The main cause of ischemic wounds is peripheral arterial disease (PAD). The overall prevalence of PAD varies within 3-10%, increasing to 15-20% among patients over 70 years of age. The PAD prevalence is slightly higher in men than in women. This problem is crucial for healthcare, since such wounds can lead to the need to amputate the lower extremities in case of ulcerative-necrotic processes and gangrene, being one of the common causes of increased disability and mortality in the population.The aim of the study was to investigate features of the wound process when healing ischemic skin wounds with local application of a unique mixture of benzalkonium chloride, dexpanthenol and pentoxifylline in combination with magnetotherapy.Materials and methods. Ischemic skin wounds were simulated on the hind limbs of 90 male Wistar rats (RU Patent for Invention No. 2807383). The animals were divided into three groups based on the features of the treatment performed. In animals of the 1st group, a unique mixture of benzalkonium chloride, dexpanthenol and pentoxifylline was applied to the skin defect; in animals of the 2nd group, magnetotherapy was used; in animals of the 3rd group, the unique medicinal mixture and magnetotherapy were used simultaneously. The analysis of the results included an assessment of the wound area, microcirculation, pH of the wound surface and the local temperature. The results were recorded on the 1st, 3rd, 5th, 8th and 10th days of the study. Microsoft Excel 2014 and Statistica 13.0 programs with the Kruskal-Wallis test were used to process data statistically. Significant differences were considered at p0.05.Results. A combination of benzalkonium chloride, dexpanthenol and pentoxifylline with the simultaneous use of magnetic therapy is effective in the treatment of ischemic wounds. The third group showed the greatest effectiveness, where the area of wounds significantly decreased on the 10th day by 1.9 times compared to group 1 and 9.4 times compared to group 2, respectively. The healing rate was also significantly higher in group 3 compared to group 1 (1.3 times) and group 2 (1.7 times), respectively. The third group also showed the best result during the assessment of microhemocirculation and a shift in pH to the slightly acidic side already on the 3rd day; only on the 8th day there were significant differences of 1.1 times between the 1st and 3rd groups.Conclusions. The use of the specifically developed unique medicinal combination of drugs applied together with magnetic therapy has confirmed its effectiveness if compared with the control treatment groups. This treatment option has a beneficial effect on the healing process of ischemic skin wounds and allows recommending it for further preclinical studies.

Currently, treatment of contaminated skin wounds aggravated by ischemia of superficial soft tissues is a problem that presents certain difficulties. The search for the new ways of treatment and drugs possessing a multidirectional effect is a relevant problem. In this study, we aimed to explore the peculiarities of wound evolution and the effectiveness of the designed combination of medicines and magnetic therapy in a contaminated skin wound case. For the experiment, we divided male Wistar rats into 3 groups and modeled a contaminated skin wound in each of the animals. In the first group, no treatment was performed, in the second, we used the developed combination (benzalkonium chloride, dexpanthenol, pentoxifylline and carboxymethylcellulose sodium salt, combined with magnetic therapy), in the third — ointment with dioxomethyltetrahydropyrimidine + chloramphenicol and magnetic therapy. Planimetry, acid-base balance registration, measurements of microhemocirculation and local temperature of the wound bed underpinned monitoring assessment of the wounds. At the end of the study, the wound area in the second group was 10.7 and 3.7 (p < ; 0.05 ) times smaller than in the first and third groups, respectively, and healing rate — 2.6 and 1.3 (p < 0.05 ) times faster. The maximum values of microhemocirculation and the lowest pH were registered in the second group. Thus, combination of drugs and magnetotherapy we designed promoted healing of a contaminated skin wound, which allows recommending this treatment method for further study at the preclinical level.

Purulent-inflammatory lesions of skin and soft tissues account for 30-35% of causes of admission to surgical hospitals. In outpatient system, this value reaches 35-60%. Moreover, suppuration of wounds after elective surgery occurs in 2-5% of cases. Adequately selected drugs for local wound therapy can achieve localization of purulent process and avoid spread of infection. This review summarizes data on development, experimental and clinical testing of wound dressings over the past 10 years, presents classification options and analyzes their advantages and disadvantages. The authors emphasize higher efficacy of hydrophilic coatings, and coatings based on chitosan, collagen, methylcellulose and its derivatives are preferred. It is advisable to introduce a component with antimicrobial, anesthetic and hemostatic activity stimulating tissue regeneration into the matrix of wound dressing. The priority is introduction of antiseptic substances causing fewer side effects compared to antibiotics. Further research and development of new wound dressings is a priority in surgery considering changing landscape and development of resistance of microorganisms.

