MD4197C1 - Method for treatment of trophic ulcers - Google Patents
Method for treatment of trophic ulcers Download PDFInfo
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- MD4197C1 MD4197C1 MDA20120091A MD20120091A MD4197C1 MD 4197 C1 MD4197 C1 MD 4197C1 MD A20120091 A MDA20120091 A MD A20120091A MD 20120091 A MD20120091 A MD 20120091A MD 4197 C1 MD4197 C1 MD 4197C1
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- oil
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- pingue
- langermannia
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- 238000000034 method Methods 0.000 title claims abstract description 22
- 208000025865 Ulcer Diseases 0.000 title claims abstract description 18
- 231100000397 ulcer Toxicity 0.000 title claims abstract description 18
- 230000001228 trophic effect Effects 0.000 title claims abstract description 15
- 239000003921 oil Substances 0.000 claims abstract description 24
- 241000684057 Langermannia gigantea Species 0.000 claims abstract description 11
- 244000010922 Plantago major Species 0.000 claims abstract description 11
- 235000015266 Plantago major Nutrition 0.000 claims abstract description 11
- 239000000203 mixture Substances 0.000 claims abstract description 11
- 239000000843 powder Substances 0.000 claims abstract description 11
- MHAJPDPJQMAIIY-UHFFFAOYSA-N Hydrogen peroxide Chemical compound OO MHAJPDPJQMAIIY-UHFFFAOYSA-N 0.000 claims abstract description 9
- 230000003449 preventive effect Effects 0.000 claims description 5
- 239000003814 drug Substances 0.000 abstract description 2
- 238000001356 surgical procedure Methods 0.000 abstract description 2
- 206010052428 Wound Diseases 0.000 description 21
- 208000027418 Wounds and injury Diseases 0.000 description 21
- 230000000694 effects Effects 0.000 description 5
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- 239000000243 solution Substances 0.000 description 5
- 102000009123 Fibrin Human genes 0.000 description 4
- 108010073385 Fibrin Proteins 0.000 description 4
- BWGVNKXGVNDBDI-UHFFFAOYSA-N Fibrin monomer Chemical compound CNC(=O)CNC(=O)CN BWGVNKXGVNDBDI-UHFFFAOYSA-N 0.000 description 4
- 229950003499 fibrin Drugs 0.000 description 4
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- 206010061218 Inflammation Diseases 0.000 description 3
- 230000009471 action Effects 0.000 description 3
- 230000000844 anti-bacterial effect Effects 0.000 description 3
- 230000002421 anti-septic effect Effects 0.000 description 3
- 238000004140 cleaning Methods 0.000 description 3
- 230000035876 healing Effects 0.000 description 3
- 230000004054 inflammatory process Effects 0.000 description 3
- 239000004615 ingredient Substances 0.000 description 3
- 210000003141 lower extremity Anatomy 0.000 description 3
- 230000009467 reduction Effects 0.000 description 3
- 230000001225 therapeutic effect Effects 0.000 description 3
- 240000005528 Arctium lappa Species 0.000 description 2
- 206010017711 Gangrene Diseases 0.000 description 2
- PEDCQBHIVMGVHV-UHFFFAOYSA-N Glycerine Chemical compound OCC(O)CO PEDCQBHIVMGVHV-UHFFFAOYSA-N 0.000 description 2
- 206010030113 Oedema Diseases 0.000 description 2
- 208000002193 Pain Diseases 0.000 description 2
- 102000035195 Peptidases Human genes 0.000 description 2
- 108091005804 Peptidases Proteins 0.000 description 2
- 238000002266 amputation Methods 0.000 description 2
- 230000003110 anti-inflammatory effect Effects 0.000 description 2
- 210000000988 bone and bone Anatomy 0.000 description 2
- 210000002808 connective tissue Anatomy 0.000 description 2
- 230000003179 granulation Effects 0.000 description 2
- 238000005469 granulation Methods 0.000 description 2
- 210000000265 leukocyte Anatomy 0.000 description 2
- 230000035800 maturation Effects 0.000 description 2
- 244000005706 microflora Species 0.000 description 2
- 239000002674 ointment Substances 0.000 description 2
- 229940024999 proteolytic enzymes for treatment of wounds and ulcers Drugs 0.000 description 2
- 230000008929 regeneration Effects 0.000 description 2
- 238000011069 regeneration method Methods 0.000 description 2
- 201000002282 venous insufficiency Diseases 0.000 description 2
- RTAPDZBZLSXHQQ-UHFFFAOYSA-N 8-methyl-3,7-dihydropurine-2,6-dione Chemical class N1C(=O)NC(=O)C2=C1N=C(C)N2 RTAPDZBZLSXHQQ-UHFFFAOYSA-N 0.000 description 1
- 206010002383 Angina Pectoris Diseases 0.000 description 1
