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gh BALM FOR DIFFICULT WOUNDS: GUNSHOT AND OTHER WOUNDS

Moscow Region, Chernogolovka , Institute of Chemical Physics Problems, Russian Academy of Sciences
13.11.2008
Russian researchers have found out why necrosis often arises around gunshot wounds. They have also invented a method that enables to efficiently fight against this problem.
Send mail Scientist: Vladislav Varfolomeyev, Doctor of Biology, leading research assistant , Moscow Region, Chernogolovka

For additional information: varfol@icp.ac.ru
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The wound shot by contemporary fire-arms is not simply a hole in the body like it was in the times of the World War II. Unfortunately (of course, it depends on which side of the barricade you are), , not only a more or less vast cavity is formed around the tissue canal “broken through” by a high-speed unstable bullet, the cavity contains blood, amorphous cellular mass, skin and clothes scraps and simply dirt. Even worse is the fact that around the wound per se, there appears roughly speaking the “contused”, traumatized tissue doomed to death (necrosis) within the first six hours. Researchers from the Institute of Chemical Physics Problems, Russian Academy of Sciences (Chernogolovka), tried to investigate the reason for secondary necrosis, due to which surgeons not only have to “clean and sew” the wound but also to ablate tissue around it. Having gained an understanding of that, they invented a method to fight with secondary necrosis, the method being highly efficient.

So, the authors have assumed that secondary necrosis of tissues (when a tissue around the wound that seems living starts to mortify) is not simply a consequence of infection, blood circulation derangements and hypostases. Probably, the true reason is molecule destruction due to instantaneous and tremendous pressure drop in the area around the tissue canal. Then, a lot of things become clear: “splintes” of molecules are radicals which can break cellular membranes, thus becoming the reason for “deferred death”. However, such suppositions should be proved. The authors have managed to do this.

The experiment, of course, had to be made on large laboratory animals – rabbits and pigs, certainly, under the most sparing conditions. The researchers shot at experimental animals and measured the quantity of free radicals in the tissues around the wound for a long time after the affection. The measuring method applied was traditional electronic paramagnetic resonance (EPR).

It has turned out that a powerful signal alien to normal tissues does occur in the EPR spectra. The presence of such a signal (if we leave out complicated physicochemical calculations) not only confirmed the authors’ assumption about appearance of free radicals but also enabled to determine the boundary to the secondary changes area provoked by free radicals. Here comes a conclusion – if activity of these radicals is reduced, i.e., if active radicals are transformed into stable ones, the tissue can be protected from affection. To this end, as the authors believe, efficient “catcher for radicals” is quite suitable - di-tret-butyl-phenol. When it meets with an active radical, the latter becomes a stable compound, and the radical – becomes a stable one, i.e., quite harmelss. This is a well-known antioxidant, which is permitted for application as a remedy. It makes part of the drug for treatment of ulcerous diseases, particularly for inhibition of processes of lipid peroxidation.

Thus, one of the candidates to the role of a fighter against secondary necrosis has been determined – it is di-tret-butyl-phenol, which is now produced under the “Tonalor” trademark. But it seemed insufficient for a group of researchers under the guidance of Viacheslav Vorfolomeyev, Doctor of Biology. They decided to add two more components – taktivin and tomicidum - into the future drug. The former is a polypeptide obtained from the thymus gland of large horned cattle. It is known for the fact that it roughly speaking reinforces immunity. Or more precisely, it normalizes characteristics of the immunity T-system in case of immunodeficiency, it stimulates lymphoquin production, including interferon, and in general brings to norm a number of cellular immunity characteristics. And finally, the authors suggested to apply tomicidum to make the action of the future drug fully comprehensive. This is a filtrate of streptococcus culture broth, which has bactericidal action.

It was indeed rather difficult to combine these components in a single medium: tonarol hardly, if at all, dissolves in the water, and the rest – on the contrary, dissolve well. However, the researchers have succeeded to solve the problem and produced the gel, the composition of which includes all three preparations. Of course, its action was tried on rabbits and pigs. The outcome has surpassed all expectations.

It has turned out that cleansing of a fresh wound by this gel practically entirely prevents the secondary necrosis development. As V.N. Varfolomeyev said in his report at the 20th symposium “Contemporary Chemical Physics”, the debrided wound heals up quickly, “in three days pigs are running so quickly that we can hardly catch them”. At that, the wounds cleansed by traditional remedies or not at all cleansed look terrible – necrosis develops around the tissue canal within several hours. In fact, the gel acts efficiently only in the first six hours after wounding. Then its efficiency decreases significantly. So, in the authors’ opinion, the best way is to extrude gel into the wound directly in the battlefield, and then the consequences will be much more sparing.

However, the developed preparation is very useful not only for treating bullet wounds - fortunately, shooting is relatively rare in common life, but burns, trophic ulcers, frostbite and ordinary wounds happen rather often. In all these cases, as the authors state, the drug also accelerates healing. “We have made sure of that by ourselves”, confessed V.N. Varfolomeyev. He did confess - because it is still impossible to apply the new gel to treating people – the preparation has passed preclinical trails, but clinical trails are still pending. There are no doubt, though, that the clinical trials results will be positive, and, hopefully, the drug will be sold at the pharmacy. Besides, it will save a lot of people at the battlefield.

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