RU2546030C1 - Ichthyosin preparation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention can be used for the local treatment of trophic ulcers, infected and persistent septic wounds, degrees I-II-IIIA burns, traumatic skin injuries, pyoinflammatory skin diseases, bed sores, etc. The invention refers to a preparation, which contains a streptocide powder 1-2.5 g, Ichthyol ointment 7-10 g and castol oil 87.5-92 ml.

EFFECT: reducing the length of treatment up to 14 days with no side effects.

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Description

The invention relates to medicine, namely to medicines used for topical treatment of trophic ulcers, infected and long-term non-healing purulent wounds, degree I-II-IIIA burns, skin injuries due to injuries, purulent-inflammatory skin diseases, pressure sores, etc.

According to the literature in medical practice, many different drugs are known that are used in the form of medicines and in ointment, which have anti-inflammatory, wound healing and analgesic effects, used to treat various pathological processes.

All known drugs differ in chemical structure, mechanism of action and pharmacological activity.

Currently widely used drugs in the form of solutions, suspensions and ointments, the main active components of which are obtained chemically.

Analogs of the invention

The following agents and ointments are known:

1) ichthyol or ichthammol - the ammonium salt of shale oil sulfonic acids contains 10.5% organically bound sulfur, which has anti-inflammatory, local anesthetic and weak antiseptic properties. Apply in the form of 5-20% ointment for skin diseases (burns, erysipelas, eczema), etc. Moshkovsky M.D. "Medicines." - 15th ed., Rev., Rev. and add. - M., 2007. - P.955;

2) streptocid ointment 10% or liniment streptocide 5% is used to heal infected wounds, burns I-II degree, purulent-inflammatory skin diseases. Moshkovsky M.D. "Medicines." - 15th ed., Rev., Rev. and add. - M., 2007. - P.825;

3) Levosin - an ointment, in 100 g, which contains 1 g of chloramphenicol, 4 g of sulfadimethoxin and methyluracil, 3 g of trimecaine, 88 g of polyethylene oxide, which has an antimicrobial, anti-inflammatory and analgesic effect, is used to treat purulent wounds. Moshkovsky M.D. "Medicines." - 15th ed., Rev., Rev. and add. - M., 2007. - P.815;

4) levomekol - an ointment, in 100 g, which contains 0.75 g of chloramphenicol, 4 g of methyluracil, 95.25 g of polyethylene glycol, has an antimicrobial, anti-inflammatory effect. Used to treat purulent wounds. Moshkovsky M.D. "Medicines." - 15th ed., Rev., Rev. and add. - M., 2007. - P.815;

5) liniment (emulsion) of synthomycin, which contains 1%, 5% or 10% of synthomycin, castor oil, a special emulsifier, distilled water, preservative. It is used to treat purulent wounds, purulent-inflammatory skin diseases, burns of the II-III degree. Moshkovsky M.D. "Medicines." - 15th ed., Rev., Rev. and add. - M., 2007 .-- P.817.

Criticism of analogues

The disadvantages of the above medicines should recognize the following.

1. Their lack of effectiveness, since the drugs used have weak anti-inflammatory, local anesthetic and antiseptic properties.

2. Allergic reactions and other side effects may occur.

3. Many drugs have a number of contraindications and are often not recommended for use due to the possible occurrence of complications.

4. The use of ointments has limitations, since their activity manifests itself in different ways in relation to certain diseases.

5. When using them, dermatitis, skin rash, itching and irritation of the skin around the wound are noted.

6. Contraindicated: with psoriasis, eczema, fungal skin lesions, with inhibition of hematopoiesis.

7. Suppresses local immunity with certain drugs that make up ointments.

Prototype of the invention

As a prototype closest to this invention is a balsamic liniment according to A.V. Vishnevsky. Moshkovsky M.D. "Medicines." - 15th ed., Rev., Rev. and add. - M., 2007 .-- P.955.

