RU2198667C2 - Method for treating trophic ulcers and prolongly unhealing wounds by applying animal fats - Google Patents

Abstract

FIELD: medicine, surgery. SUBSTANCE: before and after elimination of purulentnecrotic inflammation one should apply furred animal's fat onto wound surface once daily at 0.1 cm thickness till complete healing. One should use fat of marmots, raccoons, minks or polar foxes. The method provides efficient treatment of wounds and ulcers being simple and cheap during usage. EFFECT: higher efficiency of therapy. 4 cl, 2 ex

Description

 The invention relates to medicine, in particular to surgery, and for the treatment of long non-healing wounds and trophic ulcers. The purpose of the invention is to develop a simple and affordable way to treat trophic ulcers and long-term healing wounds of any etiology by using natural, environmentally friendly biological products of animal origin.

 A known method of treating trophic ulcers and long non-healing wounds - patent 1811402, authors A. I. Polyak, V. I. Nifedov, I.A. Timoshevskaya, A.E. Konoplev, which includes topical application of zixorin emulsion.

 The disadvantages of this method are the shortage of the drug, its high cost, the possibility of absorption by granulation, and also when using it, various side effects, individual intolerance are possible.

 There is also a method of treating trophic ulcers and long-term healing wounds - copyright certificate 1801487, authors S.A. Vasiliev, A.A. Tolkachev, G.Yu. Belinina, G.A. Ermolin, E.E. Efremov, which includes receiving from plasma 500 ml of the patient’s blood fibronectin, diluting this volume in 5-50 ml of a 3.60% Trisamine solution and applying it to the ulcer surface 1-4 times a day until the ulcer defect is completely healed.

The disadvantages of this method:
1) invasiveness,
2) to carry out this method requires special expensive equipment and specially trained medical personnel,
3) the possibilities of widespread use of the method are limited (due to the points in paragraphs 1 and 2),
4) the possibility of transfusion reactions and transfusion complications,
5) the frequency of dressings is too high (4 times a day) due to the drying of the drug,
6) the impossibility of standard industrial control over the quality of the drug (the impossibility of standardization and rationing).

 A known method of treating trophic ulcers and long non-healing wounds - patent 2001619, authors V.A. Figurnov, V.I. Tochilin, A.V. Figurnov. With this method, the cleaned ulcer is covered with fibrin powder isolated from a patient's blood clot.

The disadvantages of this method:
1) invasiveness,
2) irrevocable exfusion of blood (which is unacceptable in patients with anemia and in patients of advanced age),
3) the inability to standardize the drug,
4) the "primary" formation of the scab makes it impossible to control the progress of the wound process (the impossibility of cytological and bacteriological control),
5) the impossibility of widespread use due to the complexity of obtaining fibrin powder from a blood clot.

 There is also a method of treating trophic ulcers and long-term healing wounds - copyright certificate 1801488, authors S.Yu. Safarov, M.A. Aliev In this method, a xenosleen is used (application of a homogenate to trophic ulcers and wounds).

 The disadvantage of this method is the spleen is a protein preparation capable of causing allergic reactions.

The closest in value is a method of treating trophic ulcers and long-term non-healing wounds - copyright certificate 1718947, authors V.N. Zhukov, E.I. Neverova, P.N. Myshentsev, K.E. Nikitin. This method is carried out using primordial grease, heated to 35-37 ^o C, on the wound and ulcer surface. The use of primordial cheese-like lubrication can quickly eliminate the inflammatory irritation and wetness of the skin surrounding the ulcer or wound, thereby contributing to the growth of the epithelium and its better healing. The homogeneity and the presence of simple organic compounds without antigenic properties in the initial lubrication leads to the absence of side effects, complications and the safety of its use. The natural origin of the original lubrication and the simplicity of its production by wiping off the baby’s skin determine the significant economic effect of the proposed method and make it possible to dispense with the use of a number of expensive and scarce means of local treatment of trophic ulcers and long-term non-healing wounds.

