Молодежный инновационный вестникМолодежный инновационный вестник2415-7805Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации7207Conference ProceedingsCOMBINED PHARMACOTHERAPY OF PURULENT WOUNDS IN RATS IN AN EXPERIMENTAbramyanAngelina Araikovna<p>4th course student of faculty of General Medicine of VSMU</p>linamia2000@gmail.comhttps://orcid.org/0000-0002-9616-4362KiselevaAnastasia Igorevna<p>5th course student of faculty of Pediatrics of VSMU</p>anastasiakiseleva2804@yandex.ruhttps://orcid.org/0000-0001-6102-8734Voronezh State medical university named after N.N. Burdenko30062022112222240102202224022022Copyright © 2022, Abramyan A.A., Kiseleva A.I.2022<p>Relevance. As a result of an increase in the number of pathogenic microorganisms and their resistance not only to antibacterial, but also to antiseptic agents, the problem of pharmacotherapy of purulent-inflammatory processes is formed. Also, in the pathogenetic aspect of purulent-inflammatory pathology, the predominant role of the bacterial component should be highlighted. Moreover, in this case, the appointment of combined pharmacotherapy, including the appointment of both local and systemic use of medicines, is highly effective.</p>
<p>Goal. To study the features of the course of the wound process when using various combinations of pharmacological agents.<br /><br />Methods. In the course of the scientific work, the material of foreign and domestic literary sources in the field of methods of modeling purulent wounds, methods of pharmacotherapy of this nosological group was analyzed, a chronic experiment on modeling purulent wounds and combined pharmacotherapy of this nosological group was conducted.</p>
<p>Results. The most positive dynamics of the wound process was observed in the combined pharmacotherapy of a purulent wound with the use of intra- hydrogen water, externally - Dioxomethyl-tetrahydropyrimidine + Chloramphenicol (Levomecol) (4 experimental group), where the disappearance of hyperemia, skin edema, the end of necrolysis, the appearance of granulations, epithelialization of the wound, reduction of discharge to scanty faster compared to the data of the 1st control group was observed.</p>
<p><br />Conclusion. A large volume of research literature on the modeling of purulent wounds in the experiment has been analyzed. The most optimal, accessible and sparing tactics of modeling purulent wounds in rats in the experiment was selected. The optimization of the pharmacotherapy of purulent wounds by the combined use of hydrogen water inside and local antibacterial agents is proposed.</p>Purulent woundswound healinghydrogen waterГнойные раныранозаживлениеводородная вода<p>Relevance<br />The relevance of this study lies in the annual increase in the frequency of infectious, in particular purulent soft tissue diseases. This nosological group has a high tendency not only to the processes of chronization, but also to the processes of relapse. The standard therapeutic manual of these pathological processes with antibacterial and other drugs, as a rule, does not correct violations. This leads to a decrease in the effectiveness of the therapy. [1]</p>
<p><br />Purpose</p>
<p>To optimize the treatment of purulent soft tissue wounds in rats in an experiment by using combined pharmacotherapy.</p>
<p>METHODS <br />The main research method was a chronic experiment on modeling a purulent wound and combined pharmacotherapy of this nosological group. The animals were divided into 4 groups: 1 control and 3 experimental, 10 animals in each group. In the 1st control group, no treatment was carried out. In the 2nd group, hydrogen water was used externally and internally, and water enriched with hydrogen at a concentration of 1.6 ppm (in a cartridge) was used for local application, hydrogen water of a lower concentration obtained using the Enhel-mini device was used for ingestion. In group 3, the animals received ordinary drinking water inside, externally - dioxomethyl-tetrahydropyrimidine + Chloramphenicol (Levomecol). And in the 4th group: inside - hydrogen water from the device Enhel-mini, externally - dioxomethyl-tetrahydropyrimidine + Chloramphenicol (Levomecol). Modeling of purulent was carried out with the help of anesthesia with acetyl (8 mg/kg, intramuscularly) by dissection of the skin, subcutaneous tissue and superficial fascia in the withers. The area of the wound defect was 2 cm. After that, a daily culture of St. aureus (1 ml, 109 microbial bodies) was injected into the wound. The wound was sutured. [2]</p>
<p>Results <br />Objects of research<br />The object of the study was 40 nonlinear white male rats with a mass of 1405.6 Wistar lines. Previously, all animals have been quarantined for 7 days.<br />The main results of the study<br />On the second day after the introduction of St. aureus in the wound, there were: edema and hyperemia of soft tissues. On the third day, purulent inflammation of wounds was noted. Treatment of a purulent wound was started on the third day from the moment of modeling with the removal of stitches, while up to 4 ml of purulent discharge was observed. <br />The indicators of the course of the wound process were evaluated immediately, on the 1st, 3rd, 5th, 7th and 14th days after modeling a purulent defect.</p>