Prototype criticism

The essence of the prototype

A.V. Vishnevsky ointment containing tar and xeroform in 3 parts, Aerosil 5 parts, castor oil 89 parts, has an antiseptic, regenerative and slightly irritating effect. Used to treat wounds, ulcers, bedsores, burns.

However, this ointment during the treatment noted the following disadvantages.

- Ointment does not have a sufficiently pronounced therapeutic effect.

- Perhaps a local irritant effect, expressed in redness of the skin or mild itching, a burning sensation.

- It is not effective enough, because it has weak anti-inflammatory, local anesthetic and antiseptic properties.

- It cannot fully provide all the conditions necessary for regeneration, such as: a balanced moist environment, activation of angiogenesis, the ability to accelerate the formation of collagen fibers, granulations and the migration of cell epithelium.

- Not effective enough in terms of removing excess exudate, preserving moisture and providing gas exchange.

The purpose of the invention

The aim of the invention is the development of a simple, affordable, cheap and effective tool with a wide range of applications. Moreover, it should be free from negative side effects, and the use should not have contraindications and should be affordable and easy to use.

The essence of the invention lies in the fact that the tool contains components known in pharmacology of drugs that are used in everyday medical practice and obtained from a state pharmacy. As components of the drugs used: castor oil 94.5-87.5 ml, streptocide powder 0.5-2.5 g, ichthyol ointment 5.0-10.0 g.

The method is implemented as follows. Preliminary assess the general and local clinical criteria of the patient, the phase of the wound process, the timing of wound cleansing, the appearance of granulations and their activity, bacteriological, cytological, planimetric indicators, etc.

The proposed tool, called "Ichthiosin" was used in the clinic for the local treatment of trophic ulcers, infected and long-term non-healing purulent wounds, burns of I-II-IIIA degrees, skin injuries due to injuries, purulent-inflammatory skin diseases, pressure sores, etc. for the first time. It is an oily composition, prepared ex tempore according to the following recipe: pour 94.5-87.5 ml of castor oil into an enameled cup, put 5.0-10.0 g of ichthyol ointment therein and pour 0.5-2.5 g of streptocide powder, mix them with a spatula. Then we put the cup together with the obtained medicinal base in a water bath at a temperature of 60-70 ° C, continue to mix thoroughly the mixture until it becomes liquid, so that all incoming medicinal components are dissolved. Remove from the water bath, pour into a disinfected glass jar with a lid. Shelf life of 6 months or more in a cool dark place. The resulting tool is used in inpatient and outpatient practice.

Before each application, a toilet of the wound surface is carried out under aseptic conditions using 3-1.5% hydrogen peroxide.

The above formulations are indicated with min and max values of the components used in the preparation.

This optimal ratio was found in numerous experiments and confirmed in clinical observations.

All components of the product are approved for use by the Ministry of Health of the Russian Federation. Moshkovsky M.D. "Medicines." - 15th ed., Rev., Rev. and add. - M., 2007 .-- 1206 p.

Separate use of the components of the drug for the treatment of trophic ulcers, infected and long-term non-healing purulent wounds, burns of the I-II-IIIA degree, skin injuries due to injuries, purulent-inflammatory skin diseases, pressure sores, etc. are ineffective. When using them in the proposed combination, a pronounced clinical effect was obtained, which is explained by the synergism of their action.

In the first (partially) and second phases of the wound healing process, the mixture is used for necrolytic, anti-inflammatory and regenerative purposes, while the concentration of active substances in it is maximum.

In the second and third phases of the wound healing process to stimulate regeneration, protect the wound surface from secondary infection and epithelization, while the concentration of active substances in it is minimal.

The tool is prepared in advance before dressing, for which they lubricate a sterile gauze or swab with a spatula and then apply it to the wound with preliminary washing with hydrogen peroxide. The frequency of dressings once a day.

Indications for the use of this agent are trophic ulcers, infected and long-term non-healing purulent wounds, degree I-II-IIIA burns, skin injuries due to injuries, purulent-inflammatory skin diseases, pressure sores, etc. partially in the first, second and third phases of the wound process. It is desirable to use it in combination with hypertonic solutions and antiseptics in the first phase of the wound process.