- 241000193830 Bacillus <bacterium> Species 0.000 description 1
- 206010065929 Cardiovascular insufficiency Diseases 0.000 description 1
- 206010008909 Chronic Hepatitis Diseases 0.000 description 1
- 102000004190 Enzymes Human genes 0.000 description 1
- 108090000790 Enzymes Proteins 0.000 description 1
- CEAZRRDELHUEMR-URQXQFDESA-N Gentamicin Chemical compound O1[C@H](C(C)NC)CC[C@@H](N)[C@H]1O[C@H]1[C@H](O)[C@@H](O[C@@H]2[C@@H]([C@@H](NC)[C@@](C)(O)CO2)O)[C@H](N)C[C@@H]1N CEAZRRDELHUEMR-URQXQFDESA-N 0.000 description 1
- 229930182566 Gentamicin Natural products 0.000 description 1
- 240000000950 Hippophae rhamnoides Species 0.000 description 1
- 235000003145 Hippophae rhamnoides Nutrition 0.000 description 1
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- 235000010654 Melissa officinalis Nutrition 0.000 description 1
- 244000062730 Melissa officinalis Species 0.000 description 1
- 206010028851 Necrosis Diseases 0.000 description 1
- 229920003171 Poly (ethylene oxide) Polymers 0.000 description 1
- 210000001744 T-lymphocyte Anatomy 0.000 description 1
- 208000000558 Varicose Ulcer Diseases 0.000 description 1
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- 239000000853 adhesive Substances 0.000 description 1
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- 239000003242 anti bacterial agent Substances 0.000 description 1
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- 229940088710 antibiotic agent Drugs 0.000 description 1
- 239000003146 anticoagulant agent Substances 0.000 description 1
- 229940127219 anticoagulant drug Drugs 0.000 description 1
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- 210000004369 blood Anatomy 0.000 description 1
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- 244000309466 calf Species 0.000 description 1
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- 201000009101 diabetic angiopathy Diseases 0.000 description 1
- 201000002249 diabetic peripheral angiopathy Diseases 0.000 description 1
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- 235000011389 fruit/vegetable juice Nutrition 0.000 description 1
- 229960002518 gentamicin Drugs 0.000 description 1
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- Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
- Medicines Containing Plant Substances (AREA)
Abstract
Description
Invenţia se referă la medicină, în special la chirurgie şi poate fi utilizată pentru tratamentul ulcerelor trofice. The invention relates to medicine, especially to surgery and can be used for the treatment of trophic ulcers.
Este cunoscută metoda de tratament al ulcerelor trofice varicoase, care include asanarea ulcerului trofic de microflora patogenă şi ţesuturile necrotice, inhibarea inflamării sistemice, stimularea creşterii, maturării ţesutului conjunctiv şi epitelizarea ulcerului trofic. Componentele principale ale terapiei antibacteriene topice sunt pansamentul cu soluţii, emulsii şi unguente antiseptice care conţin diverse antibiotice, sulfanilamide şi alte preparate cu acţiune antibacteriană. După curăţarea suprafeţei ulcerului trofic se aplică diverse remedii medicamentoase ce stimulează procesele de regenerare şi contribuie la o vindecare mai rapidă a ulcerului, de exemplu: unguentul Vişnevski, balsamul Schostakovski, uleiul de cătină albă. De asemenea se utilizează enzime proteolitice ce condiţionează liza ţesuturilor necrotice şi au acţiune antiinflamatoare şi antiedemică [1]. The method of treating varicose trophic ulcers is known, which includes clearing the trophic ulcer of pathogenic microflora and necrotic tissues, inhibiting systemic inflammation, stimulating growth, maturation of connective tissue and epithelization of the trophic ulcer. The main components of topical antibacterial therapy are dressings with antiseptic solutions, emulsions and ointments containing various antibiotics, sulfanilamides and other preparations with antibacterial action. After cleaning the surface of the trophic ulcer, various medicinal remedies are applied that stimulate the regeneration processes and contribute to a faster healing of the ulcer, for example: Vishnevsky ointment, Shostakovski balm, sea buckthorn oil. Also, proteolytic enzymes are used that condition the lysis of necrotic tissues and have anti-inflammatory and anti-edema action [1].
