone in the form inclusion complexes with beta-cyclodextrin (CD) in the following ratio, wt.%:

Benzoflavone - 2,0 - 20,0

Vitamin E - 2,0 - 20,0

Polyvinylpyrrolidone - 5,0 - 30,0

Methenamine - 0,5 - 5,0

Beta-cyclodextrin - Rest

and means for the treatment of wounds are in the form of various dosage forms of wound healing drug - aerosol, powder, ointment, gel, patch and sponges.

The use of benzoflavone in combination with vitamin E can significantly enhance antioxidant activity, and their application in the form inclusion complexes with CD gives you the opportunity to significantly increase therapeutic efficacy of anti-oxidants and use the CD as the adsorbent for draining wounds. A reduction in the content of benzoflavone and vitamin E below the claimed parameters NGOs in the first stage of the course of wound process. With the increasing content of benzoflavone and vitamin E above the claimed parameters due to the increase of CD content also reduces the effectiveness of the drug, as deteriorating wound drainage and there is suppuration. The reduction in the content of urotropine below the proposed limit reduces the antimicrobial properties of the drug, while the increase in the content of urotropine above the claimed limit causes irritation (redness of the wound). When polyvinylpyrrolidone is on the one hand as the adsorbent, on the other imparts flowability to the drug and improves contact with exposed tissues.

The best technical solution is medicinal healing drug WHR-1, the preparation of which is carried out at the following ratio, wt.%:

Benzoflavone - 2 - 20,0

Vitamin E - 2 - 20,0

PVP-VMS - 5 - 30,0

Methenamine - 0,5 - 5,0

Beta-CD - Rest

After preparation of the drug WHR-1 isolate powder, air-dried and HPLC analyze the content of benzoflavone, its oxidized form and vitamin E. the Content of benzoflavone this drug is 9.8 percent. Control over the oxidized form of exercise SPECT is rmy of benzoflavone) and 306 nm (maximum absorption of regenerative forms). This ratio should not exceed 0.05 (in example 1, it is equal to 0.03). The content of vitamin E is 12.3%.

To examine the effectiveness of a comprehensive therapeutic WHR-1 was applied standard gunshot wounds of the soft tissues of the hind limbs, standard septic wounds in the back. Gunshot wound to have a characteristic structure and included the actual wound channel, adjacent area contusion with necrotic tissue and foci of hemorrhage and next zone commonly (concussion), which had no clear-cut boundaries, and passed in intact tissue. The introduction of this drug with gunshot wounds was performed after 1 h after injury. It was studied the clinical course of wound healing and performed histological examination of the tissue around wounds. Even with a single use of the drug WHR-1 on the third day showed a clear border of necrotic and viable tissue, and the depth of the zone of primary necrosis was 45% of the control group and the area of secondary necrosis of 21%, inflammatory tissue reaction was expressed significantly less wound was slight, and the wound edges are often "stick together".

When the sustained fashion less than in control, while increasing the number of macrophages and fibroblast. In macrophages was noted CHIC-positive reaction, indicating their functional activity. In addition, in this area there was a slight decrease in lipid peroxidation (LPO), although a significant increase of peroxidase activity was observed.

Subsequent observation has been a rapid subsidence of the inflammatory response and wound healing in 80% 14 - 15 days, while in the control wounds healed after 21 days. Mortality in the study group was not observed.

Other examples of the implementation of the drug WHR-1 are summarized in table.

Example 16 (nearest equivalent): standard bullet wound through 1 h after the wound was filled with 5% liniment dibunola. Observation of the healing process was carried out during the month. In the first week of observation, the depth of the zone of primary necrosis was 35% of the control group and the area of secondary necrosis of 10%. Despite the fact that the inflammatory response was less expressed than in the control group, there was a considerable amount of seep from the wounds. Subsequent observation (the second week) preserved signs of vos is 20 21 days. Mortality in the study group is not observed.

