Ointment for treating bitten wounds

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention relates to pharmaceutical industry, to creation of wound-healing ointment. Ointment for treatment of bitten wounds includes lidocaine hydrochloride, sea-buckthorn oil, water-free lanolin, medicinal purified Vaseline, metronidazole, clindamycin, rifampicin and trombolisin.

EFFECT: ointment ensures accelerated passage of active substances through inter-tissue space into tissue depth and quickly suppresses various microflora in bitten wound.

The invention relates to pharmaceutical industry and is intended for use in the treatment of patients with bacterial contaminated wounds, mostly from bites inflicted by animals mammals.

The bitten wound, even shallow in the form of scratches or abrasions, usually bacterial contaminated with pathogenic microflora contained in the saliva bite [Kollontai YOU, Panchenko, M.K., Andreson M.V. Open injuries of the hand. Kiev, "Health". 1983. C. - 88]. Such wounds are often accompanied by swelling, inflammatory edema, sometimes with redness and local temperature rise due to the expansion of blood vessels after a brief spasm reflex [Novozhilov D.A. Smirnov, N.V. IN kN.: "Multi-volume manual of Orthopaedics and traumatology". Volume 3. M. Ed. "Medicine" 1968. C. - 11, 12]. When the bites inflicted on small mammals, there are often multiple, but not deep wounds that do not serve as an indication for surgical intervention. However, the onset of their infection, despite the use of known drugs, can lead to the development of an abscess, osteomyelitis, septic arthritis, meningitis, sepsis and even rabies [Kollontai YOU, Panchenko, M.K., Andreson M.V. Open injuries of the hand. Kiev, "Health". 1983. C. - 88]. High often is and infectious complications in bite wounds, cleaned in a wide range of pathogenic microflora, has led us to develop a new more efficient for external use for the treatment of patients with bites inflicted by animals mammals.

It is known to use tools for the treatment of bite wounds inflicted by mammal: copious irrigation of the wound with soap and water, the treatment of the wound with 70% alcohol [instructions MZ the Russian Federation "On the procedure of work of medical institutions and centres for state sanitary and epidemiological surveillance for the prevention of human cases of rabies", approved by Order of RF Ministry of health No. 297. October 7, 1997].

The disadvantage used in this way means you can consider treatment of the wound with 70% ethanol, causing a sharp local pain and no signs of reducing complications through new combinations and ratios of ingredients, providing accelerated passage of active substances through the interstitial space into the tissue with the more rapid and widespread suppression in the bitten wound a variety of pathogenic organisms.

It is known for the treatment of acute inflammatory diseases of the skin by the RF patent №2105546, medicated hydrocortisone acetate, preservative nipagin and - butter vaseline and vaseline in the following ratio of components in %: hidrocor ison acetate - from 0.8 to 1.15, oxytetracycline hydrochloride is 2.55-3.45 points, nipagin - 0,019-0,021, vaseline oil - 4,6-5,0, petrolatum else.

The disadvantage of this tool is the lack of evidence of a decline in complications by new combinations and ratios of ingredients, providing accelerated passage of active substances through the interstitial space into the tissue with the more rapid and widespread suppression in the bitten wound a variety of pathogenic organisms.

Known ointment anti-inflammatory and antibacterial actions for external application according to the patent of Russian Federation №2376979, which contains 1,2 - propylene glycol, polyvinylpyrrolidone, novocaine, ascorbic acid, sulfadimezin, oxytetracycline and caffeine-sodium benzoate anhydrous, in the following ratio of components: 1,2-propylene glycol 6.5 liters, polyvinylpyrrolidone 280 g novocaine 60 g of ascorbic acid 6-7, sulfadimezina 140 g, chloramphenicol 280 g, oxytetracycline 310 g and 138 g±3 g of caffeine sodium benzoate anhydrous per 1 l of solution. The ointment is used to treat wounds and skin cracks.

The disadvantage of this ointment is the lack of evidence of a decline in complications by new combinations and ratios of ingredients, providing accelerated passage of active substances through the interstitial space into the tissue with a more rapid and broad inhibition is receiving in the bitten wound a variety of pathogenic organisms.

It is known for the treatment of purulent-inflammatory diseases of the skin and soft tissues of various etiologies in U.S. Pat. No. 2326667, which contains an antibacterial substance of some fluoroquinolones, hydrophilic base and auxiliary substance. As the hydrophilic base product contains silicone glycerokinase composition Si(C₃H₇O₃)₄·xC₃H₈O₃·yH₂O, where 3≤x≤10, 20≤y≤40. As an antibacterial substance contains pefloxacin, ofloxacin, ciprofloxacin, norfloxacin, lomefloxacin, levofloxacin, moxifloxacin, sparfloxacin or enoxacin, and as excipients - chlorhexidine digluconate, lidocaine hydrochloride, sea buckthorn oil, rosehip oil or their mixture.

The disadvantage of this tool is the lack of evidence of a decline in complications by new combinations and ratios of ingredients, providing accelerated passage of active substances through the interstitial space into the tissue with the more rapid and widespread suppression in the bitten wound a variety of pathogenic organisms.

