Local Wound Treatment Research Articles

STRUCTURAL AND FUNCTIONAL CHARACTERISTICS OF THE THYMUS OF RATS WITH ALLOXAN DIABETES AT DIFFERENT METHODS OF TREATMENT OF DEEP PURULENT WOUNDS OF THE LOWER LIMBS

The treatment of purulent wounds in patients with diabetes mellitus is a difficult and urgent problem of the modern medicine. The disruption of the immune status is one of the pathogenetic links of the cascade of pathological processes with purulent wounds in patients with diabetes mellitus. The aim of the study is to revealing the features of the morphological and functional reorganization of the thymus in various methods of the treatment of purulent wounds against the background of alloxan diabetes under experimental conditions. The therapeutic efficacy of the drug miliacylum and EHF-therapy was studied in 128 white outbred albino rats to whom simulated the wound process of the hind limbs against the background of alloxan diabetes. In 32 rats of the main group, miliacylum and EHF-therapy were used in the local treatment of wounds. In 32 animals of the first control group, wounds were not treated. Wounds in 32 rats of the second control group were treated with miliacylum. In 32 animals of the third control group, EHF-therapy was used in the treatment of wounds. We were conducted histological and immune-cytochemical studies of the thymus in animals of all groups on the 7th, 14th, 21st and 28th day of treatment. The terms of the healing of purulent wounds in animals against the background of alloxan diabetes, in the main group were 11.91 ± 0.28 days, which is statistically significantly shorter than the terms in animals that were treated only with miliacylum (13.88 ± 0.26 days), and in animals who were not treated or used only EHF-therapy (more than 28 days). In the analysis of a series of histological preparations of the thymus, an atrophy of the thymus parenchyma (of the cortex and of the medullary substance) was found, in combination with hyperplasia of the interlobar perivascular spaces with a simultaneous increase in the proportion of adipose tissue. However, the phenomenon of accidental involution was less pronounced in animals of the main group than in rats of the control groups. Treatment of purulent wounds with miliacylum and EHF-therapy provides not only optimization of reparative processes in the wound area, but also limits the involution of the thymus gland and, thus, prevents disturbances in the central organ of immunogenesis.

Pathomorphological features of wound process in the experiment

The aim — to study the pathomorphological features of wound process in the experiment under the influence of developed applicational sorbent.Materials and methods. The research was held on 40 adult white rats‑males line Vistar. Purulent wounds were modeled on them. The animals were divided into two groups: main and comparative. In the main group (20 rats), the local treatment of wounds was carried out using up‑date application sorbent, which included aerosil and immobilized ornidazole and serratiopeptidase. The second group consisted of two subgroups. Each subgroup had a total of 10 rats. In group A the treatment was carried out with application sorbent hentaxan and in group B we used 10 % NaCl solution and ointment levomekol.Results and discussion. Fourteens days after, the main group animals showed a completely epithelized wound surface that was covered with multilayer squamous epithelium and under it the fibrous connective tissue had grown, the vessels were formed and apoptosis reaction was negative. In group A the surface of the wound was with fibric purulent layers. The granulation tissue area was narrowed and the quantity of capillary structures were reduced, the cells with apoptosis were accumulated. In the group B the surface of the wound was covered with a small quantity of necrotic detritus of local infiltration. The purulent exudate was formed and spread on granulation tissue. The apoptosis was moderate.Conclusions. The main group indicated first signs of endotheliocyte proliferation with capillary generation and granulation tissue formation and epithelium formation were more than 1.5 times earlier than in comparative group.

Glucocorticoid-loaded liposomes induce a pro-resolution phenotype in human primary macrophages to support chronic wound healing

Glucocorticoids are well established anti-inflammatory agents, however, their use to treat chronic inflammatory diseases is limited due to a number of serious side effects. For example, long-term local treatment of chronic wounds with glucocorticoids is prohibited by dysregulation of keratinocyte and fibroblast function, leading to skin thinning. Here, we developed and tested liposome formulations for local delivery of dexamethasone to primary human macrophages, to drive an anti-inflammatory/pro-resolution phenotype appropriate for tissue repair. The liposomes were loaded with the pro-drug dexamethasone-phosphate and surface-modified with either polyethylene glycol or phosphatidylserine. The latter was used to mimic phosphatidylserine-harboring apoptotic cells, which are substrates for efferocytosis, an essential pro-resolution function. Both formulations induced a dexamethasone-like gene expression signature in macrophages, decreased IL6 and TNFα release, increased secretion of thrombospondin 1 and increased efferocytosis activity. Phosphatidylserine-modified liposomes exhibited a faster uptake, a higher potency and a more robust phenotype induction than polyethylene glycol-modified liposomes. Fibroblast and keratinocyte cell cultures as well as a 3D skin equivalent model showed that liposomes applied locally to wounds are preferentially phagocytosed by macrophages. These findings indicate that liposomes, in particular upon shell modification with phosphatidylserine, promote dexamethasone delivery to macrophages and induce a phenotype suitable to support chronic wound healing.