Dezavantajul metodei cunoscute este termenul îndelungat de vindecare a ulcerului trofic. The disadvantage of the known method is the long term of healing of the trophic ulcer.
Este cunoscută, de asemenea, metoda de tratament local al ulcerului trofic, care constă în aceea că pe suprafaţa ulcerelor şi plăgilor purulente se aplică un remediu care conţine următoarele ingrediente: colagenoză, gentamicină sulfurică, polietilenoxid 1500 şi glicerină 10,0…10,1 [2]. The method of local treatment of trophic ulcers is also known, which consists in applying a remedy containing the following ingredients to the surface of ulcers and purulent wounds: collagenose, sulfuric gentamicin, polyethylene oxide 1500 and glycerin 10.0...10.1 [2].
Dezavantajul acestei metode constă în aceea că se produce o cicatrizare lentă din cauza că activitatea antibacteriană şi necrolitică a compoziţiei sus-menţionate nu este suficientă, totodată activitatea fermenţilor utilizaţi în compoziţe este limitată în timp din cauza că reacţia suprafeţei plăgii repede devine alcalină sub acţiunea secreţiilor din plagă. The disadvantage of this method is that slow healing occurs because the antibacterial and necrolytic activity of the above-mentioned composition is not sufficient, at the same time the activity of the enzymes used in the compositions is limited in time because the reaction of the wound surface quickly becomes alkaline under the action of secretions from the wound.
Mai este cunoscută metoda de tratament al ulcerelor trofice, care constă în aceea că se administrează intern metilxantine, venotonice, anticoagulante, hipotonice, vasodilatante, antihistaminice, iar local se utilizează substanţe de purificare (peroxid de hidrogen de 3%, suc de colanhoe) urmată de aplicarea bureţilor din colagen pe suprafaţa plăgii curăţate pe 1…2 zile. Durata tratamentului constituie de la 2 până la 4 luni [3]. The method of treating trophic ulcers is also known, which consists in the fact that methylxanthines, venotonics, anticoagulants, hypotonics, vasodilators, antihistamines are administered internally, and purifying substances (3% hydrogen peroxide, colanhoe juice) are used locally, followed by by applying collagen sponges on the surface of the cleaned wound for 1...2 days. The duration of treatment is from 2 to 4 months [3].
Dezvantajul metodei menţionate constă în aceea că nu este destul de eficientă, deoarece la o parte din bolnavii trataţi conform metodei date n-au fost înregistrate efecte de curăţare pronunţată, iar la 2 pacienţi cu ulcere varicoase boala s-a agravat, manifestându-se prin intensificarea durerilor în regiunea ulcerelor cu mărirea lor în volum. The disadvantage of the mentioned method is that it is not quite effective, because in some of the patients treated according to the given method, pronounced cleaning effects were not recorded, and in 2 patients with varicose ulcers, the disease worsened, manifesting itself through the intensification of pain in the region of ulcers with their increase in volume.
Problema pe care o rezolvă invenţia este reducerea termenului de tratament şi sporirea efectului curativ. The problem that the invention solves is the reduction of the treatment term and the increase of the curative effect.
