Modern dressings and wound coverings

Ointment dressings;

1. "Branolind" (USA), ointment dressing on a fabric base, impregnated with Peruvian balsam;
2. "Atrauman", a hydrophobic material impregnated with neutral fat;
3. "Grassolind neutral" - large-mesh fabric impregnated with an indifferent fat base;
4. "Pyolysin" (Germany).

Ointments:

• levomekol, levosin (Russia), dermazin (Slovenia), dalacin (USA), D-Panthenol (Croatia).
• Alginins;

They are made from brown seaweed. They are hydrophilic materials and when combined with wound exudate they turn into a gel-like material.

"Sorbalgon" (Germany).

Absorbent dressings;

1. "VoskoSorb" (Russia) is a polyester non-woven fiber coated with pure beeswax and propolis in combination with a sorbent layer of cotton and viscose.
2. "Mepilex lite" (Sweden) - absorbent soft coating made of porous silicone.
3. "Mepitel" (Sweden) is an atraumatic dressing with a soft silicone coating of a mesh structure, on top of which an exudate-absorbing dressing is applied.
4. "Actisorb Plus 25" (USA) consists of a 2-layer shell made of non-woven nylon, between the layers of which activated carbon saturated with silver is placed.

Gel coatings;

1. "Gelepran" (Russia) - atraumatic, heat- and shape-stable wound gel dressing. Available in pure form and with miramistin.
2. Hydrocolloids:

Transparent hydrogel dressings with an upper layer of air-permeable film that prevents penetration of microorganisms and moisture. The lower layer of the dressing is hydrogel:

• Hydrosorb (USA), Hydrocoll (USA)
• Lita-Tsvet (Russia) - gauze bandage impregnated with exoline solution.
• "Giaplus" (Russia) - dressings based on hyaluronic acid and fibrin coatings.
• Aguacel Ag (England). Dry dressing based on Hydrofiber technology adsorbs exudate and turns into a gel with silver ions.
• Films;
• Semi-permeable polyurethane films, permeable to gases and impermeable to liquids. They have pores on the surface about 2 microns in size. Gas exchange between the wound surface and the environment occurs through these pores, but they are too small for microorganisms to penetrate.
• Silon-TSR, Telfa, Protective Dressing (USA).
• "Op-Site", "Tegaderm", "Cutinova hydro", Omiderm (USA).
• Film-forming aerosols: Lifusol, Statizol, Naxol.

By covering wounds with films that are impermeable to water and bacteria and that allow normal gas exchange, a moist environment is created in the wound, which stimulates the removal of autolysis products from necrotic tissue and the destruction of excess collagen.

Keratinocyte and fibroblast cultures are also grown on the films. Such cellular compositions are applied cell-side down to the wound. Due to the action of cytokines, high-quality and rapid epithelialization occurs.

Films: "Biokol", "Foliderm" (Russia).

• Foams;

Panthenol, Olazol, Dioxizol (Russia).

• Combination products;

Collagen sponges:

Collagen wound dressings, which contain various biostimulating, antiseptic, and bactericidal components, do not require daily dressings and are self-lysing.

1. Collagen sponge with sanguiritrin (Russia).
2. "Meturacol" (Russia) - collagen sponge with methyluracil
3. "Algikol" (Russia) - collagen sponge with furagin.
4. Porous plate "Kombutek" (Russia) with collagen, boric acid, etc.
5. "Digispon" (Russia) - a plate with collagen, dioxidine, glutaraldehyde, etc.
6. "Algipore" (Russia) - sponge with alginates.
7. Sponge "Kolotsil" (Russia), with collagen, furacilin, novocaine, etc.
8. "Collahit-FA" (Russia). Contains a collagen-chitosan complex with the addition of furagin and anilocaine.
9. "VoskoPran" (Russia). Ointment dressings on an elastic mesh base, impregnated with beeswax and propolis. Several options are available: without additional medication, with 10% methyluracil ointment, with levomekol. It is not recommended for patients with allergies to bee products!
10. "ParaPran" (Russia). Atraumatic dressing made of cotton fiber, impregnated with paraffin. Available in several versions: pure without drugs, with chlorhexidine, chymotrypsin, lidocaine.
11. "Collost" (Russia). Collagen membrane.

• Gels.

One of the options for treatment of skin scars after grinding are gels. Gel treatment forms are fat-free moisture-absorbing compositions, which in addition to the hydrophilic base include various components. Special requirements are imposed on gels that can be used to treat wound surfaces. It is known that wounds preserved in a moist, antiseptic state have optimal conditions for epithelialization. Moreover, in experiments on animals and human embryos, the possibility of scarless healing of wounds that are treated in a moist environment has been proven.

