Modern dressings and wound coverings

Ointment dressings;

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

Ointments:

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

Produced from marine brown algae. They are hydrophilic materials and, when combined with the exudate, the wounds are converted 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) - adsorbing soft coating of porous silicone.
3. "Mepitel" (Sweden) - an atraumatic bandage with a soft silicone coating of the mesh structure, on top of which an adsorbing exudate dressing is applied.
4. "Aktisorb Plus 25" (USA) consists of a 2-layer shell of non-woven nylon, between layers of which activated charcoal, saturated with silver.

Gel coatings;

1. "Gelepran" (Russia) - atraumatic, thermo- and form-stable wound gel bandage. Produced in pure form and with miramistin.
2. Hydrocolloids:

Transparent hydrogel dressings with a top layer of air-permeable, anti-permeation microorganisms and moisture film. The lower layer of the dressing is hydrogel:

• Hydrosorb (USA), Hydrocoll (USA)
• Lita-Color (Russia) - dressing gauze, impregnated with a solution of exolin.
• "Gyaplus" (Russia) - bandages based on hyaluronic acid and fibrin coatings.
• Aguacel Ag (England). A dry bandage based on Hydrofiber technology adsorbs the exudate and turns into a gel with silver ions.
• Films;
• Semi-permeable polyurethane films, permeable to gases and impermeable to liquids. The surface has pores of about 2 μm. Through these pores, gas exchange takes place between the wound surface and the environment, but they are too small to penetrate microorganisms. 
• Silon-TSR, Telfa, Protective Dressing (USA).
• "Op-Site", "Tegaderm", "Cutinova hydro", Omiderm (USA).
• Film-forming aerosols: Lifusol, Statisol, Naxol.

When the wounds are covered with impermeable films for water and bacteria that allow normal gas exchange, a moist environment is created in the wound that stimulates the removal of autolysis products from necrotic tissues and the destruction of excess collagen.

Films also grow a culture of keratinocytes and fibroblasts. Such cellular compositions are superimposed by cells down onto the wound. Due to the action of cytokines, qualitative and rapid epithelialization occurs.

Films: Biokol, Foliderm (Russia).

• Foams;

Panthenol, Olazol, Dioxysol, (Russia).

• Combined funds;

Collagen sponges:

Wound coatings on collagen, which include various biostimulating, antiseptic, bactericidal components do not require daily dressings, are independently lysed.

1. A spongy collagen with sanguirithrin (Russia).
2. Meturakol (Russia). - collagen sponge with methyluracil
3. "Algikol" (Russia) - collagen sponge with furaginom.
4. Porous plate "Kombutek" (Russia) with collagen, boric acid, etc.
5. "Digispon" (Russia) - a plate with collagen, dioxide. Glutaraldehyde and others.
6. "Algipor" (Russia) - a sponge with alginates.
7. Sponge "Kolotsil" (Russia), with collagen, furacillin, novocaine, etc.
8. "Collakhit-FA" (Russia). The composition includes a collagen-chitosan complex with the addition of furagin and anilocaine.
9. "VoskoPran" (Russia). Ointment bandages on an elastic-mesh base, impregnated with beeswax and propolis. Several variants are produced: without additional medicinal product, with 10% methyluracil ointment, with levomycol. Patients with an allergy to bee products should not be used!
10. «ParaPran» (Russia). Atraumatic bandage made of cotton fiber, impregnated with paraffin. Produced in several versions: in pure form without drugs, with chlorhexidine, chymotrypsin, lidocaine.
11. "Collost" (Russia). Collagen membrane.

• Gels.

One of the options for curative remedies for skin scarring after grinding are gels. Gel therapeutic forms are lean, moisture-consuming compositions that, in addition to the hydrophilic base, contain various components. Gels that can be used to treat wound surfaces are subject to special requirements. It is known that wounds preserved in a moist, antiseptic state have optimal conditions for epithelialization. Moreover, in experiments on animals and embryos of the human fetus, the possibility of non-wound healing of wounds, which are conducted in a moist environment, has been proved.