Conform invenţiei, metoda revendicată constă în aceea că ulcerul trofic se prelucrează zilnic cu soluţie de peroxid de hidrogen de 3%, apoi se aplică un amestec care conţine pulbere din Langermannia gigantea, ulei din Rosae pingue L. şi ulei din Plantago major L., în următorul raport al componentelor, în % mas.: According to the invention, the claimed method consists in treating the trophic ulcer daily with a 3% hydrogen peroxide solution, then applying a mixture containing Langermannia gigantea powder, Rosae pingue L. oil and Plantago major L. oil, in the following ratio of components, in mass %:
pulbere din Langermannia gigantea 60…70 ulei din Rosae pingue L. 10…20 ulei din Plantago major L. restul powder from Langermannia gigantea 60...70 oil from Rosae pingue L. 10...20 oil from Plantago major L. the rest
totodată uleiurile preventiv se iradiază cu raze ultraviolete cu lungimea de undă de 180 nm timp de 40 min, seria de tratament constituie 45 zile. at the same time, preventive oils are irradiated with ultraviolet rays with a wavelength of 180 nm for 40 min, the treatment series is 45 days.
Datorită selectării reuşite a ingredientelor acestei compoziţii se obţine un sinergim în acţiunea lor terapeutică, efectul terapeutic fiind net superior faţă de efectele fiecărui ingredient în parte, totodată prelucrarea preventivă a uleiului din Rosae pingue L. şi uleiului din Plantago major L. amplifică acţiunile terapeutice ale acestora. Thanks to the successful selection of the ingredients of this composition, a synergism is obtained in their therapeutic action, the therapeutic effect being clearly superior to the effects of each individual ingredient, at the same time, the preventive processing of the oil from Rosae pingue L. and the oil from Plantago major L. amplifies the therapeutic actions of them.
Aplicarea locală a pansamentului cu compoziţia revendicată, conform observaţiilor noastre, duce la absorbţia moleculelor adezive aflate pe suprafaţa celulelor endoteliale, care se leagă selectiv cu anumite tipuri de leucocite (T-limfocite şi macrofage). În afară de aceasta, pulberea din Langermannia gigantea leagă metaboliţii toxici, fermenţii proteolitici şi radicalii liberi care se elimină din leucocitele active, contribuie la diminuarea inflamaţiei cronice şi stimulează procesul de epitelizare a plăgilor. De asemenea se produce legarea fibrinei, polimerizarea căreia duce la formarea în jurul capilarelor a „manşetelor fibrinice”, ceea ce accelerează procesul necrobiotic, în felul acesta se ameliorează procesul de regenerare a celulelor şi ţesuturilor. De asemenea s-a observat că pulberea din Langermannia gigantea are o acţiune antiinflamatoare, contribuie la dilatarea capilarelor şi la ameliorarea circuitului sangvin şi limfatic în ţesuturile adiacente. The local application of the dressing with the claimed composition, according to our observations, leads to the absorption of the adhesive molecules on the surface of the endothelial cells, which bind selectively to certain types of leukocytes (T-lymphocytes and macrophages). In addition, Langermannia gigantea powder binds toxic metabolites, proteolytic enzymes and free radicals that are eliminated from active leukocytes, contributes to the reduction of chronic inflammation and stimulates the epithelialization process of wounds. Fibrin binding also occurs, the polymerization of which leads to the formation of "fibrin cuffs" around the capillaries, which accelerates the necrobiotic process, thus improving the regeneration process of cells and tissues. It has also been observed that the powder from Langermannia gigantea has an anti-inflammatory action, it contributes to the dilation of the capillaries and to the improvement of the blood and lymphatic circulation in the adjacent tissues.
Avantajele metodei propuse sunt reducerea perioadei de tratament cu circa 3 luni faţă de soluţia cea mai apropiată, totodată din punct de vedere economic compoziţia aplicată este mai ieftină. The advantages of the proposed method are the reduction of the treatment period by about 3 months compared to the closest solution, at the same time, from an economic point of view, the applied composition is cheaper.
