Method of treating superficial thermal burns

FIELD: medicine.

SUBSTANCE: affected areas of skin are coated with dressings impregnated with therapeutic preparations containing 1.0-2.0% hypromellose, an antiseptic specified in a group: 4% boric acid, 0.05% chlorhexidine, 1% iodopyron and 2% lidocaine hydrochloride. At the stage of wound exudation on the second or third post-injury day, the dressings impregnated with 2.0% hypromellose, the antiseptic specified in the group: 4% boric acid, 0.05% chlorhexidine, 1% iodopyron, and 2% lidocaine hydrochloride are used and changed once a day. At the stage of proliferation, the dressings impregnated with 1.0% hypromellose and the antiseptic specified in the group: 4% boric acid, 0.05% chlorhexidine, 1% iodopyron are used and changed every 2 days. At the stage of epithelisation, the dressings impregnated with 1.0% hypromellose and the antiseptic specified in the group: 4% boric acid, 0.05% chlorhexidine, 1% iodopyron are used and changed every 3 days until the wound surface is completely epithelised.

EFFECT: invention provides the humid environment on the burn wound surface which stimulates wound epithelisation and prevents the infectious complications.

1 ex

 

The invention relates to medicine, namely to surgery, traumatology, combustology and can be used for the treatment of superficial thermal burns.

Among all types of injuries burns constitute more than 5%. In the Russian Federation the annual number of patients registered in medical institutions, with thermal injury is more than 450 thousand people. In recent years there has been a tendency to increase the proportion of victims with deep and extensive burns due to increased number of natural and man-made disasters, which leads to massive inflows of patients with thermal injury (VV Azoles, VA Zhigalov, Ponomarev M.A., 2002). Almost all the victims with deep burns is surgical treatment, which requires up to half of patients (A.A. Alekseev, V. Lavrov, 2008).

Among all operations conducted in patients with thermal burns, the principal remains autodermoplasty split skin grafts, which ranges from 56,3 up to 90% of all surgical interventions in burn units and centres (BS Varies, V.M. Burmistrov, 1986; A.A. Alekseev, V. Lavrov, 2008).

Clinical manifestations burns. Burns first degree, manifested in the form of hyperemia, enough to cool the damaged skin and apply any ointment with anesthetic properties. Clinches the e manifestations are from several hours to two days.

When the II degree burns is the care of the bubbles, they are emptied puncture and aspiration or incision at the base, then the dome bubble will form on the wound, forming a natural bandage for 2-3 days. The infection produces toilet wounds, removal of necrotic tissue, dressing with antiseptic solution, you can add antibiotics. In phase cleansing wounds to the epithelization used water-soluble ointment base. As in the open procedure with early epithelization use vaseline or ointment on a fat basis. If the bandage clean and dry, and tightly adjacent to the underlying tissues, they are not removed, and treated with ointments, adding aseptic bandage.

Burns IIIA degree clinical symptoms are swelling, redness, large confluent vesicles with serous or jelly-like content. When downed the epidermis wounds pale pink or red with scanty discharge, when pressed on the wound she pales. First aid, like burns, I and II degree, in the future if adequate treatment of the formed surface scab, which is self-epithelialization 14-20 day. When suppuration or inadequate therapy is "deepening" burn with the formation of granulating wounds.

Burns IIIB degree occur with prolonged exposure to thermal agent. Going on the t education primary scab different density and color (from pale grey to black). While clearly distinguishable and do not disappear when pressed thrombosed vessels. On the periphery of burn scab severe swelling and redness, you may receive the secondary trophic bubbles. Pain sensitivity is reduced or absent due to the death of nerve endings. Ligation carried out with solutions of antiseptics for preventing sepsis (solutions itaperuna, chlorhexidine, boric acid and so on). Subsequently remove the scab with the formation of granulating wounds and holding autodermoplastiki.

Burns IV degree carry out the same activities that burns IIIB degree. When charring produce emergency amputation or early necrectomy followed by autodermoplastiki.

New treatments burnt fundamentally different from the methods that were adopted for another 10-15 years ago. Modern treatment for burns is aimed at preventing possible infectious complications.

There is a method of local treatment of burns, characterized by the fact that before ligation of preparing a suspension (a mixture of skin and placenta) from the rate of 1 g tissue to 8-9 ml of saline or ringer's solution, the treatment is carried out during bandaging, starting with 1-3 days after injury until complete epithelialization of burn wounds, and after the usual toilet on a burn wound on ladywood sterile wipes, impregnated with a suspension of fetal human tissues with different ratios of skin and placenta, respectively, from 1:9 to 9:1 depending on the stage of the course of wound healing, bandaging, exercise daily or every other day (patent RU 2122416, 1998).