MEDICAMENTAL THERAPY IN THE TREATMENT OF POSTOPERATIVE WOUNDS PERINEUM AND ANAL CANAL

AIM. Postoperative wounds of the anal canal and perineum, even small in volume, heal long enough. Along with the local treatment of such wounds in some cases, it is effective to prescribe medications for oral administration, in particular venotonic drugs. In the State Scientific Center of Coloproctology from November 2016 to March 2017, a study was conducted to evaluate the efficacy of Venarus for the treatment of postoperative wounds perineum and anal canal METHODS. The study included 113 patients diagnosed with hemorrhoids. In some patients, along with hemorrhoids, there were concomitant diseases - a chronic analfissure or fistulas of the rectum. The main group consisted of 59 people who were treated with Venarus, and 54 people in the control group. The evaluation methods included clinical examination, profilometry, cytological examination of print smears, quality of life of patients on the QoL SF-36 scale before surgery, on discharge and on the 28th day after surgery. In each group, patients were included, homogeneous in terms of key indicators. RESULTS. Patients in the main group needed significantly fewer non-narcotic analgesics after surgery. The pain level in the first 4 days of the patients of the main group against the background of the ongoing therapy with the Venarus drug was significantly lower in comparison with patients receiving only traditional local treatment. The level of reliability was directly dependent on the stage of hemorrhoids - the more the stage of hemorrhoids was, the higher the level of reliability. In patients in the control group, hyperthermia was significantly longer than in the main group - 1.61 ± 0.11 and 1.22± 0.10, respectively (p<0,008). In clinical evaluation of postoperative period, minimal edema in the postoperative wound area or infiltrate after sclerotherapy of internal hemorrhoids was preserved in 81.5 % of patients even on day 28, whereas by this time in all 100 % of patients of the main group of edema in the wound area was not observed. At the cytologic examination, no significant inflammatory infiltration was registered in the patients of the main group already 15 days after the operation, whereas in 50 % of patients in the group only cytological signs of active inflammation (p<0.0001) remained in the group with only local treatment. On day 28, in 100 % of patients in the main group, no signs of inflammation were present, and in 74.1 % of the control group there were still signs of minimal inflammation (p<0.00001), Application ofVenarus ultimately affected the quality of life patients - physical and mental, because a significant reduction in pain, as well as inflammatory wound reaction led to a faster recovery. Especially the differences in the quality of life were manifested on day 28 after the operation (p<0,001).