Metoda propusă se realizează în modul următor: plaga se prelucrează cu soluţie antiseptică de peroxid de hidrogen de 3%, apoi pe plagă se aplică un pansament îmbibat cu o compoziţie care conţine pulbere din Langermannia gigantea, ulei din Rosae pingue L., Plantago major L., în următorul raport al componentelor, în % mas.: The proposed method is carried out in the following way: the wound is treated with a 3% hydrogen peroxide antiseptic solution, then a dressing soaked with a composition containing Langermannia gigantea powder, Rosae pingue L. oil, Plantago major L. is applied to the wound ., in the following ratio of components, in mass %:
pulbere din Langermannia gigantea 60…70 ulei din Rosae pingue L. 10…20 ulei din Plantago major L. restul powder from Langermannia gigantea 60...70 oil from Rosae pingue L. 10...20 oil from Plantago major L. the rest
totodată uleiurile preventiv se iradiază cu raze ultraviolete cu lungimea de undă de 180 nm timp de 40 min, seria de tratament constituie 45 zile. at the same time, preventive oils are irradiated with ultraviolet rays with a wavelength of 180 nm for 40 min, the treatment series is 45 days.
Am observat că curăţarea suprafeţei plăgilor începe la a doua zi. În timpul pansamentului la a doua zi masele necrotice şi fibrina se scot în formă de peliculă. La a 3…4-a zi apar granulaţii, încetează inflamaţia perifocală, se micşorează cantitatea de exsudat, este stimulată creşterea şi maturizarea ţesutului conjunctiv şi epitelizarea ulcerelor trofice. I noticed that the cleaning of the surface of the wounds starts on the second day. During the dressing on the second day, the necrotic masses and fibrin are removed in the form of a film. On the 3rd...4th day, granulations appear, the perifocal inflammation stops, the amount of exudate decreases, the growth and maturation of connective tissue and the epithelialization of trophic ulcers are stimulated.
Metoda propusă a fost aplicată la 13 bolnavi. La toţi bolnavii s-a produs epitelizarea, iar la 4 pacienţi cu cangrenă la picior metoda revendicată a făcut posibilă prevenirea amputaţiei membrului inferior. Perioada medie de tratament al bolnavilor a constituit 1…1,5 luni, în funcţie de dimensiunile plăgilor, caracterul plăgilor, precum şi de etiologia insuficienţei venoase, ceea ce este cu mult mai puţin în comparaţie cu metoda descrisă în soluţia ceea mai apropiată, care durează până la 4 luni. The proposed method was applied to 13 patients. Epithelialization occurred in all patients, and in 4 patients with leg gangrene, the claimed method made it possible to prevent the amputation of the lower limb. The average treatment period of the patients was 1...1.5 months, depending on the size of the wounds, the nature of the wounds, as well as the etiology of the venous insufficiency, which is much less compared to the method described in the closest solution, which lasts up to 4 months.
Exemplu concret de realizare Concrete example of realization
Bolnava N, 58 ani, s-a adresat cu acuze la dureri insuportabile în regiunea plantei drepte cu eliminări necrotice purulente şi cu miros putrid, în cadrul examinării clinice s-a depistat defectul pielii pe suprafaţa anterioară a plantei (12…16 cm), acoperit cu necroză, degetul IV necrotizat cu distrugere a ţesutului osos al falangelor, edem până la treimea superioară a gambei cu hiperemie. Din plagă se elimină fibrină şi mase necrotice. S-a efectuat însămânţarea la microfloră, s-a depistat bacilul piocianic. Pe baza anamnezei şi a datelor obţinute în cadrul examenului medical s-a stabilit diagnosticul: insuficienţă circulatorie, boală ischemică a cordului, angină pectorală, boală hipertonică, diabet zaharat tip II, hepatită cronică, angiopatie diabetică, insuficienţă venoasă a membrelor inferioare, gangrena plantei drepte. Până la aplicarea tratamentului conform metodei revendicate, pacienta s-a tratat în condiţii de staţionar în raion şi de ambulatoriu timp de 5…6 luni, dar tratamentul a fost fără efect. S-a efectuat tratamentul conform metodei revendicate. Plaga a fost prelucrată cu soluţie antiseptică de peroxid de hidrogen de 3%, apoi pe plagă s-a aplicat un pansament îmbibat cu o compoziţie care conţine pulbere din Langermannia gigantea, ulei din Rosae pingue L. şi Plantago major L., în următorul raport al componentelor, în % mas.: Patient N, 58 years old, complained of unbearable