Example 17 (control group): gunshot wound through the day had distinct signs of inflammation - increased swelling around the wound tissue, marked redness of the skin and fever, you receive the wound, disturbed function of the limb. Histological examination in the area of contusion is marked alteration of tissue, muscle fibers necrotized lose transverse striation, much swell. In addition, there is karyopyknosis and karyolysis. Visible disintegrating neutrophilic leukocytes, gemoliticaskie erythrocytes, significant colonies of microorganisms. In the area of concussion observed the predominance of degenerative processes occurring on a background of sharply altered microcirculation, the development of lymphostasis, exit from the vascular bed of cellular elements and proteins. In this zone are observed activation of lipid peroxidation, reduction of antioxidant activity. On the third day after the injury, clinically and histologically observed the formation of a zone of necrosis with severe progressive inflammation, purulent discharge, the death of some animals. In the area of concussion continue the e confirm the clinical picture and show the development of destructive changes of muscle fibers, the development of edema and lymphostasis. In subsequent acute course of the wound process is dominated by reparative processes with formation of granulation tissue and subsequent healing in a month. As can be seen from the examples, while reducing the content of benzoflavone and vitamin E below the proposed limit (examples 6 and 8) show the expansion of secondary necrosis and the development of purulent complications. Wound healing in 70% of cases there is only during the third week of observation, while in 10% of cases the death of animals. The increase in the content of benzoflavone and vitamin E above the claimed limit (examples 7 and 8) does not give a significant increase in therapeutic effect and therefore from an economic point of view is inappropriate. With decreasing content of PVP below the proposed limit (example 10) it turns out the drug WHR-1 is not in the form of a free flowing powder and lumps, which are poorly applied to the wound and therefore does not give the desired effect. The increase in the content of PVP above the claimed limit (example 11) from an economic point of view is inappropriate. Upon decrease of the concentration of hexamine below the proposed limit (example 12) increases the severity of septic complications and expanded Gras is ate (example 13) is irritating effect of the additive, in the second week, there are signs of increasing inflammation of the wound. The healing process in the third week was observed in 80% of cases. The final healing is observed only after a month. With complete exclusion of benzoflavone and vitamin E from wound healing drug (example 11) there has been a significant expansion of secondary necrosis and the development of purulent complications. The death of animals is observed in 15% of cases. With complete exclusion of the CD from the formulation of the drug (example 15) deteriorates the process of draining wounds, in the second week there is suppuration of wounds, inflammation. The wound-healing process ends only in a month. The death of animals is observed in 10% of cases.

Based on the above we can conclude that the proposed method of cooking tools for the treatment of wounds has the criteria of "novelty" and "significant differences", because the use of benzoflavone in combination with vitamin E in the form inclusion complexes with CD to get wound healing drug WHR-1 and achieve the specified task is not known, indicating the novelty of this technical solution.

Thus, the claimed remedy for the treatment of wounds is complex ranozazhivleniyu onerownim antioxidant and antiseptic action, has good drainage properties. The combination in one product of these properties allows you to actively influence the formation of the structure of the RAS, reducing the area of secondary necrosis and contributing to a more favorable course of the wound healing process and reduce the time of healing.

Sources of information

1. Wounds and wound infection. /Ed. by M. I. Cousin. - M., 1981.

2. Diagnosis and treatment of injuries. /Ed. by Y. G. Shaposhnikov. - M., 1984.

3. The first all-Union conference on wounds and wound infection. - M., 1977.

4. The second all-Union conference "Wounds and wound infection". - M., 1986.

5. Abstracts of the 2nd all-Union conference "Bioantioxidants". - Chernogolovka, Moscow. region, 1986.

6. Shaposhnikov, Y., etc. BHT in the treatment of wounds of different origin: the Abstracts of all-Union meeting "Bioantioxidants". - Chernogolovka, Moscow. region, 1983, S. 117. (similar).

7. Rudakov B. J. Prevention and treatment of infectious complications of gunshot wounds. Military the honey. Journe. N 7, 1988, S. 34 - 38 (prototyp).

The method of preparation tools for the treatment of wounds, including the use of polyvinylpyrrolidone containing as an antiseptic methenamine, characterized in that the composition further the AI components, wt.%:

Benzoflavone - 2,0 - 20,0

Vitamin E - 2,0 - 20,0

Polyvinylpyrrolidone - 5,0 - 30,0

Methenamine - 0,5 - 5,0

Beta-cyclodextrin - Rest

and perform comprehensive wound healing in the preparation of various dosage forms - aerosol, gel, sponge, tape, powder and ointment.

 

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