Регенерация глубоких резаных ран кожи при различных вариантах местной терапии

Актуальность. Глубокие резаные раны являются одной из наиболее распространенных травм при авариях и, по-прежнему, остаются глобальной проблемой общественного здравоохранения. Несмотря на многочисленные успехи в терапии ран, все еще существует необходимость поиска и разработки новых препаратов для их местного лечения. Цель - определить возможности применения местной терапии трансглютаминазой микробного происхождения (МТГ) с вспомогательной экспериментальной субстанцией авторской фитомази при моделировании полнослойных резаных ран на основании изучения особенностей морфогенеза регенераторных процессов кожи. Методы. В эксперименте на 150 белых мышах самцах исследована динамика регенераторных процессов кожи в группах: без лечения; при использовании препарата Солкосерил и авторской фитомази; а также ее комбинации с ферментом МТГ в различных концентрациях. Применяли комплекс морфологических методов, направленных на изучение структуры кожи на органном, тканевом, клеточном и субклеточном уровнях организации: макроскопический метод - для описания и измерения размеров повреждений; гистологические методы на светооптическом уровне - для качественной оценки морфологических преобразований кожи; метод трансмиссионной электронной микроскопии - для выявления ультраструктурных преобразований различных клеток эпидермиса и дермы. Результаты. Наиболее эффективным препаратом для заживления полнослойных резаных ран по итогам визуальной оценки и гистологического исследования является комбинация фитомази с МТГ в концентрации 0,1%, что подтверждается остановкой кровотечения и образованием фибринового сгустка в 3 раза быстрее, чем в других экспериментальных и контрольной группах; ранним началом эпителизации (на 3 сутки эксперимента), окончательным завершением регенераторных процессов к 10 суткам, что свидетельствует о перспективах использования трансглютаминаз в хирургии и эстетической медицине. Заключение. Применение инновационной методики местной терапии глубоких резаных ран кожи ферментом микробной трансглютаминазой с вспомогательной экспериментальной субстанцией авторской фитомази характеризуется ранним началом эпителизации, что свидетельствует о перспективах использования трансглютаминаз в хирургии и эстетической медицине. В то же время, механизмы репарации должны быть дополнительно исследованы в серии клинических испытаний. Background. Deep cut wounds are one of the most common injuries in accidents and still remain a global public health problem. Despite much success in treatment of wounds searching for and developing new medicines for local treatment are still relevant. The study objective was to test a possibility of local treatment with microbial transglutaminase (MTG) supplemented with an auxiliary experimental substance of the author’s herbal ointment by studying morphogenesis of skin regenerative processes on a model of full-thickness cut wounds. Methods. We studied the dynamics of skin regenerative processes using the following groups: no treatment; a standard treatment with the medicine Solcoseryl in combination with the author’s ointment; the ointment alone; and the ointment in combinations with the enzyme MTG at different concentrations. A set of morphological methods was used for studying the skin structure at organ, tissue, cell, and subcellular levels in experiments on 150 white male mice. The methods included macroscopic description and measurement of skin lesions; histological methods at the light-optical level for qualitative evaluation of skin morphologic changes; and transmission electron microscopy for identifying ultrastructural transformations of different epidermal and dermal cells. Results. Visual evaluation and histological study showed that he most effective treatment for healing of full-thickness cut wounds was 0.1% MTG as evidenced by arrest of bleeding and formation of a fibrin clot, which occurred three times faster than in other experimental and control groups; an early onset of epithelialization on day 3 of the experiment; and the completion of regenerative processes by day 10, which suggested prospective benefits of using transglutaminases in surgery and aesthetic medicine. Conclusions. The innovative local treatment of deep cut wounds of the skin with microbial transglutaminase supplemented with an auxiliary experimental substance of the author’s herbal ointment is characterized by an early onset of epithelization, which suggested prospective benefits of using transglutaminases in surgery and aesthetic medicine. At the same time, mechanisms of reparation need further investigation in clinical trials.

Investigation of physical-chemical indices of complex action cream for treating wounded process of wounded servicemen

The aim of the work was to study the physical-chemical parameters (colloid stability, thermal stability, osmotic activity, homogeneity and pH) of a complex action cream for local treatment of wounds, with subsequent establishment of compliance with State Pharmacopoeia of Ukraine requirements for this dosage form.Materials and methods. In carrying out experimental studies, the authors used active pharmaceutical ingredients - metronidazole, miramistin (gift sample from Dr. Reddy's labs, Hyderabad, India), anesthesine (Merck, Germany), plant extracts (Aromatika, Ukraine) and auxiliary substances - propylene glycol, glycerol (Loba Chemie Pvt. Ltd., Mumbai, India), polyethylene oxide-400, monoglycerol stearate, cetostearyl alcohol, vaseline oil (Sigma-aldrich, Germany).Physical-chemical parameters of the cream were determined according to generally accepted procedures according to State Pharmacopoeia of Ukraine.The studies were carried out in five series (five samples each). Statistical processing of the results was carried out with the help of Statistica 6.0 package (StatSoft Inc., USA).Results. In vitro experiments using dialysis through a semipermeable membrane, it was determined that the test samples exhibit osmotic activity for 24 hours. After 24 hours exposure, the osmotic activity is 110.7 ± 4.23% and 118.3 ± 4.9%, respectively, for samples of placebo cream and cream. Screening of data on the determination of acid-base balance showed that the pH values of all the test samples of the cream lie in the range from 6.5 to 7.5 and correspond to the pH of the wound. The test to determine the uniformity of the cream showed that all samples are uniform at different storage temperatures for 24 months.Experimental studies of the thermo- and colloidal stability of the cream samples, obtained both immediately after manufacture, and those stored for 24 months under natural conditions and at temperatures recommended by State Pharmacopoeia of Ukraine, showed that no separation was observed in one tube. All samples were stable during storage, which is especially important for emulsion systems.Conclusions. Physical-chemical studies have shown that colloid stability, thermal stability, osmotic activity and pH of the cream meet the established requirements for this dosage form.

