RU2093126C1 - Surgical dressing - Google Patents

Abstract

FIELD: medicine, in particular, heat injure healing dressing. SUBSTANCE: surgical dressing is made from polyethylene film with mixture of talc and drug preparations applied to one side of film. Polyethylene film is provided with rows of rectangular openings having sides of 1 mm and 3 mm and spaced one from another by distance of 1 mm. Rows of openings define rectangles having continuous surface with side sizes of 100 and 200 mm. EFFECT: increased efficiency by accelerated healing of heat injures and reduced treating time.

Description

 The invention relates to medicine, specifically to the production of dressings that can be used to treat burns.

 With traditional methods of treating burns of 3-4 degrees, local treatment is started after the patients are taken out of shock with a toilet on the burned areas of the body. It is performed in the operating room after preliminary administration of pain medications to the patient. The skin around the burn is wiped with napkins moistened with 0.5% ammonia solution or soapy water, dried and treated with alcohol. Then, with a gauze ball moistened with an antiseptic solution or 0.25% novocaine solution, foreign bodies, scraps of the epidermis are removed from the burned surface. After the toilet, burns are treated with wet-drying and ointment dressings (see "Big Medical Encyclopedia", M. Publishing House "Soviet Encyclopedia", 1981, v.17, p.231).

 The use of traditional dressings in the treatment of burns requires the preparation of burned surfaces before dressing, the use of painkillers for toilet wounds, because these procedures are very painful, dressings dry to the surface of the wounds, injure granulation and young epithelium, wound infection is often observed. Healing is accompanied by skin scars and scarring.

 Known dressing material DDB (dressing, dressing, dr.R.Breitman), made of plastic film coated with Breitman complex powder. Breitman's powder is a mixture of 95% talc and 5% of drugs taken in equal proportions: cephalolexin, streptomycin, erythromycin, terramycin, tetracycline, vibromycin, syntomycin, neomycin, kanamycin, nystatin, dactarin, canesten and rivanese (see. surgical congress "Wounds, burns, dressings", Israel, Tel Aviv, 1990, pp. 86-87 and 114).

 Known dressings DDB devoid of the disadvantages of traditional dressings, because Under the film, special moist conditions are created that contribute to the dissolution of the necrotic layers of the surface of a deep burn. Necrotic crusts do not transform, the burn surface does not dry out and the lesion does not deepen. Dressings are painless, the use of painkillers is not required, local treatment of the affected surface begins immediately, because no preparation of the wound surface is required for applying a film dressing.

 Under film dressings with a mixture of drugs, the healing of burns is much faster and the healing time is shortened by about 40% compared with treatment with traditional means. When using film dressings, an organism with fairly extensive burns almost does not lose protein and fluid through the surface of the burn, the burn wound does not become infected. These conditions allow for burns of degrees 3A, 3AB to avoid skin transplantation surgery, which is necessary with traditional treatments.

 The disadvantages of the known dressing material DDB is the lack of drainage ability, because in cases of abundant discharge from the wound surface, the patient feels certain inconvenience when using film dressing due to leakage of these discharge from under the film. In these cases, when using the DDB dressing material, it is necessary to apply a large number of gauze napkins or cotton wool to the dressing to absorb the secretions. In addition, the lack of drainage ability in DDB materials somewhat slows down the course of regenerative processes under the film in the treatment of burns of 3-4 degrees.

 The invention solves the problem of creating a film dressing material with improved performance properties, accelerating the healing processes of burns and reducing the time of their treatment.

 The problem is solved due to the fact that in the dressing material made of a polyethylene film with a mixture of talc and drugs applied to one of the sides, the film contains rows of holes forming rectangles of a solid surface with side sizes of 100 and 200 mm, while the holes are made rectangular with dimensions of the sides 1 and 3 mm at a distance of 1 mm.

