Method of treating septic wounds with using modified montmorillonite clay

FIELD: medicine.

SUBSTANCE: experimental wound is cleaned daily, first with normal saline (NaCl), and then coated with modified montmorillonite clay containing 0.1 to 4.35 wt % of silver. The preparation is introduced into the wound in an amount of 0.1 g per a wound of 1.5 cm in diameter.

EFFECT: higher rate of septic wound healing.

3 tbl, 3 dwg

 

The invention relates to the field of veterinary medicine and can be used in particular for the treatment of purulent wounds.

There is a method of treatment of purulent wounds with the use of sorbents, in particular the use of special dressing devices containing sorbents. For example, bandages Tender Wet (Germany). Tender Wet is a multilayered wound dressing comprising as sorbent polyacrylate. The sorbent before using activate ringer's solution, which for 12 hours continuously secreted into the wound. This contributes to the softening and separation areas of necrosis. Simultaneously wound exudate is absorbed by the sorbent. This exchange is due to greater affinity sorption-active layer containing protein with wound exudate, than with a saline solution, in connection with which the wound exudate displaces ringer's solution from the absorber. Dressing Tender Wet for several hours at a time irrigates the wound and removes microorganisms, tissue debris and toxins, together with the wound. Thus, the wound is washed and easy to clean. [http://www.new-info.com.ua/hartmann/hartl 01.htm]/

The disadvantage is the need for regular wetting the bandage ringer's solution, as well as the fact that it may be spontaneous bleeding.

There is a method of treatment of septic wounds according to the patent of Russian Federation №2466720, publ. 20.11.2012, where f is PS regeneration and epithelialization of the wound surface dressings, impregnated with ointment of the following composition, wt.%: silicone glycerokinase - 95,25, ciprofloxacin is 0.2, the oxytocin - 4,55. The method allows to accelerate the regenerative processes in the second and third phases of wound healing, prevent persistent infection and septic complications, shorten the treatment time. In the treatment of septic wounds, carried out in this way, complete wound healing in animals was about 16-17 days from the start of treatment.

The increasing application at the present time finding ways of treatment of purulent wounds with the use of materials containing silver ions.

Examples of treatment efficacy of silver-containing materials is given in the way of treatment with application of dressings company Urgo on the basis of lipids-colloid technology (Cellosorb NA, Cellosorb Ag, Urgotul, Urgotul S.Ag), which are headbands, created with the use of lipids-colloid technology and containing sulfadiazine [Hermelin NR. Application of dressing devices on the basis of lipids-colloid technology in local treatment of diabetic foot syndrome. Official website of the scientific-practical journal "diabetes", 2010, №3. 3/2010 3 1291. And in the article "Modern lipid-colloid dressings in treatment of trophic ulcers and nonhealing extensive wounds to the of acestei" (Dry, Dsabel, V.Vasiliev, Iagree / J. Surgeon, No. 2 // 2013), where the marked reduction in the time bandaging 4.9±0.6 minutes and the duration of inpatient treatment of patients with trophic ulcers and nonhealing extensive wounds of the extremities 7.8±3.2 days.

The closest selected for the prototype, is a method of treatment of infected wounds with natural mineral material, modified with silver, RF patent No. 2245151, publ. 27.01.2005. The method is carried out by application of a thin layer of powder containing zeolite powder Golynskogo field modified with silver, with a particle size of 17 to 20 Å. The method provides a more therapeutic effect by increasing the porosity of the zeolite and increase the area of interaction besieged in the silver surface of the wound. A complete cleansing of wounds and the beginning of the development of granulation tissue and regional epithelialization was observed for the 9th day of treatment when used to prevent contact of the wound with the environment of a special device - fixing and insulating rings.

The objective of the invention is to expand the Arsenal of methods of treatment of purulent wounds.

The technical result is to increase the speed of healing of purulent wounds through the use of modified montmorillonite-containing clay, containing from 0.1 to 4.35 mass% of silver.

The technical result is achieved by using the proposed method of treatment of purulent wounds in the experiment, including the use of natural mineral material, modified with silver, according to which the treatment of purulent wounds carried out as follows: daily pre-treated wound isotonic NaCl solution, and then on the wound surface, at a rate of 0.1 g on the wound with a diameter of 1.5 cm, make modified montmorillonite-containing clay, containing from 0.1 to 4.35 wt.% silver.

The invention is characterized by the following graphics:

Figure 1 - Graph of the dynamics of change in the number in the wound exudate in the healing process.

Figure 2 - Graph of dynamics of changes of the presence of necrotic tissue in the wound during treatment.