Evaluation of the results of local treatment of donor site wounds in patients with deep burns

Цель. Оценка эффективности лечения ран донорских участков кожи в условиях собственной жидкой среды у пациентов с глубокими ожогами.&#x0D; Методы. В исследование вошли 135 пациентов с глубокими ожогами, которым выполняли свободную аутодермопластику расщеплёнными трансплантатами. Средний возраст пациентов составил 52,4±1,5 года. Распределение по полу: мужчин - 89 (65,9%) пациентов, женщин - 46 (34,1%). В основной группе (n=74) лечение ран донорских мест осуществляли плёночными влагосберегающими повязками DDB-M. В группе сравнения (n=61) лечение выполняли с помощью влажно-высыхающих марлевых повязок с раствором йодофоров в сочетании с дополнительными методами физического высушивания ран. Оценку эффективности методов лечения ран донорских участков проводили с помощью анализа клинико-лабораторных данных, бактериологических, цитологических, морфологических исследований, а также статистических методов.&#x0D; Результаты. В структуре осложнений со стороны ран донорских мест при лечении традиционным способом преобладает нагноение - 23,7% больных, а при лечении плёночной влагосберегающей повязкой DDB-M преобладает кровотечение - 12,2%. Эпителизация в основной группе (n=74) наступала в среднем на 2 дня раньше, чем в группе сравнения (n=61), разница статистически значима (U=146,0; p=0,000).&#x0D; Вывод. Лечение ран в условиях собственной жидкой среды служит эффективным способом, так как достоверно сокращает сроки эпителизации; существенный недостаток данного способа - отсутствие гемостатической профилактики кровотечений из ран донорских мест в послеоперационном периоде, что может ухудшить его течение, особенно у пациентов с тяжёлыми ожогами.

Evaluation of local treatment of donor sites wounds in patients with deep burns

To assess the impact of local treatment of donor sites wounds in patients with deep burns on the frequency of complications and to identify the main risk factors of complications of donor sites wounds. There were 486 patients with deep burns who underwent split-thickness skin grafting. Treatment of donor sites wounds was carried by using of moisture-controlled dressings DDB-M in the main group (n=56). Conventional approach including once imposed wet-to-dry gauze bandages was applied in the control group. We identified the structure of complications of the donor sites wounds and the main risk factors of suppuration.

The Analysis of the Treatment of Rhabdomyolysis by Snake Bites

Objective: To explore the treatment measure of rhabdomyolysis caused by snake bites, and provide guidance for further prevention and control of snake bites. Methods: To retrospectively analyze the 841 cases of serpentine bites in our hospital from January 2006 to July 2017; 127 cases of patients with rhabdomyolysis syndrome were screened out, and their clinical manifestations, laboratory results, related treatment and prognosis were analyzed. Results: 127 cases patients were rhabdomyolysis out of 841 cases, 28 cases patients developed acute renal failure; treatment measures included local wound treatment, application of tetanus antitoxin, anti-snake venom serum, anti-infection, fluid “hydration” and diuretic, alkaline urine and hybrid renal replacement therapy. 112 cases were cured, improved conditions in 9 cases, 3 cases of death, 3 cases uncured. The improvement rate of is 95.26% after treatment. Conclusion: The rhabdomyolysis had a high incidence in snake bite patients, severe cases often developed acute renal failure. Serum myopsin and related biochemical blood tests could be used to diagnose rhabdomyolysis quickly. Combined treatment methods are the main measure to increase the cured rate and decrease the death rate.

Genetic parameters of wound healing in patients with neuropatic diabetic foot ulcers