 It is the ratio of the areas of the continuous surface and the openings that makes it possible to obtain a film dressing material with drainage properties that ensure the outflow of such an amount of liquid, the removal of which creates conditions under the film that accelerate the healing process of burns by about 50-60% compared with traditional burn treatment 2 -4 degrees and approximately 10-20% compared with the dressing DDB.

 The proposed dressing DDB-M (dressing, dressing, dr.Breitman-dr. Menzul) is non-toxic, does not cause allergies, protects the wound from infection from the outside, is non-invasive, does not cause secondary necrosis, provides a moist environment, in its general nature close to the composition of the internal environment of the body, stops the development of the microbial process, stimulates regenerative processes in the wound, migration of epithelial cells, contributes to marginal epithelization, scarless wound healing.

 With burns of 2, 3A, 3 AB degrees, before applying the proposed dressing material, preparation of the burned surface is not required. After opening the package, the material is applied to the wound with an inner surface with a sprayed layer of drugs. Usually the film is well fixed on the wound and it is enough to fix it with adhesive tape. For a better fit, 2-4 layers of gauze or bandages can be applied over the film.

 Dressings are changed first after 24 hours, and then after 48 hours and 72 hours as necessary.

In case of burns 3B, the degree of dressing is applied until complete wound necrolysis (cleansing) and subsequent skin transplantation (autodermoplasty)
For 3B-4 degree burns after necrectomy and stopping bleeding, a dressing is applied on the operating table.

 The proposed dressing material can be made of film of various configurations of sleeves of various diameters, film canvases of various sizes, which are folded along the fold lines, which is an additional advantage of the proposed dressing, because allows you to compactly pack dressings of a large area.

The material is prepared as follows:
On a plastic film containing rows of holes forming rectangular sections of a continuous surface with side sizes of 100 and 200 mm with a side size of the holes made rectangular, 1 and 3 mm and located at a distance of 1 mm from each other, Breitman complex powder is sprayed so as to cover the film in an even layer, it did not crumble due to electrostatic attraction forces. A film dressing is obtained, which is folded along the lines of the holes with a sprayed layer inside and sterilized with gamma radiation at a dose of 2.5 Mrad.

 The invention is further illustrated by examples.

Example 1
Patient N., age 8 years old, received 2nd degree burns with a lesion area of 20%. He was admitted to the burn department of the Lyubertsy Burn Center on the 3rd day. Treatment with DDB-M film dressings started immediately upon admission. Dressings were made as needed, were painless. The wound surface was not infected, antibiotic treatment was not required. Complete healing occurred after 8 days.

Example 2
Patient B., age 6 years old, received thermochemical burns in the collector of a heating plant of degree 1, 2, 3A, 3AB, 3B with a total lesion area of 70%. Upon admission to the intensive care unit in combination with anti-shock therapy, he began treatment of wounds using DDB-M film dressing . During the treatment of wounds, the presence of a moist environment under the film was noted. In this case, no leakage from the film was observed, since Excess moisture was removed through the holes and absorbed with a bandage, without causing discomfort to the patient and at the same time not leading to drying of the wound surface, i.e. keeping the necessary moist environment under the film, contributing to the acceleration of regenerative processes. Dressings were carried out as necessary, were painless, the introduction of painkillers and antibiotics was not required. Wound cleansing, the appearance of marginal and islet epithelization, and complete scarless wound healing took 30 days with a long-term good result.

Example 3
Patient A., age 8 years old, received burns with 3B flame, grade 4 with a total lesion area of 70%. On the seventh day a phased necrectomy of burn wounds was performed with treatment with film dressings, as in example 2, and subsequent autodermoplasty with complete engraftment of the transplanted skin flaps and discharge home after 50 days. Moreover, the operated area with autodermoplasty was 30% less than with traditional treatment.

Claims (1)

 Dressing material for the treatment of wounds and burns, made of a polyethylene film with a mixture of talc and drugs applied to its surface, characterized in that the film contains rows of rectangular holes with side sizes of 1 and 3 mm at a distance of 1 mm, forming rectangles of a solid surface with dimensions sides 100 and 200 mm.