<p>On the 1st day, the behavior of the animals in the groups was the same: the animals were adynamic, showed anxiety during palpation of the wound. Visually, serous-purulent discharge was observed on the bandages, hyperthermia and swelling of tissues were noted in the wound area. On the 3rd day, the animals of the main group became active, the wetting of the hypoxic-purulent wound discharge became less, the signs of inflammation decreased. On day 5, there was no normalization of the general condition of the animals in the 1st group of the study, similar results were observed in the 2nd group, where the animals received hydrogen water internally and externally. Treatment of the wound with dioxomethyl-tetrahydropyrimidine + Chloramphenicol (Levomecol) and simultaneous administration of hydrogen water inside in the 4th group led already on the 4th day to significantly higher activity of animals and improved appetite, and by the 6th day to the absence of anxiety during palpation along the course of the wound. Higher activity and improved appetite of animals in the 3rd group was also observed on the 5th day. On the 7th day in the 1st control group, normalization of the general condition was also absent by the 7th-8th day. When pressing along the course of the wound, a significant amount of serous discharge was observed. In group 2, normalization of the general condition of animals was noted only by the 7-8 days from the start of treatment, while serous discharge in a small amount continued to be detected in all animals. In the 3rd group of animals, when palpating the edges of the wound, a small amount of scanty serous discharge continued to be observed in individual animals. In group 4, serous discharge was practically absent and was recorded only in isolated animals. On the 14th day in the 1st control group, complete normalization of the general condition was not observed in all animals only and only by the 13th-14th day. When pressing on the edges of the wound, a small amount of serous discharge was observed in isolated cases. In group 2, complete normalization of the condition was not observed in all animals and was noted by the 12th-13th day from the start of treatment, on the 14th day there was an insignificant amount of serous discharge in isolated cases. In the 3rd group of animals, serous discharge was absent when pressing along the wound, however, complete normalization of the condition was not observed in all animals. In group 4, complete normalization of the general condition in all animals, serous discharge was absent and complete normalization of the condition was observed.[3, 4]</p>
<p>Additional research results <br />In the course of scientific work, additional results of the study were revealed. In rats taking hydrogen water, earlier activation was observed regardless of the course of the wound process. <br />Undesirable phenomena<br />Absence of undesirable phenomena.</p>
<p><br />Discussion<br />Summary of the main research result<br />The optimization of pharmacotherapy of purulent wounds in the experiment through the use of hydrogen water and local antibacterial agents is proposed.<br />Discussion of the main result of the study<br />The most pronounced positive dynamics of the wound process was noted in the treatment of the inside hydrogen water, externally Dioxomethyl-tetrahydropyrimidine + Chloramphenicol (Levomecol) (group 4), where the disappearance of hyperemia was noted by 22.4%, edema of the skin by 11.3%, the end of necrolysis by 24.8%, the appearance of granulations by 23.1%, epithelialization of the wound by 16.2%, reduction of discharge to scanty by 27.5% faster, compared to with data from the 1st control group. The analysis made it possible to talk about the acceleration of the flow rate of the 1st and 2nd phases of the wound process in the 4th group by an average of 1.2-1.4 and 1.21.3 times, respectively, compared with the data obtained in the 1st control group.[5]<br />Limitations of the study<br />Additional factors contributing to the restriction should be counted, including genetic features that can affect the pharmacokinetics of the drug and reduce its pharmacological effects.</p>
<p><br />Conclusion<br />Thus, it seems appropriate to use the combination of antibacterial agents with water enriched with molecular hydrogen in therapeutic concentration for optimal corrective pharmacotherapy. Hydrogen water has an anti-inflammatory and anti-apoptotic effect, free hydrogen binds to radicals and prevents disruption of the cellular development process. Levomekol, in addition to antimicrobial and action, stimulates regeneration processes.</p>[Земсков А.М. Неспецифичные и специфичные механизмы антиинфекционного иммунитета / А.М.Земсков, В.А.Земскова, Т.А.Бережнова, Я.В.Кулинцова, К.С.Дядина, А.В.Ларин, Д.И.Коруняк // Прикладные информационные аспекты медицины. – 2018. – Т. 21. – № 1. – С. 176-183.][Земсков А.М. Лабораторные показатели, как маркеры диагностики и иммунотерапии инфекций / А.М.Земсков, В.М.Земсков, Т.А. Бережнова, В.А.Земскова, Я.В.Кулинцова // Вестник новых медицинских технологий. Электронное издание. – 2017. – № 4. – С. 186-193.][Фармакология: химиотерапевтические лекарственные средства / Бережнова Т.А., Левченко Ю.А., Преображенская Н.С., Резников К.М., Китаева Р.И., Брездынюк А.Д., Борисова Е.А. // Рабочая тетрадь для самостоятельной работы студентов, обучающихся по специальности «лечебное дело» / Воронеж, 2016.][Berezhnova T.A. Immune-Metabolic Therapy of Purelent Inflammatory Diseases / T.A. Berezhnova, K.S. Dyadina, Ya.V. Kulintsova // Research Results in Pharmacology. – 2020;6(4): 1–6. https://doi.org/10.3897/rrpharmacology.6.55628][Zemskov A.M. Immune-metabolic genesis of pathological processe / A.M. Zemskov, T.A. Berezhnova, V.A. Zemskova, K.S. Dyadina, A.V. Larin // Research Results in Pharmacology. – 2019;5(4): 19-31. https://doi.org/10.3897/rrpharmacology.5.38386]