Gel compositions that can be used as wound coverings should be absolutely biocompatible with tissues, do not cause toxic allergic reactions, have antiseptic and immunostimulating properties, retain wound surface for some time in a wet state, after which it can be transformed into an air-permeable film. For today, in our opinion, such properties are possessed only by the gel preparation "Curious Gel" (Gedeon Richter AO, Hungary), based on zinc hyaluronate. The main active substance of the drug is zinc hyaluronate. Hyaluronic acid (HA), which is a part of the preparation, is a natural mucopolysaccharide, which forms the basis of human dermis mucopolysaccharides. In addition, hyaluronic acid is not a species-specific substance, therefore, obtained by any method and from any kind of tissue, is perceived by the body as its own. Hyaluronic acid in kuriosine is derived from chicken combs. It is known that 1 molecule of hyaluronic acid retains near to itself about 500 molecules of water, due to what it is a super-hydrophilic substance. Hyaluronic acid also has a zinc immunomodulatory effect as well as a trace element. To all these properties, the attractiveness of curiosin for treating surfaces after grinding or after the removal of various benign skin formations, or after surgery is that patients can use it themselves. This is especially true when visiting a doctor for dressings is for some reason impossible. We recommend that patients several times a day gently squeeze the gel on the wound surface and distribute it with a corner of a sterile wipe and they successfully cope with this task.

Recommendations for care of wound surfaces after grinding with Kuriozin gel.

Immediately after the operation of dermabrasion of the rumen, washing and drying of the wound surface, we lubricate the whole erosive surface with a thick layer of gel and in this form we release the patient home or, if the surfaces are large (the whole face), we leave in the hospital. Of course, such management of wound surfaces is possible only in open areas of the body. The wound surface looks unprotected, but this need not be feared, as the gel, as we have said, has a protective and immunostimulating effect. On this day and the next it is recommended to treat the surface of grinding every 1.5-2 hours to create the most favorable conditions for the skin cells to interact and exchange information. By the end of the second day, as a rule, an elastic crust begins to form on the place of grinding. Despite this, we continue to process it, but more rarely, 2-3 times a day until the crust completely disappears after 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 transferring chitosan from linear to microgranular form, which made it possible to reduce the molecule size by more than 8 times. Thus, the permeability of chitosan through the skin has been greatly increased many times. According to the chemical structure, it is related to cellulose and is a natural polysaccharide of 1,3-betta-glucan. Binding to the cell wall of bacteria, fungi and viruses manifests its fungicidal, antiviral and bactericidal activity. When the skin application is also regenerative, immunostimulating and hemostatic action. There are data on its antitumor properties. Due to the high moisture retention ability of chitosan interacting with proteins and lipids of the epidermis, forms a film bound to them. As a result, transdermal skin loss of water stops and a moist environment is created in the wound, which is necessary for optimal cell interaction and epithelialization. Chitosan compositions are very effective after various types of grinding and maintenance of postoperative sutures. The chitosan gel can be used not only by applying to the skin, but also for administration by microgalvanic and electrophoresis from the positive pole. It is recommended to use a method similar to curiosin.

• "Aloe Vera gel" (USA).

About immunostimulating, adsorbing, bactericidal, regenerating and moisturizing properties of Aloe Vera has been known for a long time. Due to its unique properties, aloe creates in the wound conditions for rapid repair. It is used by analogy with kuriosin.

• Allogeneic skin and its substitutes.

Allogenic fresh and cadaveric skin could be an ideal biological coating, if not for the complexity of obtaining. It can be stored for a long time in the frozen state. This type of wound cover is considered to be biological, compatible with the tissues of the recipient. After the onset of epithelialization of the wound, the coating is rejected.

• «AlloDerm», (Integra).
• Xenoderma (Russia).

From xenogenic skin is used the skin of a pig, as the tissues of a pig and a man are close in their structure. Just like the cadaveric skin, it is rejected after epithelization of the wound surface.

Of the wound coverings close to this group and having a very high wound healing potential, it is necessary to note films from the amnion. They also refer to biological wound coverings, have a bacteriostatic effect, stimulate procollagen synthesis, are elastic, easily lie on the wound surface, are transparent, which allows you to observe the condition of the wound surface and re-epithelialization.

Cultivated skin substitutes: "Fibrodermis", "Fibropor" (Russia).

• Other technologies.
  • It is possible to care for wound surfaces with an open method with repeated washing with water or saline. It can be combined with treatment with panthenol, bepantene, solcoseryl.
  • You can also conduct wound surfaces under sterile vaseline, bismuth powder, etc. 
  • In the scientific literature, there is even information about the use of boiled potatoes as a biological wound coating, which is processed, sterilized and widely used for the treatment of burns in developing countries (138).
  • Wound treatment with local antiseptics can also be considered as one of the simplest ways to care 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 increasing.

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

[1], [2], [3], [4]