ОЦЕНКА ВОСПАЛИТЕЛЬНОЙ РЕАКЦИИ И ПРОЛИФЕРАЦИИ КЛЕТОК ФИБРОБЛАСТИЧЕСКОГО РЯДА В ОБЛАСТИ ИМПЛАНТАЦИИ ПОЛИПРОПИЛЕНОВОГО ЭНДОПРОТЕЗА В ЗАВИСИМОСТИ ОТ НАНЕСЕНИЯ КОЛЛАГЕНСТИМУЛИРУЮЩЕГО ПОКРЫТИЯ (ЭКСПЕРИМЕНТАЛЬНОЕ ИССЛЕДОВАНИЕ)Лазаренко В.А. 1

3 Медицинский институт ФГБОУ ВО «ОГУ им

Background. Purulent wound healing is a pressing surgical challenge relevant in 30−35% of patient cases. To the more, wound infectious agents elaborate resistance to available drugs warranting the development of new drug combinations exserting a multidirectional effect on the wound process.Objective. Using a purulent wound model to experimentally evaluate the efficiency of a new multicomponent wound coating comprised of polyethylene oxide and carboxymethylcellulose sodium-immobilised dioxidine, methyluracil, metronidazole and lidocaine hydrochloride in comparison with a legal approved wound coating drug preparation of beeswax and propolis-based dioxidine ointment.Methods. The antimicrobial activity range (disk-diffusion method) and local anaesthetic effect (Rainier’s method) of the developed wound coating have been assessed. The healing process was studied in a purulent wound model with 72 Wistar rats divided between two equal groups. The following methods were applied: visual wound inspection (wound cleansing time, absence of wound-surrounding tissue oedema, granulation and epithelisation), planimetric parameter estimation (wound area, healing rate, wound area reduction ratio), wound contamination and pH measurement, wound section cell morphometry (granulocyte, macrophage, lymphocyte and fibroblast counts, cell index estimation). Daily dressings were applied for 15 days.Results. The developed wound coating exhibited high efficiency against Gram-positive and Gram-negative bacteria in the zone of inhibition tests. Its local anaesthetic effect was significantly superior to the approved drug by the duration of action. The wound area reduction was 94.2 (93.7; 94.8)% in the experimental group and 86 (84.2; 88.8)% in the control (differences statistically significant) already on day 10. A maximal healing rate in both groups was registered in phase 1 of the wound process being 1.4 times higher in experiment compared to the control. The wound contamination was significantly lower in experiment vs. control on day 8 (p = 0.0075). Wound pH negatively correlated with the fibroblast count and positively — with the contamination level.Conclusion. The study demonstrates high efficiency of the developed wound coating against infectious agents and its positive healing impact via reducing phase 1 and stimulating proliferation in phase 2 of the wound process.

Treatment of purulent wounds is an urgent problem in modern surgery. The need to develop new combinations that improve the treatment process is one of the priorities. Materials and methods. A purulent wound model was formed on 180 Wistar rats divided into 5 equal groups. The percentage of reduction of the wound area, healing rate, microbial contamination were evaluated, histological examination was performed. Results. In groups with the use of a photosensitizer, complete wound healing occurred by 15 days. The maximum healing rate of the combined use of hexethidine and photoditazine occurred in the first phase of the wound process, and microbial contamination by the 10th day was less than 15 thousand times compared to the control, and 187,5 times - with the comparison group (p < 0,05). Conclusions. The developed combinations have a positive effect on the course of the wound process, accelerating wound healing and reducing microbial contamination.