There is a method of treatment of infected wounds, which can be used in the treatment of burns, which consists in surgical and mechanical wound debridement, drainage and irrigation, restoration operations, local drug therapy. Washing is carried out once with an aqueous solution of bilastine (choleragen-toxoid or cholera vaccine) a concentration of 0.25 to 0.8 person-doses/ml for 3-5 days, local drug therapy is carried out by applying to the wound dressing with an aqueous solution of bilastine the same concentration 24-48 hours for 5-8 days (patent RU 2128518, 1999).

A known method of complex antibacterial treatment of burn generalized infection by local and parenteral exposure to antiseptics and antibiotics in patients with deep and superficial burns, namely, that the wound in 1-3 days is applied in the form of vlazhnovysyhayuschih bandages solution "Butal"within 4-10 days on the wound every other day cause the ointment "Butanol", in subsequent periods ointment "Botolan", with superficial burns to full the th epithelialization, and with deep burns after surgery - how agressively to debride, to prepare wounds for the autodermoplasty; simultaneously with local treatment with 1 to 12 day administered Ceftriaxone, IV, 2 g per day, and Galavit, intramuscularly, on the first day, 200 mg, and 2-12 day 100 mg / day (patent RU 2302859, 2007).

There is a method of local treatment of burn wounds, characterized by the fact that apply antiseptic solution: 1% solution of itaperuna, iodophenol and ointments - levocin, levomicol, 5% dioxidea, toxicol, itapiranga. To prepare wounds for the autodermoplasty "Alginat". Parenteral use antibiotics: pefloxacin, ciprinol, zanolin, and immunocorrector - sandoglobulin (Alekseev A.A. Burn sepsis: diagnosis, prevention, treatment, abstract. Diss. Doc. the honey. Sciences, M., 1993.).

The closest in technical essence and the achieved result is a method for the treatment of burn wounds, lies in the fact that topically on wounds impose dressing with antiseptic solution during exudation, ointments during periods of proliferation and epithelialization (Paramonov B.A., etc. Burns: a Guide for physicians. SPb.: Spec lit, 2000. - 480 C.). The disadvantage of this method is the lack of effect of treatment of burn wounds in a wet environment with the use of antiseptic solutions and ointments that slows down the process of epithelialization, and in the process of treatment is Jovovich RAS choice of means for the local impact of extensive and requires constant change of drugs.

The objective of the invention is to develop a method of local treatment of patients with thermal lesions, creating optimal conditions for epithelization and accelerate healing of superficial burn wounds.

Technical result achieved the claimed invention is to create a moist environment at the surface of burn wounds, promotes stimulation of epithelialization of burn wounds while maintaining high efficiency of the treatment and in the prevention of infectious complications.

To achieve the technical result in the treatment of superficial thermal burns which includes applying to the affected areas of dressings impregnated with pharmaceutical preparations according to the invention, as drugs for impregnation imposed on the wound dressings use 1.0 to 2.0% solution hypromellose, antiseptic selected from the group: 4% boric acid solution, 0.05% chlorhexidine, 1% solution of itaperuna, and 2% lidocaine hydrochloride, and in the stage of exudation of the wound process in the second, the third day after injury use a bandage soaked in a 2.0% solution of hypromellose, antiseptic agent, selected from group: 4% boric acid solution, 0.05% chlorhexidine, 1% solution of itaperuna, and 2% solution of lidocaine hydrochloride, and the changing of the bandages holding the 1 time per day, in the stage of proliferation using bandages soaked in a 1.0% solution of hypromellose and antiseptic selected from the group: 4% boric acid solution, 0.05% chlorhexidine, 1% solution of itaperuna, and change dressings spend 1 every 2 days, in the process of epithelialization use a bandage soaked in a 1.0% solution of hypromellose and antiseptic selected from the group: 4% boric acid solution, 0.05% chlorhexidine, 1% solution of itaperuna, and change dressings spend 1 every 3 days until complete epithelialization of the wound surface.

Burns first degree indication for use of the claimed method of treatment of thermal burns is not installed. Burns II-IIIA degree after stopping severe exudation from the surface of wounds on the second, the third day after the heat defeat in the process of wound surface impose bandages from 1.0 to 2.0% solution of hypromellose, antiseptic selected from the group: 4% boric acid solution, 0.05% chlorhexidine, 1% solution of itaperuna and a local anesthetic of 2.0% lidocaine hydrochloride.