The closest in technical essence and the achieved result is described a tool for Pat. Of the Russian Federation No. 2326667 that we take for the prototype, and the drawbacks set forth above.

The technical result of the invention is glycaemia in reducing complications through new combinations and ratios in the ointment ingredients providing accelerated passage of active substances through the interstitial space into the tissue with a more rapid suppression in the bitten wound wide variety of pathogenic organisms.

The technical result of the invention is achieved in that ointment for treatment of bite wounds consists of lidocaine hydrochloride, sea buckthorn oil, as ointment bases anhydrous lanolin and vaseline cleared medical, contains metronidazole, clindamycin, rifampicin, thrombolysis, in the following ratio of components:

metronidazole - 0,25-0,5%,

clindamycin - 0,3-0,45%,

rifampicin - 0,45-0,6%,

thrombolysis - 30-36%,

sea buckthorn oil is 0.15%,

lidocaine hydrochloride - 0,1-0,2%,

anhydrous lanolin is 18-20%,

vaseline cleared medical - up to 100%.

therapeutic effect of the stated means tested over the entire range of changes in the quantity of components. The validity ointment when stored in a dark place at a temperature of from 5 to +25°C shall be ten days from the date of preparation. Use the claimed ointment applying it, for example, the spatula on the bitten wound and adjacent skin areas, or first cause its a continuous layer on a sterile cloth and then the wax surface cover the wound. Apply the ointment once a day, mainly in the first phase of wound healing.

Spiral is hydrated example in the production of medical ointments in the mass of 10 g primarily for use in small bite wounds or abrasions from bites mammals animals. Under aseptic conditions in a sterile vial measure of 0.015 g of sea buckthorn oil, sealed, sterilized at 180°C for 30 minutes. The calculated amount of the components (anhydrous lanolin - 1.8 Gy and vaseline cleared medical - 4,925 g) melted in a porcelain Cup on a water bath, filtered in a molten state through 3-4 layers of cheesecloth and sterilized for 30 minutes at 180°C. under aseptic conditions in a sterile mortar placed weighed dry active components ointment: clindamycin - 0,03 g, rifampicin - 0,045 g and metronidazole - 0,025 grams, pound and mix with the prepared sterile sea buckthorn oil (0,015 g). The mashed pulp in several techniques add chilled sterile ointment base (lanolin 1.8 Gy and vaseline 4,925 gr). In a homogeneous mass add drip lidocaine hydrochloride 0.01 ml, carefully emuleret, then add the drip thrombolysis 3.0 ml and stirred from time to time relieving ointment from the walls of the mortar and pestle with a sterile scraper to obtain a homogeneous ointment. Ready ointment placed in sterile vials and stored at a temperature of +5 - +25°C in a cool dry place for up to 10 days.

The second specific example is similar to the manufacture of medicinal ointments, but the mass of 100 g with a higher concentration of active ingredients. Components take in the following sootnoshenie is: sea buckthorn oil - 0,15 g; anhydrous lanolin - 20 gr; vaseline cleared medical - 42,1 gr; clindamycin - 0,45 g; rifampicin - 0.6 g; metronidazole - 0,45 g; lidocaine hydrochloride 0.2 ml; thrombolysis 36 ml. Keep concentrated ointment temperature +5 - +25°C in a cool dry place for up to 10 days.

A specific example of using the claimed ointment. Woman three hours ago was bitten by a cat. Complains of pain at the bite location. On the skin of the forearm are located near four small bite wounds with redness and swelling around them. The wound and the surrounding skin of the forearm washed with soap and water, dried with a sterile swab and smeared a thin continuous layer designed ointment with subsequent daily bandage change with ointment. When viewed on the third day the redness of skin wounds and no swelling. The wound healed without complications.

The rationale for the use of ingredients in the claimed ointment. The use of purified anhydrous lanolin due to its good absorption in the tissues of the body, and with it the active ingredients. It is characterized by inertia, neutrality and stability during storage, do not go rancid, has a cooling and anti-inflammatory effect, and it is widely used for the manufacture of ointments [www.wikipedia.ru; www.wikiznanie.ru] as ointment bases.

The presence of local anesthetic tools - lidocaine hydrochloride - m is beleno fact, that, in comparison with novocaine, he is faster, stronger and longer lasting [Mashkovsky PPM Medicines. Manual for doctors. Volume 1, 14th edition, M: LLC "New wave". Ed. Sbbbb. 2002. C. - 294].

The introduction of the claimed ointment medical vaseline due to its viscosity, mutualrespect, aseptic and hydrophilic properties. It expands the pores, increasing their permeability, increasing the penetration of active drug substances in the tissue. Its ability to absorb large quantities of water and leave on the surface of the body sticky oily difficult to wash away plaque that holds in itself the drugs prolong their therapeutic effect [www. wikipedia. EN].