Purpose of the study. To study experimental model of purulent wounds efficiency of the combined effects of benzalkonium chloride and metronidazole immobilized on various bases.Materials and methods. The material was in vitro studies and experimental animals (Wistar rats), which was modeled a purulent wound and then divided into 3 groups according to the treatment method with the three studied combinations, each of which contained benzalkonium chloride and metronidazole, the combinations differed in bases, which were polyethylene oxide or sodium salt of carboxymethylcellulose, or polymethylsiloxane polyhydrate. Research methods: in an in vitro experiment, growth retardation zones were determined for the most common pathogens of wound infection using the standard disc method. In an in vivo experiment the healing process was evaluated by Popov's planimetric method, the contamination of the wounds was studied by sowing the biopsy of wounds on nutrient media with subsequent counting of the grown up colonies. The data were processed statistically, the reliability of the differences was assessed by the Kruskal-Wallis test.Results. All test combinations showed high growth retardation areas for all test strains of microorganisms. Objectively, the highest results were observed with a combination of polyethylene oxide (Staphylococcus aureus 30 (29; 30), Bacillus cereus 27 (27; 28), Escherichia coli 20.5 (20; 21), Proteus vulgaris 21.5 (20; 22), Pseudomonas aeruginosa 17 (16; 17), Candida albicans 25.5 (25; 26)). In determining the healing rate, it was noted that the maximum values in the groups when using combinations based on the sodium salt of carboxymethylcellulose and polymethylsiloxane polyhydrate occurred on day 1–3 (29.6 (27.6; 31) and 20.2 (18.8; 24.2) mm2/day, respectively), and in the group using a combination on polyethylene oxide — for 3–5 days (20.6 (17.3; 22.8) mm2/day).Conclusion. Our studies have shown the high antimicrobial activity of all the developed combinations for all the strains of microorganisms studied. It is also possible to recommend combinations on polyethylene oxide and sodium salt of carboxymethylcellulose for further preclinical studies at all times of treatment, and a combination based on polymethylsiloxane polyhydrate only in the first phase of the wound process.

The quality of Paracetamol suppositories produced by domestic manufacturers has been investigated and their compliance with pharmacopoeial requirements has been established. Dissolution profile test of paracetamol suppositories of different producers has been carried out and nonequivalence of profiles due to the properties of the suppository basis has been shown. The importance of hydroxyl value and melting point of fat suppository bases used as pharmaceutical factors has been highlighted.

In article theoretical and practical results of longstanding work of collective of Pharmaceutical technology department of Kursk State Medical University for the development of rectal and vaginal suppositories for the treatment of infectious and inflammatory diseases have been shown and approaches to the choice of rational suppositories composition and technology, including using of Dissolution test, have been formulated.

Objectives. To optimize treatment of purulent wounds with the help of a wound coating with a multidirectional action that combines broad-spectrum antimicrobial effect, stimulation of regeneration, sorption activity and local anesthetic action. Materials and methods. The material for the study was a wound covering in the form of a film developed by the authors at Kursk State Medical University (Russian patent No. 2601897). Theexperiment was performed on laboratory animals (Wistar rats), which were divided into 2 groups (comparison and experimental), each group containing 36 animals. Purulent wound was modeled in the animals according to the method of P.I. Tolstykh. To evaluate the effectiveness of the treatment, the following methods were used: microbiological method (determination of areas of growth retardation and bacterial contamination in the wounds), Renier’s method (determination of local anesthetic activity), visual assessment of wounds, planimetric method (measurement of the wound area, percentage of area reduction and healing speed) and measurement of pH in the wounds. The statistical significance of the differences was determined with the nonparametric Mann–Whitney test. The differences were considered statistically significant at p ˂ 0.05. Results. Initially, high efficiency of the film was detected in vitro for the most common strains of test organisms, which werewound infection pathogens. The Renier index was 1.2 times higher in the film with chlorhexidine than in 2% lidocaine ointment, and the duration of general anesthesia was 25% longer. Following visual assessment of the wounds we revealed that purification and regeneration of the wounds first occurred in the animals in the experimental group; however, no statistical significance was detected. The maximal differences in the healing speed (1.6 times) were observed at 3–5 days, and the contamination of the wounds was 1.3 times lower in the experimental group than in the comparison group. According to the results of pH assessment, significant differences between the groups were noted only on day 15. Approximation of pH values to intact skin values also proved the effectiveness of treatment. Conclusion. The developed contact wound covering has high antimicrobial activity against a broad spectrum of wound infection pathogens, creates a fairly good local anesthetic effect, significantly speeds up the healing process and reduces bacterial contamination of the wound area. Thus, the developed wound covering can be recommended for further studies in the clinical setting for treatment of inflammatory processes in soft tissues.