Background. Tissue repair processes are impaired in diabetic foot ulcers (DFUs). Previous research has shown that glycaemic control, cytokines and growth factors play an important role in wound healing. Emerging evidence also suggests that genes play a role via their regulation of cell proliferation, collagen synthesis and granulation tissue formation.&#x0D; Aim. To evaluate collagen genes expression in different stages of wound healing in patients with DFUs.&#x0D; Materials and methods. Prospective study included four patients with neuropathic DFUs after surgical debridement. Tissue samples were taken for morphological and genetic tests on days 0, 10 and 15 of local treatment to evaluate expression of collagen genes (i.e. COL1A1, COL1A2, COL3A1) and to perform morphological tests.&#x0D; Results. The present study confirmed that the size of wounds decreased by 8.8 7% after 10 days of local treatment and by 18.3 8% after 15 days of local treatment. According to histological examination of wound biopsies at day 10, all patients showed a tendency for lower levels of inflammatory infiltrate, increased number of fibroblast-like cells, presence of maturing granulation tissue and emergence of connective tissue fibres. After 15 days, we detected inflammatory infiltration in the wounds, despite the formation of mature granulation tissue. According to results of genetic analysis on day 10 of local wound treatment, we found a tendency for increased expression of collagen genes relative to the baseline: COL1A1 increased by 3.2 1.3 times, COL1A2 by 2.0 1.0 times and COL3A1 by 1.25 1.1 times. On day 15 of local treatment, in contrast, we found a tendency for decreased expression of COL1A1, COL1A2 and COL3A1 relative to the baseline (1.7 0.6, 2.5 2 and 20.0 3 times, respectively).&#x0D; Conclusions. The expression of collagen genes (COL1A1, COL1A2, COL3A1) is more pronounced in proliferation phase and is subsequently reduced towards the end. These data were confirmed by morphological study and clinical pictures.

Results of local treatment of postoperative wounds in patients with acute paraproctitis

Background. In patients operated for acute paraproctitis, the postoperative period has its own peculiarities. The main of them is that topographiсal anatomy of perineal zone allows performing mechanical necrectomy to the limits of healthy tissues only in part. The purpose of our study was to evaluate the effectiveness of using acerbin and oflocain ointments in one group and levomekol in another group of patients during local treatment of surgical wounds after acute paraproctitis. Materials and methods. For local treatment of perineal wounds in the first phase of the wound process, patients of the main group from the first day after the operation used acerbin in ointment. At the same time, oflocain ointment was used in these patients for local treatment of anal canal. In comparison group, local treatment of purulent wounds of the perineum and anal canal was carried out with levomekol or levosin in ointments. When evaluating the local signs of the course of purulent-destructive process, we have took into account the results of cytological and bacteriological studies. Results. Elimination of microbial contamination of wounds in patients of the main group was more intense than in the comparison group. After 7–10 days of local treatment, complete bacteriological wound healing occurred in 35.7 % of patients in the main group. In the control group, complete bacteriological wound healing occurred only in 17.2 % of patients, which is 2.1 times less than in the main group of patients. The transition of the wound process to the second phase in patients of the main group was observed after 7–9 days, and in the control group it was after 9–11 days. According to our data, patients in the comparison group were staying in the hospital for 19.70 ± 0.43 days, in the main group — 14.8 ± 0.6 days (p &lt; 0.01). Conclusions. Application of acerbin and oflocain in ointments during the local treatment of wounds in patients after surgery for acute paraproctitis substantially accelerated wound healing and improved the results of treatment.

Characteristics of Microbiocenosis of Wounds in Patients with Skin and Soft Tissue Infections on the Background of Type II Diabetes Mellitus

Relevance. Assessment of microbiocenosis of wounds in patients with infections of the skin and soft tissues is an integral part of the complex of diagnostic measures carried out for patients of this nosological group, which allows predicting the severity of the course of the purulent inflammatory process and monitoring the effectiveness of the selected method of systemic and local treatment.&#x0D; Objective: To assess the microbiocenosis of wounds in patients with infections of the skin and soft tissues against the background of type II diabetes mellitus and the effectiveness of using a local, directed flow of the ozone-oxygen gas mixture.&#x0D; Materials and methods. A qualitative and quantitative assessment was made, an analysis of the antibiotic resistance of the microbial composition of wound biopsies in 90 patients in three clinical groups. The first group consisted of patients with background type II diabetes mellitus who underwent local wound sanation with an ozone-oxygen gas mixture as the local treatment, the second and third groups consisted of patients receiving basal therapy as a topical treatment. However, in the second group, type II diabetes mellitus was registered in patients, while in the third group there were patients without it.&#x0D; Results and discussion. Based on the results of the microbiocenosis assessment, it was found that in patients with background type II diabetes mellitus, in addition to representatives of staphylo-, strepto-, enterococci and enterobacteria, nonfermentative Gram-negative bacteria were significantly more often from the biopsy specimens of the wounds, which were represented by acinotobacteria. Significantly higher in the first two groups methicillin-resistant strains of staphylococci were verified. Along with the difference in the qualitative composition of the pathogens in the study groups at the time of admission, pathogens of the purulent-inflammatory process in patients with background diabetes mellitus type II showed a high primary antibiotic resistance to the main classes of antimicrobial agents.&#x0D; Also, in the patients of the first group, a significantly lower incidence of secondary surgical interventions resulted from the persistence and superinfection of wounds from the data of the dynamic microbiological evaluation of the causative agents.&#x0D; Key words: skin and soft tissue infections, type II diabetes, purulent wounds, ozone, local treatment of wounds.