A contraindication is only an allergy to the components of the mixture, which our patients did not have in any case. This tool was used even with severe allergic dermatitis in the wound healing zone, microbial, fungal and eczematous dermatitis.

Using the invention allows to obtain the following technical result.

Ichthiosin is an effective combination drug for local treatment of many diseases: trophic ulcers, infected and long-term non-healing purulent wounds, burns of I-II-IIIA degrees, skin injuries due to injuries, purulent-inflammatory skin diseases, pressure sores, etc., requiring removal pain, inflammatory reaction and stimulator of regeneration. The effectiveness of the tool is ensured by the selection of components that make up its active part, and their quantity.

The terms of treatment compared with the known drugs for local treatment are sharply reduced and amount to only 14 days per course. In this case, there are no side effects, in connection with which the contingent of patients and patients has expanded.

When using this tool, a marked improvement in the general and local clinical status is observed.

The tool can be used both for treatment and for the prevention of purulent-inflammatory reaction of the wound.

The proposed drug "Ichthiosin" was tested in polyclinic No. 6, Makhachkala, Geriatric Center of the Veterans Hospital of the Ministry of Health of the Republic of Dagestan, the surgical department of the Veterans Hospital of the RMC of the Ministry of Health of the Republic of Dagestan, the burn department of the Clinical Hospital of the Ministry of Health of the Dagestan.

A clinical study of the drug was conducted on 145 patients. With all indications, a positive therapeutic effect was noted. Negative side effects were not observed in any of the cases.

The technical result is achieved due to the combined use of the components included in the ichthiosin product, which together allowed us to obtain a therapeutic drug with anti-inflammatory, analgesic and wound healing effects, which underlies its wide use in the treatment of many diseases. The authors found that the Ichthiosin product contains components in such quantities that, when used together, provide the most pronounced therapeutic effect, and the used oil base helps to effectively maintain an optimal environment for good wound healing.

The difference between the proposed tool from the prototype is that the tool contains components of drugs known in pharmacology that are used in everyday medical practice. Castor oil, streptocide powder, ichthyol ointment were used as the components of the drugs, and when combined, the proposed combination due to the synergy of their action has a pronounced clinical effect, which dramatically reduces the treatment time compared to known drugs for local treatment.

An example of a specific implementation of the method

The method proposed as an invention is used in the treatment of trophic ulcers, infected and non-healing purulent wounds, degree I-II-IIIA burns, skin injuries due to injuries, purulent-inflammatory skin diseases, pressure sores, etc. in 145 patients in the surgical department of the Hospital veterans of the RMC Ministry of Health of the Republic of Dagestan, the burn department of the Republican Clinical Hospital of the Ministry of Health of the Republic of Dagestan, the surgical room of Clinic No. 6 of Makhachkala and the Geriatric Center of the Veterans Hospital of the Ministry of Health of the Republic of Dagestan. With all indications, a positive therapeutic effect was noted. Negative side effects were not observed in any of the cases.

Example 1: Patient K ..., 73, husband. He turned with an extensive purulent wound on his right leg in the lower leg region on 05.03.2013 to the surgical department of the Veterans Hospital of the RMC MH RD. For a week, a patient with a 3% solution of hydrogen peroxide was applied a gauze napkin with Ichthiosine daily after a wound toilet. At the same time, the dressing changed once a day, in the subsequent dressing was carried out after the toilet wounds with a 1.5% solution of hydrogen peroxide every other day. Bandaging was performed without painful sensations of the patient. After 12 days, the wound healed. The patient was discharged for outpatient treatment. Upon repeated examination, a month later the wound healed with a fully tender scar.

Example 2: Patient T ..., 62, female I went to the clinic with complaints of pain in the feet. The examination revealed severe cracking of the calcaneal region, complicated by bleeding of the calcaneal region. A wound toilet was carried out according to the accepted method with a bandage with "Ichthiosine". After 3 days, the skin softened, pain and bleeding disappeared, and after 8 days from the moment of treatment, the wounds healed completely and healthy soft soft elastic skin formed in the heel region.