In the stage of exudation of the wound healing process change bandages with these solutions is carried out 1 time per day. In the stage of proliferation dressing burn wounds II-IIIA degree make bandages with a 1% solution hypromellose and these antiseptics 1 every 2 days, in the process of epithelialization dressing about the W ill result armbands with a 1% solution hypromellose and these antiseptics 1 every 3 days until complete epithelialization of the wound surface.

Spent an analysis of the prior art, including searching by the patent and scientific and technical information sources, and identify sources that contain information about the equivalents of the claimed method, has allowed to establish that the petitioners have not found a similar, characterized by signs, identical to all the essential features of the claimed method.

Therefore, the claimed combination medicinal product meets the criterion of "novelty."

To verify the conformity of the method of the prior art, the applicants conducted an additional search of the known solutions to identify signs that match the distinctive features of the prototype of the characteristics of the claimed invention.

The search results showed that the claimed invention not apparent to the expert in the obvious way from the prior art, certain applicants have identified no impact envisaged the essential features of the claimed method transformations to achieve a technical result.

Therefore, the claimed invention meets the criterion of "inventive step".

The authors proved that the proposed method for the treatment of superficial thermal burns, including ligation by applying bandages with a 2.0% solution of hypromellose, antiseptic and m is the local anesthetic in the stage of exudation 1 time per day, in the stage of proliferation bands with a 1% solution hypromellose and antiseptic 1 every 2 days, in the process of epithelialization dressing with 1% solution of hypromellose and antiseptic 1 time in 3 days, creates a moist environment at the surface of burn wounds to stimulate epithelialization of burn wounds, accelerates the healing of superficial burn wounds while maintaining high efficiency of the treatment and the prevention of infectious complications.

Therefore, the claimed invention meets the criterion of "industrial applicability".

The claimed method was treated 7 patients with superficial burns in MBUS GKB №18 of Ufa. In all cases, was achieved this technical result.

The invention is illustrated by the following example.

The patient was admitted to the burn Department MBUS GKB №18 of Ufa with a diagnosis of burn II - IIIA extent of the right lower limb 12%. After stopping severe exudation from the surface of wounds on the second, the third day after injury in the process of wound surface applied bandages: a 2.0% solution of hypromellose, antiseptic selected from the group: 4% boric acid solution, 0.05% chlorhexidine, 1% solution of itaperuna, and a local anesthetic to 2.0% lidocaine hydrochloride.

In the stage of exudation of the wound healing process change bandages with these solutions spend the 1 time per day. In the stage of proliferation shift bandages for burn wounds II-IIIA degree held bandages soaked in a 1% solution of hypromellose and these antiseptics 1 every 2 days, in the process of epithelialization change bandages conducted bandages soaked in a 1% solution of hypromellose and antiseptic 1 every 3 days until complete epithelialization of wounds.

The proposed method is easily reproducible in the hospital and when it is achieved the specified technical result, which is to create a moist environment at the surface of burn wounds, promotes stimulation of epithelialization of burn wounds while maintaining high efficiency of the treatment and in the prevention of infectious complications.

The method of treatment of superficial thermal burns which includes applying to the affected areas of dressings impregnated with pharmaceutical preparations, characterized in that the quality of medicinal products for impregnation imposed on the wound dressings use 1.0 to 2.0% solution hypromellose, antiseptic selected from the group: 4% boric acid solution, 0.05% chlorhexidine, 1% solution of itaperuna, and 2% lidocaine hydrochloride, and in the stage of exudation of the wound process in the second, the third day after injury use a bandage soaked in a 2.0% solution of hypromellose, antiseptic selected from the gr is PPI: 4% solution of boric acid, 0.05% chlorhexidine, 1% solution of itaperuna, and 2% solution of lidocaine hydrochloride, and the change of dressing is carried out 1 time a day, in the stage of proliferation using bandages soaked in a 1.0% solution of hypromellose and antiseptic selected from the group: 4% boric acid solution, 0.05% chlorhexidine, 1% solution of itaperuna, and change dressings spend 1 every 2 days, in the process of epithelialization use a bandage soaked in a 1.0% solution of hypromellose and antiseptic selected from the group: 4% boric acid solution, 0.05% chlorhexidine, 1% solution of itaperuna, and change dressings spend 1 every 3 days until complete epithelialization of the wound surface.



 

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