Experimental data on the development of composition and technology of oro-dispersible tablets with azithromycin. There is shown the study of sweet taste of the tablets masses, the production of tablets on the basis of their granulates. Antimicrobial properties of the tablet granulates are investigated for studying of the antibiotic stability, when azithromycin is used in wet granulation tableting technology. Identifies the main technological characteristics of the granulates, the tablets are produced by compression and indicators of quality are studied.

Objectives. To substantiate the effectiveness of the wound coating developed by us, which combines broad-spectrum antimicrobial effect, sorption activity, analgesic effect and prolonged action on a purulent wound.Materials and methods. The material for the study was wound coating in the form of a film developed at Kursk State Medical University (Russian patent number 2605343). Experimental animals (Wistar rats) were divided into 2 groups (comparative and experimental) of 36 animals in each. In all the experimental animals a purulent wound was modeled according to the method proposed by P.I. Tolstikh. Local anesthetic activity was determined on rabbits of the Chinchilla breed (20 individuals in each group). In the course of the study, the following methods were used: microbiological method (identification of the areas of growth retardation and wound contamination), visual assessment of the wounds, planimetric method, pH evaluation of the wounds, and Renier’s technique (for determination of the anesthetic activity). The data were processed statistically, and the statistical significance of the differences was determined using the nonparametric Mann – Whitney test. The differences were considered statistically significant at p ≤ 0.05.Results. Before the experiment on animals, high efficacy of the developed film was proven for the most common test strains of microorganisms capable of causing wound infection, using the microbiological method of investigation. Using the Renier’s method, the ability of the film to provide a local anesthetic effect was demonstrated, which was significantly higher than that of the 2% lidocaine ointment. Following visual evaluation of the wound, it was found that purification and regeneration of the wounds occurred earlier in the animals from the experimental group. The speed of wound healing in the experimental group was 1.3 times higher at 1–3 days, whereas at 5–8 days the situation was reversed in favor of the comparison group. In addition, at day 8 wound contamination in the experimental group was 1.2 times lower than in the comparison group. According to the results of the pH evaluation, significant differences between the groups were noted at days 5, 8, 15. Approximation of pH values to those of intact skin also proved the effectiveness of using the developed film.Conclusion. The results of the conducted studies confirmed broad-spectrum antimicrobial activity of the developed film, its local anesthetic activity and efficacy in treatment of experimental purulent wounds, which allows to recommend it for further preclinical trials.

Аннотация.Среди различных воспалительных заболеваний полости рта у детей стоматиты занимают лидирующие позиции в стоматологии.Актуальность данной проблемы объясняется не только высокой распространенностью стоматитов в детской практике, но и хронизацией патологического процесса, контагиозностью и нарушениями со стороны иммунологической системы.По частоте распространения на первом месте стоят инфекционные стоматиты вирусной, бактериальной или грибковой этиологии.Большое значение в лечении стоматитов у детей уделяется местному воздействию лекарственных средств на слизистую оболочку полости рта.В статье дается обоснование использованию таблеток для рассасывания, содержащих метиленовый синий и анестезин, обладающих комплексным антисептическим и обезболивающим действием