Figure 3 - Graph of dynamics of growth of granulation tissue in the wound during treatment.

The proposed method meets the criteria:

- "novelty", as in the prior art unknown set of features;

- "inventive step", as in the prior art unknown effect on the rate of healing of purulent wounds montmorillonite-containing clay, modified with silver ions.

Industrial applicability is confirmed by the experiments that were conducted on 40 nonlinear white Wistar rats, weighing 190-200 g

Were simulated skin and muscle wounds on the back of animals, which are then pipette introduced strains of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Proteus vulgaris and Candida albicans in fixed infecting dose of 2×108microbial bodies (by 0,5 McFarland). All rats were divided into three groups: in the treatment of the rats of the first group (I) used a modified silver montmorillonite-containing clay, containing from 0.1 to 4.35 wt.% silver, at the rate of 0.1 g on the wound with a diameter of 1.5 cm In the treatment of the rats of the second group (II) used lipidology absorption bandage Urgosorb, the third group (III) was the control. Dressing in all groups was carried out daily, pre-treating the wound surface isotonic NaCl to remove the samples deposited previously.

Throughout the experiment 1, 3, 5, 7, 10, 14, 17, 19, 21 days conducted versatile evaluation course of wound process.

Evaluation of macroscopic picture of the points presented in table 1, where 0 is the absence of exudate in the wound, 10 - maximum amount in accordance with conventional scoring from 0 to 10.

Figure 1 shows the dynamics of changes in quantities in the wound exudate in the healing process. As can be seen from table 1 and the graph in figure 1, the reduction of exudate in the wound is more in the first group of animals, where the wound was treated opredelennomu method.

Table 1
The day of the experimentI groupGroup IIGroup III
1111
3458
55710
7569
10478
14578
17457
19245
21133/td>

Table 2 shows that objectively wounds in the first experimental group were "cleaner" and the process of necrosis, and thus the cleansing of wounds from nonviable tissues has occurred much faster than in other groups. Figure 2 presents the corresponding table 2 the graph.

Table 2
The day of the experimentI groupGroup IIGroup III
1---
3+++
5+++++++
7+++++++++
10++++++++++
14-++++++++
17 -++++++
19-+++
21--+

Dynamics of growth of granulations, rich in blood vessels and young connective tissue cells developing in the healing of wounds and foci of inflammation, which multiply rapidly and replace lost tissue area, are presented in table 3, where+is the minimum amount of granulation tissue (pale, sluggish), "+++++" - granulation bright juicy, easy contact bleeding, fill in the wound, is the process of epithelialization from the wound edges.

Table 3
The day of the experimentI groupGroup IIGroup III
1---
3+--
5++-
7+++++
10++++++++
14+++++++++++
17++++++++++++
19+++++++++++++
21+++++++++++++++

The data of table 3 presents the graph 3.

The resulting experiment data indicate that the rate of "purification" of purulent wounds in group I using for the treatment of montmorillonite-containing clay was 2 times faster than in the control group III and faster 1.5 times than in group II with the use of lipids-colloidal absorption dressing.

Histomorphologically picture of the course of wound process.

Morphological changes in wounds after 1 day from the moment of contamination in the two groups n is so There are intense neutrophilic infiltration by leukocytes and their fragments, as well as deposits of fibrin, edema.

On the day 3 histological picture in the main group I differs from the compare II and test III the emergence of eosinophilic leukocytes, a large number of fibroblasts, fat cells, absence of fragments of cells.

On the 5th day in the main group I, prevails granulation tissue, newly formed blood vessels, histiocytes, fibroblasts, fat cells, which cannot be said about the comparison II and test III groups, indicating the incompleteness of the exudative phase of inflammation in them.

On the 7th day in groups I and II takes place granulation tissue, which confirms the occurrence of the 2 phases of the wound healing process. In control group, along with neutrophil white cells are macrophages, mast cells, lymphocytes, indicating the completion of only 1 phase of the wound healing process.

Also were measured temperatures (thermometry) in the wound before and after the introduction of the investigated substances using electrotermometry. Reliable data on Exo - and endothermic effect of substances have been identified.

Thus, the experimental results confirm that the rate of healing of purulent wounds in group I, under the proposed method using modified montmorillon the containing clay was faster 3 times, than in the control group III and 1.5 times than in group II.

The method of treatment of purulent wounds in the experiment using montmorillonite-containing clay, modified with silver, wherein the treatment is conducted daily, and at first the wound treated with isotonic NaCl solution, and then applied a modified montmorillonite-containing clay, which contains from 0.1 to 4.35 wt.% silver, at the rate of 0.1 g on the wound with a diameter of 1.5 see



 

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