Example 3: Patient P. ..., 67 years old, female. Was admitted to the hospital on January 14, 2012 with a diagnosis of venous-trophic ulcer in the lower third of the right lower leg along the anteromedial surface of 112 cm ² in size, dermatosclerosis and hyperpigmentation in the lower third of the right lower leg. Local treatment with "Ichthiosinum" was carried out during the week. Every day, the patient after the toilet of the wound with a 3% solution of hydrogen peroxide was applied a napkin with Ichthiosine and external elastic compression was performed. At the same time, the dressing changed once a day. Subsequently, dressings were performed after the toilet wounds with 1.5% hydrogen peroxide solution every other day. Dressings were performed without pain. After 12 days, the trophic ulcer healed. The patient was discharged for outpatient treatment on day 18 with an almost completely healed ulcer. Upon re-examination after 6 months, the trophic ulcer healed completely with a tender scar.

Example 4: Patient X ..., 72, female I went to the surgical department of the Veterans Hospital of the RMC of the Ministry of Health of the Republic of Dagestan on 04/03/2012 with erysipelas in the necrotic stage (extensive wound) on the right leg in the ankle joint along the outer front side with severe pain cider, high fever. For a week, every day, after the toilet of the wound, a patient with a 3% hydrogen peroxide solution applied a napkin with Ichthiosine to the wound. After the first dressing, after 10-15 minutes, the pain is much reduced, and on the 3rd dressing was almost absent. At the same time, the dressing changed once a day, in the subsequent dressings were carried out after the toilet of the wound with a 1.5% solution of hydrogen peroxide every other day, the dressings were performed without pain to the patient. After 12 days, the wound healed. The patient was discharged for outpatient treatment. Upon repeated examination, a month later the wound healed with a fully tender scar.

Thus, as the treatment shows, Ichthiosin has a local anti-inflammatory effect, promotes resorption of the inflammatory process, dermatosclerosis and hyperpigmentation, exhibits analgesic and wound healing effects, which, with ease of use and the absence of side effects, allows the drug to be widely used in outpatient and inpatient settings.

Features of the invention, distinctive from the prototype

1. Means "Ichthiosin" has a fairly pronounced therapeutic effect.

2. There is no locally irritating effect, itching, burning sensation of skin and wounds.

3. The drug has a pronounced anti-inflammatory, local anesthetic, antiseptic and wound healing effect.

4. When using the proposed combination of drugs provides all the necessary conditions for regeneration (balanced moist environment, activation of angiogenesis, helps to accelerate the formation of collagen fibers, granulation and migration of cell epithelium).

5. It is quite effective in terms of protecting the wound surface, removing excess exudate, preserving moisture, providing gas exchange, improving tissue blood supply, stimulating epidermal regeneration, enhancing keratinization processes, temperature control, eliminating the development of hypoxia and atraumaticity.

The positive effect of the application of the invention

The proposed tool, unlike other currently known drugs, can improve the results of treatment of patients with a trophic ulcer, infected and long-term non-healing purulent wound, burns of I-II-IIIA degree, skin injuries due to injuries, purulent-inflammatory skin diseases, pressure sores, etc. The results obtained from the use of this tool allow you to accelerate 1.5-2 times the cleaning of the wound from a purulent-necrotic process; provide rapid elimination of pathogenic microflora due to the bactericidal action of the drug; to activate the processes of wound healing by stimulating the regeneration of multidimensional agents; reduce the degree of scar-sclerotic changes in paravasal tissues and provide optimal conditions for the mechanism of wound contraction due to the components that make up the drug.

Reducing the treatment of patients, the cheapness of the drug and its ease of use in any conditions, also favorably affects the economic effect, which allows to improve the quality of treatment for this category of patients.

Claims (1)

An agent for the treatment of purulent wounds and trophic ulcers, containing antiseptic drugs and an oil base, characterized in that it consists of drugs:
streptocide powder 1.0-2.5 g ichthyol ointment 7.0-10.0 g castor oil 87.5 - 92.0 ml