ПРИМЕНЕНИЕ МИРАМИСТИНА И МЕТРОНИДАЗОЛА В ЛЕЧЕНИИ ЭКСПЕРИМЕНТАЛЬНЫХ ГНОЙНЫХ РАНС. И. Тиганов 1 , А. Ю. Григорьян 2 , Ю

Relevance. Purulent complications occur in 35-45% of patients with surgical diseases, lethality rate from these conditions achieves 25%. The purpose of the study. To investigate the wound process while treating the purulent wounds with immobilized forms of miramistin and benzalkonium chloride in gel of sodium salt of carboxymetylcellulose. Materials and methods. There were analysed results of experimental study of the wound process on 108 male Wistar rats. Experimental animals were divided into 3 groups, each group included 36 rats. In a comparison group ‘Levomekol’ ointment was used for treatment. In the first experimental group treatment was done by the ointment with the following composition: 0,01% solution of miramistin — 100 g, metronidazol –1,0 g, sodium salt of carboxymetylcellulose — 4,0 g, while in the second experimental group ointment composition included benzalkonium chloride 0,02 g, metronidazol — 1,0 g, sodium salt of carboxymetylcellulose — 4,0 g, purified water — up to 100,0 g. The wound process was evaluated by planimetric, microbiological and histological methods of investigation. Results and its discussion. The reduction of wound area in the first experimental group was higher than in a comparison group on the 3rd day of the experiment by 9,7%, on the 5th day — by 7,6%, on the 10th and 15th days — by 10,5%, while in the second experimental group the change was 37,2%, 27,3%, 13,8% and 6,9% respectively. In the first experimental group microbial contamination of the wound was less than in a comparison group by 5,8х106, on the 5th day — by 3,1х105, on the 10th day — by 6,1х104, while in the second experimental group on the 3rd day there were no differences, on the 5th day — by 6,3х105, on the 10th day — 1,1х104. Histological investigations of the wound biopsies on the 10th day of experiment showed that in a comparison group the bottom of the wound was covered by granulation tissue without signs of epithelization, there was full coverage of the wound with a newly formed epithelium in experimental groups. Conclusions. The use of prolonged quaternary ammonium antiseptics in treatment of purulent wounds is pathogenetically justified and efficient.

Experimental data on the development of composition and technology of oro-dispersible tablets with azithromycin. There is shown the study of sweet taste of the tablets masses, the production of tablets on the basis of their granulates. Antimicrobial properties of the tablet granulates are investigated for studying of the antibiotic stability, when azithromycin is used in wet granulation tableting technology. Identifies the main technological characteristics of the granulates, the tablets are produced by compression and indicators of quality are studied.

The purpose of the study is to investigate the wound-healing effect of the immobilized form of benzalkonium chloride and metronidazole based on the sodium salt of carboxymethylcellulose (Na-CMC) or polyethylene oxide (PEO) in the treatment of an experimental purulent wound.Materials and methods. The following compositions were studied, %. Combination 1: benzalkonium chloride – 0.02; Metronidazole – 1,0; Sodium carboxymethylcellulose (NaCMC) – 4,0; Purified water – up to 100,0. Combination 2: benzalkonium chloride – 0,02; Metronidazole – 1,0; Polyethylene oxide, m. 400 – 80.0; Polyethylene oxide, m. 1500 – 20,0. The experiment was performed on 180 male Wistar rats, which were divided into three statistically homogeneous groups of 60 animals in each, a purulent wound was modeled in all experimental rats using the method of P.I. Tolstykh. In the control group local treatment of the wound was performed with the help of “Levomekol” ointment, in two experimental groups, the combination was treated with 1 and 2.The course evaluation of the wound process was carried out using planimetric, microbiological and histological methods of investigation. The data were recorded and the animals were eliminated from the experiment on the 1st, 3rd, 5th, 8th, 10th and 15th days.Results. The data of the microbiological study confirmed the high efficiency of the combinations developed by the authors in relation to standard test strains of pathogen microorganisms. As a result of the planimetric study, a significant decrease in the area of wounds in the experimental group 1 was found compared to the ontrol group, which indicates a more effective course of the healing process in experimental group 1. The same process was noted in the experimental group 2, starting from the 5th day of observation relative to the Control. The use of combinations developed by the authors in the treatment of the purulent-inflammatory process of the subcutaneous layer promotes the rapid reduction of microbial contamination of wounds compared to “Levomekol” ointment. After the histological examination, it was noted that the processes of regeneration and epithelization proceeded better in the experimental groups relative to the control.Conclusion. The immobilized form of benzalkonium chloride and metronidazole in polyethylene oxide gel (combination 2) has the highest antimicrobial activity, in comparison with the rest of the preparations, and is statistically significant, in comparison with the control group. It also reduces the wound area and accelerates the epithelization period. At the same time, there are no significant differences between combination 1 and ointment “Levomecol” in the zones of growth retardation of microorganisms. Combination 1 shows the highest activity in the 1st day of the wound process, so it should be recommended for the treatment of purulent wounds in the first 3 days of the first phase of the wound process. Combination 2 should be recommended starting from the 3rd day of treatment, when the highest healing rate has been noted when applied in the experimental group 2.