Gel compositions that can be used as wound dressings must be absolutely biologically compatible with tissues, not cause toxic-allergic reactions, have antiseptic and immunostimulating properties, keep the wound surface moist for some time, after which they turn into an air-permeable film. Today, in our opinion, only the gel preparation "Curiosin gel" (Gedeon Richter A.O., Hungary), based on zinc hyaluronate, has such properties. The main active ingredient of the preparation is zinc hyaluronate. Hyaluronic acid (HA), which is part of the preparation, is a natural mucopolysaccharide, which forms the basis of mucopolysaccharides of the human dermis. In addition, hyaluronic acid is not a species-specific substance, therefore, obtained by any method and from any type of tissue, it is perceived by the body as its own. Hyaluronic acid in curiosin is obtained from chicken combs. It is known that 1 molecule of hyaluronic acid holds about 500 molecules of water, due to which it is a superhydrophilic substance. Hyaluronic acid has the same immunomodulatory effect as the trace element zinc. In addition to all the listed properties, the attractiveness of Curiosin for the treatment of surfaces after grinding or after the removal of various benign skin formations, or after surgical interventions is that patients can use this drug themselves. This is especially true when visiting a doctor for dressings is impossible for some reason. We recommend that patients carefully squeeze the gel onto the wound surface several times a day and distribute it with a corner of a sterile napkin, and they successfully cope with this task.

Recommendations for the care of wound surfaces after polishing with Curiosin gel.

Immediately after the scar dermabrasion operation, washing and drying the wound surface, we lubricate the entire erosive surface with a thick layer of gel and send the patient home in this form or, if the surfaces are large (the entire face), leave him in the hospital. Of course, such management of wound surfaces is possible only on open areas of the body. The wound surface looks unprotected, but this should not be feared, since the gel, as we have already said, has a protective and immunostimulating effect. On this day and the next, it is recommended to treat the grinding surface every 1.5-2 hours to create the most favorable conditions for skin cells to interact and exchange information. By the end of the second day, as a rule, an elastic crust begins to form at the grinding site. Despite this, we continue to treat it, but less often - 2-3 times a day until the crust completely falls off in 6-8 days.

Recommendations for working with other gels are similar.

• "Solcoseryl (Actovegin) jelly" (Bulgaria).
• Chitosan gel, "Argovasna" (Russia).

Russian scientists have developed a unique technology for converting chitosan from a linear to a microgranulated form, which has reduced the size of the molecule by more than 8 times. Thus, the permeability of chitosan through the skin has been increased many times. In terms of chemical structure, it is related to cellulose and is a natural polysaccharide 1,3-beta-glucan. By binding to the cell wall of bacteria, fungi and viruses, it exhibits its fungicidal, antiviral and bactericidal activity. When applied topically, it also exhibits a regenerating, immunostimulating and hemostatic effect. There is evidence of its antitumor properties. Due to its high water-retaining capacity, chitosan interacts with proteins and lipids of the epidermis, forming a film associated with them. As a result, transdermal water loss by the skin stops and a moist environment is created in the wound, which is necessary for optimal cellular interaction and epithelialization. Chitosan compositions are very effective after various types of grinding and postoperative sutures. Chitosan gel can be used not only by applying to the skin, but also for introduction using microgalvanics and electrophoresis from the positive pole. It is recommended to use a method similar to Curiosin.

• "Aloe Vera Gel" (USA).

The immunostimulating, adsorbing, bactericidal, regenerating and moisturizing properties of Aloe Vera have been known for a long time. Due to its unique properties, aloe creates conditions for rapid reparation in the wound. It is used in a similar way to curiosin.

• Allogenic skin and its substitutes.

Allogenic fresh and cadaveric skin could become an ideal biological covering, if it were not for the difficulties with obtaining it. It can be stored frozen for a long time. This type of wound covering is biological, compatible with the recipient's tissues. After the wound epithelialization, the covering is rejected.

• "AlloDerm", (Integra).
• Xenoderma (Russia).

Pig skin is used as xenogenic skin, since pig and human tissues are similar in structure. Like cadaveric skin, it is rejected after the wound surface epithelialization.

Among wound coverings that are close to this group and have a very high wound-healing potential, it is worth noting amnion films. They also belong to biological wound coverings, have a bacteriostatic effect, stimulate the synthesis of procollagen, are elastic, easily fit onto the wound surface, are transparent, which allows observing the condition of the wound surface and re-epithelialization.

Cultured skin substitutes: Fibrodermis, Fibropor (Russia).

• Other technologies.
  • It is possible to care for wound surfaces in an open manner with repeated washing with water or saline solution. It can be combined with treatment with panthenol, bepanten, solcoseryl.
  • You can also keep the wound surfaces under sterile petroleum jelly, bismuth powder, etc.
  • There is even information in the scientific literature about the use of boiled potato peels as a biological wound covering; they are processed, sterilized, and widely used to treat burns in developing countries (138).
  • Treatment of wounds with local antiseptics can also be considered as one of the simple options for caring for wound surfaces. In connection with the emergence of new strains of microorganisms resistant to antibiotics in the prevention and treatment of wound infection, the practical importance of chemical disinfectants is increasingly increasing.

"Lavasept" (Russia) - local antiseptic, diluted 1 ml. in 1 liter of distilled water (0.1% solution). The wound is treated with an aspiration-washing method, after which a napkin soaked in the solution is left in the wound until the next dressing.

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