Included in the claimed ointment sea buckthorn oil has antimicrobial, antioxidant and cytoprotective effect and protects from damage cellular and subcellular membranes due to the presence of fat-soluble bioantioxidants, stimulates reparative processes in the skin, accelerates the healing of damaged tissues and has a restorative effect [www.webapteka.ru/drugbast/name 4539 html].

The significance of differences invented ointment is the following. All bite wounds consider bacterial contaminated and infected - in the presence of local signs of bacterial inflammation. Installation is Leno in bite wounds often streptococci, staphylococci, bacteroids and other anaerobes, anaerobic bacteria, gram-negative Bacillus [Managing bites from humans and other mammals. DTB 2004; 42(9): 67-70; Treatment of bite wounds. Published: Wednesday, may 25, 2005 - 08:55]. In scientific literature, we have not identified a single universal remedy against such a diversity of pathogenic microorganisms in the bitten wound that led us to create a new ointment with more targeted combination of various ingredients for external use it when bitten wound.

In the composition of ointments as active substance included metronidazole, as an effective antibacterial drug with a wide spectrum of action. It has a high penetrating power, achieving bactericidal concentrations in most tissues and fluids of the body, including the skin. Metronidazole interacts with deoxyribonucleic acid cells of microorganisms by inhibiting the synthesis of nucleic acids, which leads to the death of bacteria [http://www.reanimatolog.ru/fs_instr.php?id=254]. Metronidazole has high activity against anaerobic microorganisms, obligate anaerobic bacteria and some encountered in the mammalian bites gram-positive bacteria: Ebacterium spp., Peptostreptococcus spp. and other microflora [ru.wikipedia.org/wiki/metronidazol]. However, it is etronidazole not sensitive aerobic microorganisms and facultative anaerobes [http://amt.allergist.ru/metronidazol_l.html], therefore the claimed added ointment clindamycin.

Clindamycin by inhibiting the protein synthesis of bacteria in the microbial wound, has both bacteriostatic and bactericidal action. He is highly active against aerobic gram-positive and anaerobic microorganisms: staphylococci, gram-negative Haemophilus ducreyi; anaerobic: Actinomyces spp.; Bacteroides spp., Clostridium spp. and other Clindamycin is characterized by a large volume of distribution of the fluids and tissues of the body, but it is not effective against the causative agent of rabies [http://ru.wikipedia.org/wiki/clindamycin]. This disadvantage is compensated entered in the claimed ointment rifampicin.

Rifampicin is a semisynthetic antibiotic derivative of rifamycin, but with a broader antibacterial spectrum, bacteriostatic, and in high concentrations bactericidal action. It penetrates well into tissues and body fluids, active against intracellular and extracellular microorganisms are. Especially active it against gram-positive microorganisms: Staphilococcus spp., including Staphylococcus epidermidis and multiple steady; Streptococcus spp., Clostridium spp., and gram-negative microorganisms such as Haemophilus [http://amt.allergist.ru/309_b.html]. Active it is also relatively fast and etiology of anaerobes, microaerophilic gram-positive cocci, including Peptotreptococcus spp., Bacteroides spp.; Fusobacterium spp. Rifampicin has virulotsidnoe effect on the rabies virus, inhibits the development rabicheskogo encephalitis [http://woman.winsov.ru/medicines/ml470.html].

In the claimed therapeutic agent entered thrombolysis obtained from the umbilical cord of the newborn. It contains the enzyme hyaluronidase, which causes an increase in tissue permeability and facilitate the movement of fluids in the interstitial spaces [Milinevsky IV, Milinevsky N.A., Nikitin, V.P., Baturin I.E. ParameterName introduction of drug thrombolysis in the treatment of exudative otitis media. Vestnik of Kemerovo scientific center. Issue # 9 "Modern approaches to prevention, diagnosis, and treatment of cerebrovascular diseases. "Current health". Kemerovo. 2009]. Such properties thrombolysis accelerating the passage of active substances in the tissues and their more rapid and profound effect on the microflora. Thrombolysis serves also as a biogenic stimulator (RF patent No. 2154477).

Thus, the claimed ointment includes a set of compatible antibiotics that impact virtually all pathogens, especially in the early exudative phase of wound healing in the bitten wound caused mammal. Together the active ingredients of the ointment provides faster movement of pieces of the participating substances through the interstitial space into the tissue and longer local therapeutic effects. Bite wounds require emergency care. The use of antibiotics without knowing what pathogenic microflora present in the wound, not all cases can give the desired result. Obtaining the same results of laboratory studies of the microflora of the wound takes a lot of time. Therefore, early use of the claimed ointment, acting on a wide range of pathogenic microorganisms, accelerates the effect of treatment. Invented ointment extends the choice of treatment of patients with bite wounds. Its application is possible at the scene by the victim himself or employee of a medical emergency, which accelerates the start of treatment, reducing the frequency of complications and creates economic effect.

Ointment for treatment of bite wounds, including lidocaine hydrochloride, sea buckthorn and a base, characterized in that it further contains metronidazole, clindamycin, rifampicin, thrombolysis and as the basis of the anhydrous lanolin and vaseline cleared medical in the following ratio of components, %: