Abstract

This article presents experimentally proved scientific-practical methods of developing modern vulnerary medical preparations in the form of an ointment with antibacterial, anti-inflammatory and anesthetic properties for the purposes of military medicine. In pursuit of the designated goals, the authors used modern methods of research: pharmacological-technological, physical-chemical, structural-mechanical and biological methods – for proving the compound of the combined ointment including ofloxacin, nimesulide and lidocaine. On the basis of the research conducted, we proved the content and rational technique of the complex antimicrobial ointment with anti-inflammatory and anesthetic effect using ofloxacin (0.05 g), nimesulide (1.0 g) and lidocaine (4.0 g). We experimentally established the optimal content of the main component of the ointment: emulsive base of mixture of Polyethylene Oxide-400 and Polyethylene Oxide-1500 (1 : 4) and a complex of emulsifiers of the first and the second generations – cetostearylic alcohol – 3%, monoglyceryl stearate – 5% at the constant concentration of paraffin oil – 20%, which involves a certain temperature regime during preparation, a sequence of introducing active pharmacological ingredients and adjuvants to the water and oil phases, frequency and duration of mixing. Physical-chemical tests of the ointment base determined the optimum concentration of glycerine as 5%, which encourages elimination of purulent discharge from damaged tissues, causing an anti-inflammatory effect and providing a prolonged, but milder dehydrating effect. The relation between physical-chemical, rheological, biopharmaceutical properties of the developed preparation and the concentration and method of introduction of the active pharmaceutical ingredients was theoretically and experimentally proven. We conducted pre-clinical studies (in vivo) for defining the therapeutic efficiency of the ofloxacin-nimesulide composition in the compound of the developed ointment for complex treatment of the wound process. We studied the specific activity (anti-alternative – model of standard tissue wounds in rats), which allowed us to establish the optimum concentration of nimesulide, which is 1%. Biopharmaceutical studies (in vitro method) determined the optimum method of introducing ofloxacin, nimesulide and lidocaine in the ointment base as a solution in dimethyl sulfoxide. To select an anesthetic substance for the ointment, the authors conducted a comparative study on the anesthetic effect of the anesthetics most widely available in Ukraine: novocaine, dicainum, lidocaine, trimecainum and pyromecainum. The research conducted on the time it took for the anesthetic effect to occur and on the duration and extent of the effect enabled us to select a 4% concentration of lidocaine anesthetic for the preparation. The choice of the temperature regime for the ointment’s preparation was proved. The in vitro method and rheological studies determined that the optimum temperature regime for the technological process of preparing the ointment on the emulsive base is 25–30 ºС. The development and introduction of the new combined ointment on a contemporary hydrophilic ointment base into practical pharmacy would lead to an enlargement in the nomenclature of the medical preparations used for local treatment of the purulent – necrotic phase of the wound process, which is relevant for pharmaceutical technology and global medical science and practice.

Highlights

  • In the course of the Anti-Terrorist Operation in Ukraine, gunshot and combined wounds dominate in the structure of sanitary casualties among the combatants; two thirds of these are limb wounds, combined wounds and head wounds, all of which require urgent and high quality medical treatment, including use of modern highly-efficient wound-healing preparations

  • The aim of this article is to present research focused on the scientific grounding and development of a modern Ukrainian-made medical preparation with a complex effect for local treatment of wounds, in the form of an ointment, capable of anti-bacterial, antiinflammatory and local anesthetic effect, and which does not require frequent changes in the treatment of wounded military personnel

  • As cell cultures recommended by the National Pharmacopoeia of Ukraine (Hryzodub et al, 2015), etalon test strains from the American Type Culture Collection were used (USA): Escherichiа coli ATCC 10536, Klebsiella pneumoniae АТСС 10031, Pseudomonas aeruginosa ATCC 27853, Candida albicans АТСС 885/653, Proteus vulgaris 4636, Clostridium реrfringens A28 (BP6K), Staphylococcus aureus АТСС 25923, Bucillus subtilis АТСС 6633 and strains of the same microorganisms, selected from patients with pathological purulent-inflammatory processes

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Summary

Introduction

In the course of the Anti-Terrorist Operation in Ukraine, gunshot and combined wounds dominate in the structure of sanitary casualties among the combatants (around 86.9%); two thirds of these are limb wounds, combined wounds and head wounds, all of which require urgent and high quality medical treatment, including use of modern highly-efficient wound-healing preparations. Groups, and require urgent elimination of the development of the microflora in the wound, creating optimum conditions for the wound process to develop into the regeneration phase (Cardinal et al, 2009; Healy and Freedman, 2010). Of pharmaceutical safety and allow efficient local treatment of wounds in accordance with the stage of the wound process (Atiyeh et al, 2009; Hotz et al, 2010). The importance of developing wound-healing preparations with complex effects is conditioned by the increase in the number of post-operational infectious complications, resistance of microorganisms to antibiotics, changes in immune-biological responsiveness of the macroorganism, etc. (Dohmen, 2008; Cardinal et al, 2013)

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