Traumatic Cerrebral Fungus: Experience From an Institution in North East India

Background:Traumatic brain fungus is manifestation of neglected head injury. Although rare it is not uncommon. The patients are usually intact with good Glasgow coma (GCS) score inspite of complex injuries and exposed brain parenchyma but morbidity and mortality is very high with time if no proper and timely management is offered. There is very less study on traumatic brain fungus with no defined management protocols. So an attempt was made to explain in details the surgical strategies and other management techniques in patients with traumatic brain fungus.Aims:To study and evaluate the pattern of causation, clinical presentations, modalities of management of traumatic brain fungus and outcome after treatment.Methods:All patients with fungus cerebri, admitted to our centre from January 2012 to December 2015 were studied prospectively. All the patients were examined clinically and triaged urgently for surgery. CT head was done in all patients to look for any brain parenchymal injury. All patients were managed surgically. Outcome was assessed as per the Glassgow Outcome Score.Results:Total 10 patients were included in the study. 8 were men and 2 women. The patients’ ages ranged from 3-48 years (mean 31.6 years). The interval between initial injury and protrusion ranged from 3 days to 6 days (mean 4.1 days). Mean GCS at the time of presentation was 13.2.60% of the patients (n = 6) sustained moderate head injury. (GCS-9-13). Size of the fungus ranged from 5cm×3cm to 8cm×10cm.Conclusion:Early and proper local wound treatment prevents fungus formation. Pre-emptive antibiotics, AEDs and cerebral decongestants are recommended. Loose water-tight duroplasty prevents CSF leak. But mortality and morbidity can be reduced significantly if brain fungus is managed properly by applying basic surgical principles and antibiotic protocols combined with newer surgical modalities.

A comparative evaluation of the antimicrobial activity of local antiseptics in revision hip arthroplasty.

In our study there is presented information on the research of antagonistic activity of medications octenidine, decamethoxine, dioxydine, myramistin, povidone-iodine, chlorhexidine in standard dosage form and in dilution (1:1 and 1:5) on microorganisms: S. aureus, S. epidermidis, S. haemolitycus, P. aeruginоsa, E. agglomerans, E. coli isolated from patients in revision hip arthroplasty. A considerable bacrteriostatic and bacreticidal activity of investigated medications on microorganisms was shown. The investigation of antagonistic activity of medications was conducted by the “well” method according to methodological guidelines for experimental (pre-clinical) investigation of medic inal product s for local treatment of purulent wounds. As a solid nutrient solution there was used Mueller-Hinton agar, in which we made cavities with diameter of 8 mm where experimental medications (0,01 ml) were put . As experimental test-cultures there were used main clinical strains of microorganisms (S. aureus, S. epidermidis, S. haemolitycus, P. aeruginоsa, E. agglomerans, E. coli) isolated from patients, receiving treatment in the department of orthopaedics N 2, I.I. Mechnikov regional clinical hospital. 0.9% physiologic saline was used a s a control. C hlorhexidine, octenidine, dioxydine, decamethoxine and povidone-iodine undiluted and in dilution 1:1, cause b actericidal effect on staphylococcus , in dilution 1:5 – bacteriostatic effect. Myramistin has practically no effect on staphylococcus. Dioxydine and octenidine in initial dilution have a steady bactericidal effect on E. coli and P. aeruginosa and in dilution 1:1 only dioxydine has bactericidal effect. Chlorhexidine and povidone-iodine have bacteriostatic effect on E.coli and P. aeruginosa. In dilution 1:5 only dioxydine has a bactericidal effect on E. coli and P. aeruginosa. For E. agglomerans only dioxydine in standard dosage form and in dilution 1:1 and 1:5 has bactericidal effect 36mm, 33mm and 25 mm accordingly. But octenidine in a standard dosage form has bactericidal effect on E. agglomerans and in dilution 1:1 – bacteriostatic. Other medications have no effect on E. agglomerans. Antimicrobal effect in a standard dosage form on the greatest amount of experimental microorganisms strains was in octenidine and dioxydine; in dilution 1:1 – in octenidine and dioxydine on enterobacteria, on staphylococc i – chlorhexidine, octenidine and dioxydine; in dilution 1:5 – the maximal effect on enterobacteria was in dioxydine and on staphylococc i in chlorhexidine.