pain in the region of the right plant with purulent necrotic discharges and a putrid smell, during the clinical examination a skin defect was detected on the anterior surface of the plant (12...16 cm), covered with necrosis, fourth finger necrotized with destruction of the bone tissue of the phalanges, edema up to the upper third of the calf with hyperemia. Fibrin and necrotic masses are removed from the wound. Microflora seeding was performed, the pyocyanic bacillus was detected. Based on the history and the data obtained during the medical examination, the diagnosis was established: circulatory insufficiency, ischemic heart disease, angina pectoris, hypertensive disease, type II diabetes, chronic hepatitis, diabetic angiopathy, venous insufficiency of the lower limbs, gangrene of the right plant. Until the application of the treatment according to the claimed method, the patient was treated in inpatient conditions in the district and on an outpatient basis for 5...6 months, but the treatment was without effect. The treatment was carried out according to the claimed method. The wound was treated with a 3% hydrogen peroxide antiseptic solution, then a dressing soaked with a composition containing Langermannia gigantea powder, Rosae pingue L. and Plantago major L. oil was applied to the wound, in the following ratio of components , in mass %:
pulbere din Langermannia gigantea 60…70 ulei din Rosae pingue L. 10…20 ulei din Plantago major L. restul powder from Langermannia gigantea 60...70 oil from Rosae pingue L. 10...20 oil from Plantago major L. the rest
uleiul din Rosae pingue L. şi Plantago major L. preventiv a fost supus acţiunii razelor ultraviolete cu lungimea de undă de 180 nm, timp de 40 min. the preventive Rosae pingue L. and Plantago major L. oil was subjected to the action of ultraviolet rays with a wavelength of 180 nm, for 40 min.
Treptat pe suprafaţa plăgii a apărut granulaţie vie, edemul dîn jurul plăgii a dispărut, la periferia plăgii a apărut epitelizarea fină, de aceea s-a hotărât ca pansamentul cu compoziţia dată să se aplice o dată în 2 zile. S-a continuat tratamentul timp de 8 zile, plaga s-a micşorat treptat în volum, din plagă a fost înlăturat ţesutul osos al degetului IV. Treptat toată suprafaţa plăgii a fost acoperită cu o crustă subţire, care devenea tot mai groasă. S-a observat că porţiunea cutanată în jurul plăgii a devenit de culoare roz-pal, la palpare nu era dureroasă, inflamaţia periferică a dispărut şi suprafaţa plăgii s-a epitelizat. Pacienta a evitat amputaţia membrului inferior drept. Pe parcursul următoarelor 3 luni recidive nu au apărut. Gradually, living granulation appeared on the surface of the wound, the edema around the wound disappeared, fine epithelization appeared on the periphery of the wound, therefore it was decided that the dressing with the given composition should be applied once every 2 days. The treatment was continued for 8 days, the wound gradually decreased in volume, the bone tissue of the IV finger was removed from the wound. Gradually, the entire surface of the wound was covered with a thin crust, which became thicker. It was observed that the skin portion around the wound became pale pink in color, it was not painful when palpated, the peripheral inflammation disappeared and the surface of the wound became epithelialized. The patient avoided amputation of the right lower limb. During the following 3 months, relapses did not occur.
1. Савельев В. С. Болезни магистральных вен. Москва, Медицина, 1972, с. 421-423 1. Saveliev V. С. Diseases of the main veins. Moscow, Medicine, 1972, p. 421-423
2. RU 2174389 C2 2001.10.10 2. RU 2174389 C2 2001.10.10
3. Скоринкина Л. Е., Поляков В. А., Тканевой имитатор кожи (колагеновая губка) в терапии трофических язв. Вестник дерматологии и венерологии, 1981, №5, с. 55-57 3. Skorinkina L. E., Polyakov V. A., Тканевой имитатор кожи (collagenous sponge) in therapy of trophic ulcers. Journal of dermatology and venereology, 1981, №5, p. 55-57
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| MDA20120091A MD4197C1 (en) | 2012-10-22 | 2012-10-22 | Method for treatment of trophic ulcers |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| MD1179Z (en) * | 2017-03-29 | 2018-03-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Method for treating trophic ulcers |
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