The disadvantages of this method:
1) low birth rate,
2) the presence of a woman in labor is required,
3) the presence of a newborn is necessary,
4) special aseptic conditions are required (delivery room),
5) special tools are needed to remove the cheese-like lubricant,
6) special conditions are necessary for the storage and transportation of this medium,
7) _ the possibility of viral transmission from a sick mother through the specified environment, since the environment is not subject to reliable disinfection,
8) the environment is not subject to long-term storage, since biological factors are rapidly inactivated.

 We propose a method for treating trophic ulcers and long-healing wounds, the essence of which is that after the elimination of purulent-necrotic inflammation of trophic ulcers and long-healing wounds, patients were treated with pre-treated animal fats (groundhog, raccoon, polar fox, etc.) on the wound surface ( TU 10 of the RSFSR 848-91). Every day, 1 time a day after the toilet of the ulcer or wound surface, a sterile napkin with fat 0.1 cm thick was placed on it and fixed with a gauze bandage. A similar procedure was repeated until the skin defect was completely healed.

A comparative study of the effectiveness of local palliative treatment of trophic ulcers of various origins and sluggish wounds with fats of polar fox, raccoon, groundhog, and mink in groups of 10 patients was performed — a total of 40 observations. Of these, 25 are women and 15 are men, with trophic ulcers - 32 people and with long non-healing wounds - 8 people, aged 30 to 85 years. Elderly and senile patients prevailed with contraindications for radical surgical treatment due to systemic lesions. In the vast majority - 19 people (47.5%) - ulcers complicated chronic venous insufficiency. In addition, the causes of trophic ulcers were obliterating atherosclerosis of the vessels of the lower extremities, diabetic angiopathy, burns, osteomyelitis. The main reason for long non-healing wounds were injuries, burns, purulent-inflammatory diseases. In 29 patients, ulcers did not heal from 1 year to 20 years, in 22 patients they exceeded 10 cm ² , in 10 were multiple. The control was a retrospective study of the results of the treatment of 40 patients with trophic ulcers and long-term non-healing wounds in the surgical department of the medical department of Lepse JSC in previous years. The groups were comparable in age, genesis and size of ulcers and the volume of the overall pathogenetic treatment. The topical treatment was traditional antiseptics and epithelizing officinal ointments. The criteria for evaluating the effectiveness of the treatment along with clinical data and the final results at discharge were indicators of the rate of cleansing of the wound surface from bacterial contamination, the histological picture of the wound and the healing rate.

 Clinical observations carried out during the complex treatment of patients with trophic ulcers and long-term non-healing wounds allowed us to note a pronounced positive effect from the local use of fats, especially groundhog and raccoon. It was noted the cessation of pain in the area of an ulcer or wound after 2-3 dressings with animal fats. After 2-3 dressings with fats, a stimulating effect on the growth of granulations was demonstratively manifested - islands of red fine-grained granulations appeared at the bottom of the wound or ulcer. In the presence of sick granulations under the influence of animal fats, their normalization occurred. The healing of trophic ulcers and long-term healing wounds ended with epithelization followed by scarring, and the scars are usually tender, flat, not fused with the underlying tissues.

 A positive effect of the use of animal fats was observed in all 40 patients (100%) with an average bed-day of 40.9 ± 5.3, complete healing was achieved in 33 patients (82.5%) and partially in 7 patients (17.5%) . In patients of the control group (archived data), a positive result was achieved in 36 patients (90%), with an average bed day of 42.0 ± 7.2, complete healing was achieved in 10 patients (25%). partial healing in 26 patients (65%), in 4 patients (10%), treatment was unsuccessful. Analyzing our treatment results in comparison with the control group, we note that in the treatment of trophic ulcers and long-term non-healing wounds, very good results can be achieved when dressings with animal fats are used in a complex conservative treatment.

Trophic ulcers and nonhealing wounds before treatment were seeded with staphylococci in the form of monocultures (65%) and associations (35%), and the seeding rate was critical from 1.3 • 10 ⁵ ± 0.2 to 2.6 • 10 ⁶ ± 0 , 26 (P <0.05). "Clean" wound surfaces were not identified. The dynamics of changes in the microbial landscape during the treatment of trophic ulcers and long-term non-healing wounds was as follows: after the first week, the critical level remained, after two weeks of treatment was below critical. After the third week of treatment with almost all fats, all ulcers became free of pathogenic bacteria, which indicates a weak bactericidal activity of animal fats.