Treatment of purulent wounds with wound dressing on a foamy basis with Hydrofiber technology

to evaluate the effectiveness of modern approaches to the treatment of purulent wounds with the use of foam-based wound coatings with the Hydrofiber technology in comparison with the traditional method of wounds. An analysis of the results of treatment of 34 patients with purulent wounds of various etiologies was performed. Patients were divided into two groups: control and basic. In the main group, local treatment of wounds was carried out using a foam-based wound coating with Hydrofiber technology. In the control group, local treatment of wounds was carried out using traditional methods with the use of gauze bandages. With the use of foam-based wound coatings with Hydrofiber® technology, the inflammation process in the wound and surrounding tissues is more rapidly eliminated, the periods of purification and microbial decontamination in the purulent focus are reduced.

Experimental Evaluation of the Efficacy of Sodium Selenite as a Remedy for Wounds

Relevance. Emergencies, both of natural and anthropogenic origin, are accompanied by a large number of injuries and wounds, the treatment of which is associated with great difficulties due to frequent infectious complications and lethargic repair of damaged tissues. Promising approach to this problem is the use of antioxidants to reduce the severity of inflammation and stimulate repair. Intention. To evaluate the efficacy of topical application of the antioxidant composition based on selenium for acceleration of reparative processes in woundу. Methods. Experimental studies were carried out on 45 male Wistar rats. Wounds in rats were modeled under ether anesthesia by up to 4 cm excision of a pre-depilated area of the skin of the back to the underlying fascia. Wounds were treated by daily dressings with 0.5 % sodium selenite vs dimethyl sulfoxide solvent as a comparator. The presence and nature of the inflammatory reaction, the condition of edges and bottom of wounds, time to cleaning out necrotic tissues and the appearance of granulation, the nature of granulation tissue, time to the onset of epithelialization of wounds and the general condition of animals, the cytogram of wound prints, and the activity of antioxidant protection enzymes were evaluated in rats. Results and Discussion. It has been established that local use of sodium selenite has a stimulating effect on reparative processes in the wound due to increased activity of antioxidant enzymes. Thus, after 6-day treatment. sodium selenite increased catalase activity by 18.1 %, glutathione peroxidase by 63.2 %, glutathione reductase by 46.1 % compared to ointment with dimethyl sulfoxide. It was revealed that enhanced antioxidant protection of wound tissues accelerates maturation of granulations and wounds heal 1.6 times faster than in the control group. Conclusion. Medicinal compositions with sodium selenite are promising for local treatment of wounds.

A Community based cross sectional study of dog bites in children in a rural district of Tamil Nadu

Background: Worldwide dog bites are becoming a significant public health problem and the annual frequency of dog bite injuries in children is estimated to be 22 per 1000 children of which less than half of them are reported in medical facilities. Objective: To study the period prevalence of dog bites in children, its risk factors and treatment seeking behavior. Materials and Methods: The present cross sectional study was conducted in field practicing areas of rural health centre covering 4150 households in 34 villages involving 5841 children. Data was collected by trained medical interns and social workers. Collected data was entered and analyzed using EPI_INFO software (3.5.3). Result: The period prevalence of dog bites episodes in last one year is 17.9 per 1000 children. Most of bites happened in male children (51.5%), less than 10 years of age (56%), and children below poverty line (80%). Almost 78% of bites are unprovoked and the most common place of bites is in and around the house (70%). The most common site of bite is lower limb (53.6%) followed by upper limb (27.6%). The most common treatment source for bites is primary health centre followed by traditional faith healers. Almost 67% of wounds belonging to class 3 wounds but only 4% of dog bite victims received immunoglobulins. Conclusion: Period prevalence of dog bites is high and it is common in children belonging to poor socioeconomic conditions. In a country with very high population of unvaccinated dogs, health education program focusing on prevention of dog bites, correct methods of local wound treatment, vaccine, and rabies immunoglobulin’s are needed.

