Reference
for polyurethane foam cover for wounds, burns and ulcers
PUF “LOCUS”
Over the time of many centuries for cover of wound surface, cotton wool and gauze made of natural cotton or lint, have been used. However, these materials have very essential disadvantages, such as traumatism, non-sufficient hygroscopicity, breakdown in the wound, risk of secondary infection and etc.
With the coming of macromolecular chemistry, cellulose and viscose materials, covers on the basis of collagen, fibrin and etc have become to be offered as bandages. Bandages with the use of holed polymer films (“Perfon” J&J), hydrophilic threads and with the use of metal (“Metallin”, Germany) are created. Carbonic atraumatic bandages “Legius” have been created in Russian Federation. Small-granulated dextranomer “Debrisan” is produced in Sweden. Biological active bandage materials have been also created:
1. With proteolytic ferments – on the basis of cellulose, polyamide, alginate and collagen fibers and also of “Phtorlon” fiber;
2. With sorption capability – on the basis of algid acid and collage, fibrous carbonic materials;
3. Antimicrobial – on the basis of cellulose and polypropylene fibers, silk, “Phtorlon” fiber;
4. Haemostatic – on the basis of alginor, collagen, gelatin;
5. Absorbable covers on the basis of polysaccharide, synthetic polymers;
6. With anesthetic activity on the basis of collagen and gelatin as film covers and etc.
So, there is big range of various bandages and covers for the treatment and healing of wounds, but till present time so-called “ideal’ bandage, the parameters of which were formulated by T.Tuner in 1990 has not been created:
• to create and control moisture of wound surface optimal for healing, keeping minimal possible amount of cell detritus, wound exudates and microorganisms on the surface of wound;
• to provide and control optimal gas content of wound environment, especially, the content of oxygen and carbonic acid;
• to keep optimal concentration of hydrogen ions (pH) in wound;
• to provide thermal isolation of wound from environment;
• to be impervious for microorganisms both from the side of wound (for prevention of contamination of skin surrounding wound) and from outside;
• to be non-toxic with regards to wound cells and to the organism of the patient in whole, not to content substances or fragments which are able to destroy healing;
• to be atraumatic, not provoking pain or injury of newly formed tissue or epithelium during change of bandage.
At present time, polyurethane foam cover created in frontier hospital of Federal Security Service of Russia (Nizhny Novgorod city) PUF “LOCUS” complies with the criteria most of all. It does not have analogs in the world. Foamed mass, received during mixing of polyol and isocyanate components, during applying on the wound, produces finely porous elastic cover which is about 70 cm2 with thickness of 0.8-1 cm. The cover is sterile and bactericidal at the moment of applying. It posses moisture resistance and perfectly protects from secondary infection, during this, the aeration of wound is kept. It absorbs exudates well and is tightly fixed to healthy skin around the wound for 5-7 days, not requiring care.
PUF “LOCUS” has the following medical biological characteristics:
• perfect water-bio isolating properties;
• perfect sorption properties;
• absence of adhesion to wet surfaces, with good adhesion to dry surfaces;
• non-toxic, self-sterilized during missing of components;
• fully repeats relief of wound surface, improves capillary blood flow.
During study of cover’s usage it was seen that PUF “LOCUS” optimizes the flow of traumatic process at patients with trophic ulcers, non-healing, burn, gunshot wounds, and also actively impacts to traumatic process at patients with diabetes mellitus, complicated syndrome of diabetic foot, that allows to decrease period of patients’ treatment in 2-3 times. Use of PUF “LOCUS” is especially effective during the treatment of:
• fresh wounds of any origin;
• burns;
• patients with long time non-healing wounds;
• trophic ulcers of any genesis;
• bedsores and etc.
The cover was also successfully used:
• for prevention of tissue infection at skeleton extension;
• for cover of donor wounds;
• for protection of skin around fistulas of gastrointestinal tract;
• for strengthening of drainages on body’s skin.
There are no direct contraindications for use of the cover, excluding rare cases of severe suppuration, anaerobic and suppurative infection.
During study of PUF “LOCUS” administration in Russia several Candidate's dissertations and one doctoral dissertation (“Work out and experimental clinical explanation of administration of polyurethane foam bandage in surgery” A.A.Kuranov, 205) have been defended.
At present time small serial batches of PUF “LOCUS” are produced for the needs of interested medical organizations. Comfortable packing for usage in field conditions has been worked out for the needs of naval forces and Ministry of Emergency Situations of Russian Federation.
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