 In the study of fingerprint smears taken before treatment with animal fats and at different periods of treatment, it was noted that against the background of a sluggish course of the inflammatory process and a decrease in reparative processes, a significant increase in active cellular elements, the development of a histiolymphocytic reaction and an increase in repair phenomena occurred.

The healing rate of trophic ulcers and long-term non-healing wounds was 0.56 ± 0.1 for groundhog fat, 0.46 ± 0.11 for raccoon fat, 0.37 ± 0.06 for fox fat, and 0 for mink fat , 39 ± 0.08 cm ² / day. All indicators exceeded the healing rate with the traditional treatment of 0.2 ± 0.03 (according to the literature of A.D. Chadayev et al., 1996) (P <0.05). The healing rate of trophic ulcers and long-term non-healing wounds in the treatment of groundhog fat increases by 2.8 times, when using raccoon fat by 2.3 times, when treating with fox fat increases by 1.7 times, and when treating with mink fat, it increases by 1.9 times compared to traditional treatment.

 The following clinical observations can illustrate the above.

Example 1. Patient M., 59 years old, was admitted to the General Surgery Clinic 2.09.94, with a diagnosis of PTFS of the right lower leg, CVI III degree. Trophic ulcers of the right lower leg. Long existence of ulcers about 20 years. At the initial examination: in the region of the right lower leg there are three trophic ulcers of 7 cm ² , 16 cm ² , 17 cm ^{2 in} size, which do not heal for the last 2 g. Their bottom is covered with fibrin, around perifocal pruritic dermatitis. Received traditional phleboprotective therapy (troxevasin, eskusan), B vitamins, nicotinic acid with heparin. Locally, the ulcer was sanitized with aqueous iodopyron, and the skin around the ulcer was treated with Lassar paste. After cleansing the ulcer, marmot fat was used as an epithelializer. Achieving complete epithelial erection occurred in a 40-day period.

Example 2. Patient K. 71 g was admitted to the clinic of general surgery 11/14/96 g with a diagnosis of PTFS of the lower extremities, CVI III degree, trophic ulcers of both legs. Diabetes. Diabetic angiopathy of the lower extremities. The duration of ulcers is about 5 years. PTFS suffers for about 35 years. Periodically received conservative therapy in the hospital, ulcers did not completely close. At the initial examination: in the region of the inner surfaces of the ankle joints, trophic ulcers on the right are 2 cm ² , on the left 8 cm ² , the skin around the ulcers is hyperpigmented, induced, compacted, hyperemic and painful on palpation. The bottom of the ulcer is covered with fibrin plaque. She received traditional venoprotective therapy, antidiabetic drugs and antiseptic dressings. After stopping the inflammatory process in the area of ulcers, mink fat was used as a repair agent. Complete healing occurred within a 50-day period.

Thus, the proposed method for the treatment of trophic ulcers and long-term non-healing wounds has the following advantages compared to the method in which the original lubricant is applied to the wound surface:
1) has a local analgesic effect,
2) has a bactericidal effect.

3) the method is safe in relation to infection of the patient with infectious diseases,
4) does not require the use of expensive equipment, specially trained medical and technical personnel for its implementation,
5) the method is technically simple, inexpensive, highly effective and can be widely used to treat patients with trophic ulcers and long non-healing wounds in outpatient and inpatient settings,
6) there is a sufficient raw material base, a technology has been developed to obtain fat for use in medical practice.

Claims (5)

 1. A method of treating trophic ulcers and long-term non-healing wounds, comprising applying a biological product to a wound, characterized in that after the elimination of purulent-necrotic inflammation, the fat of fur animals is used as a biological product, and a sterile napkin is applied daily 1 time per day to the wound surface with fat 0.1 cm thick and fixed with a gauze bandage, the procedure is repeated until the wound surface is completely healed.  2. The method according to claim 1, characterized in that the fat of groundhogs is used as the fat of fur animals.  3. The method according to claim 1, characterized in that raccoon fat is used as the fat of fur animals.  4. The method according to claim 1, characterized in that the fat of fur animals use mink fat.  5. The method according to claim 1, characterized in that the fox fat is used as the fat of fur animals.