APPLICATION OF NEGATIVE PRESSURE IN THE LOCAL TOPICAL TREATMENT OF OPEN SURGICAL WOUNDS IN PATIENTS WITH PYLONIDAL DISEASE

AIM to improve results of treatment of patients pylonidal disease. PATIENTS AND METHODS. Thirty two patients with pylonidal disease had a wide excision with postoperative wounds left open. The patients were allocated into 2 groups: in the main group a local negative pressure was used for management of postoperative wounds, while in the control group ointment dressings was used only. Groups were well matched by age, stage of the process and the area of the surgical wound. RESULTS. The use of local negative pressure in the topical treatment of open surgical wounds allowed to reach complete recovery in the main group on 32 ± 5 POD, while in the control group it lasted 41 ± 7 days. No recurrences of the disease in both group were detected. CONCLUSION. Application of the negative pressure in the local topical treatment of open surgical wounds after excision of pylonidal disease accelerates wound healing, helps to avoid the development of suppuration and provide an earlier recovery.

Comparative evaluation of the intensity of reparative processes in the lower extremity soft tissues of diabetic patients receiving local negative pressure wound treatment and standard wound care

To study the intensity of soft tissue repair in patients with diabetic foot syndrome (DFS) during local negative pressure wound treatment versus standard wound care. The investigators estimated the clinical (wound sizes, local tissue oxygenation), histological (light microscopy), and immunohistochemical (CD31, CD68, MMP-9, and TIMP-1) markers for reparative processes in patients with DFS during vacuum therapy versus standard wound care. Forty-two patients with the neuropathic and neuroischemic (without critical ischemia) forms of DFS were examined after debridement. In the perioperative period, 21 patients received negative pressure wound therapy and 21 had standard wound care. During vacuum therapy, the area and depth of wound defects decreased by 19.8±7.8 and 42.8±5.6%, respectively (p=0.002) (as compared to the baseline data). In the control group, these indicators were 17.0±19.4 and 16.6±21.6% (p=0.002). There was a significant intensification of local microhemodynamics according to transcutaneous oximetry readings in the negative pressure wound treatment group. After 9±2 days of treatment, histological examination of granulation tissue revealed a significant reduction in edema, cessation of inflammatory infiltration, and formation of mature granulation tissue in Group 1. Immunohistological examination indicated a more obvious increase in the count of macrophages (CD68 staining) and a significant increment in the number of newly formed vessels, as evidenced by anti-CD31 antibody staining. During the treatment, there was a decline of the expression of MMP-9 and an increase in that of TIMP-1, as compared to those in the control group. The findings are indicative of the enhanced intensity of reparative processes in patients with DFS during vacuum therapy versus standard wound care, resulting in more rapidly decreased wound sizes, increased local microhemodynamics, reduced inflammation, and accelerated wound transition from the inflammatory to the proliferative phase.

Factors associated with prolonged duration of post-tympanoplasty local treatment in adult chronic otitis media patients: A retrospective observational study using a Japanese inpatient database.

The occurrence of persistent infection following tympanoplasty has been reported in many studies, and it is important to know the risks for site infection after tympanoplasty. In this study, we aimed to explore the factors affecting early wound complications after tympanoplasty for chronic otitis media. We conducted a retrospective cohort study using the Diagnosis Procedure Combination database. Data on a total of 13,094 adult patients from 420 acute-care hospitals who received tympanoplasty for chronic otitis media from 2010 to 2013 were extracted. The duration (days) of postsurgical local wound treatment was measured as an outcome, because this duration was assumed to be prolonged by the existence of wound infection. The associations between treatment duration and background characteristics (age, sex, body mass index, smoking status, diabetes mellitus, use of antithrombotic agents, with or without cholesteatoma, duration of anesthesia, academic hospital or not, and hospital volume) were assessed by multivariable linear regression analyses, fitted with a generalized estimating equation to adjust for within-hospital clustering. The median treatment duration in each hospital was 8 days (interquartile range: 7-11). Factors significantly associated with longer treatment duration were: older age (0.2 days for 10-year increase), use of antithrombotic agents during hospitalization (1.8 days), and prolonged duration of anesthesia (vs. <120min of anesthesia, additional 1, 2, 3, and 4 days for 120-179, 180-239, 240-299, and ≥300min of anesthesia, respectively). Body mass index and smoking status were not significantly associated with treatment duration. Older age, antithrombotic agents during hospitalization, and longer anesthesia time were independently associated with early local wound complications after tympanoplasty for chronic otitis media.