Drugs for local treatment of burns

2021-01-30 12:00 AM

Daily examination of burns is the regular job of the doctor, to complement the diagnosis of burn depth, and to prescribe medication.

Outline

Burn injuries are the source of all the pathological disorders associated with burns.

Use local treatment of burn injuries to limit or remove this pathological factor.

Medicines for the local treatment of burns include the following groups of drugs:

Antibacterial drugs for burn injuries.

Drugs that deplete burn necrosis.

Drugs that stimulate regeneration of burns.

The medicine dries and makes a film to cover the burn.

In the treatment of modern burns, the use of skin replacement materials is a world concern.

Daily examination of burns is the regular job of the burn therapist to complement the diagnosis of the depth of the burn and prescribe appropriate local and systemic medications.

Medicines for the local treatment of burns 

The drug inhibits bacteria wound burns 

Requirements of an antimicrobial agent for burns:

Works with bacteria that cause burn infection with the lowest rate of drug resistance.

No or less damage to healthy tissue and healthy cells.

No or few side effects.

Penetrates deep into the tissues.

- Cream Silver sulfadiazine 1%.

Features and effects: A combination of silver (Ag) with a sulfamide. Produced since 1960, in the form of a white 1% water-insoluble cream. This is an antibacterial drug used in place of burns that is quite popular today.

The drug causes little or no pain.

Less drug penetrates deep into necrosis.

The drug has a wide antibacterial spectrum with many types of bacteria such as S.aureus, E.coli, Klebsiella, P.aeruginosa, Proteus, Enterobacteriaceae and even C.albicans.

Point:

Treat shallow and deep burn wounds.

Contraindications:

After skin grafts.

Pregnant women in the last months of pregnancy, infants (because of jaundice).

Allergy to ingredients of the drug.

How to use:

Medicines used to apply to a new burn (after the first wound has been treated well) can be applied directly to the wound or soaked in a gauze.

Change the dressing once or twice a day.

Side effects:

Silver sulfadiazine 1% (SSD 1%) may cause leukopenia. This sign usually occurs after 2-3 days of using the drug when applying a large area. This symptom is common in 5-15% of patients.

Some common brand name drugs:

Silvadene (United States).

Flammazin (France).

Silvin (Pakistan).

Silvirin (India).

Silver sulfadiazine (Hue Central Pharmaceutical Factory).

- Axit Boric.

This is a weak acid, the drug is used in the form of a 3% solution or in the form of a white crystalline powder, packaged for 10 grams.

Boric acid inhibits the growth of the green purulent bacillus.

Point:

Treatment of wounds infected with green pus bacillus.

Use to neutralize burns caused by hot hydrated lime.

Contraindications: Other types of burns.

How to use: Soak the medicine in gauze to cover the wound areas infected with green pus bacillus, soak the medicine in gauze to cover the burned lime wound, only cover the area of ​​about 10%.

Caution for use: Do not use in too large area because of the risk of drug causing metabolic acidosis.

- Silver nitrate solution (AgNO3).

Characteristics: The drug has the effect of killing green pus bacillus, the drug causes less allergies.

Indications: Green pus bacillus infection burns.

Contraindications: Other burns.

How to use: Soak the drug in gauze, apply to areas infected with green pus bacillus.

Drug form: 0.5% solution; 0.25% in colour bottles. The downside of the drug is the use of gauze, causing black cloth.

Caution for use: Only cover with an area of ​​less than 10% of the body area because the drug causes hyponatremia and blood chlorine, causing metabolic alkalosis and methaemoglobin

- Maduxin grease.

Features and effects: Maduxin (Madhuxin) is a dark brown ointment cooked from the leaves of the tree (Madhuca pasquieri - Dubard H. Sapotaceae). Maduxin oil is the extract of chrysanthemum leaf, chrysanthemum seed oil and vaselin. Maduxin was researched and manufactured from 1990-1995 (Le The Trung, Nguyen Liem, Tran Xuan Van). This is an effective remedy for burn infections. The drug works with staphylococci, green pus bacillus. E.coli, Proteus ... 

Medicinal gauze applied to the wound reduces exudation, reduces odor The drug stimulates epithelialization in superficial burns and produces granulation tissue in deep burns. The drug works well with lime burns.

Indication: treatment of superficial burns, deep burns and lime burns.

Contraindications: After skin grafting.

How to use: After cleaning the wound, soak the medicine in a gauze, apply it on the wound, change the bandage once a day or twice a day.

Cons: The drug often hurts the patient and darkens the fabric.
II.2. Drugs that deplete burn necrosis:

Essentially protein-destroying enzymes derived from chemicals, animals, plants and microorganisms.

From chemicals (weak acids): salyxilic acid 40% grease.

Indications and usage:

Use in dry necrosis from the second week after burns.

Disposable area is less than 10% of body area.

Apply the drug directly to the necrosis, use the drug every other day (Apply the drug about 1mm thick).

Contraindications:

Wet necrosis.

Severe systemic state (heart failure, respiratory failure ...) because of prolonged use of drugs can cause metabolic acidosis.

Animal origin: Trypsin, pepsin, chymotrypsin ..

From plants: yeast papain (from papaya pus), bromelain (from pineapple) works to dissolve fibrin and inhibit platelet clumping.

From microorganisms: enzymes secreted by bacteria such as Streptokinase (secreted by streptococci), Subtilain (by Bacillus subtilist). The Travase preparation has been used clinically with good results.

Drugs that stimulate regeneration of burns (epithelial stimulation and granulation)

In this group of drugs there are many drugs such as:

Ointments: Mackerel liver oil, Gac oil (The essence is vitamins A, D). 

Ointment prepared from gotu kola, madecasol.

Turmeric cream pills.

Dampommade (golden high fat) medicine, this is the inheritance remedy of old master Dam Luong in White Pagoda. Ingredients include: persimmon, beeswax, rose honey, luyn oil ...

Indication: - 5-7 days after skin grafts.

The burn is slow to heal, long-lasting ulcers narrow a narrow area.

Contraindications: Large area (because the ingredients contain lead), only cover less than 5% of body area at a time.

Usage: Applying medicine to gauze to apply to wounds has the effect of stimulating epithelization in areas with narrow granulation tissue and used in long-lasting ulcers. Change the dressing once a day, or change the dressing every other day.

Membrane covering burns (film-forming agents)

The composition of the drug has tannin that coagulates wound fluids, precipitates proteins, binds collagen silk to form a membrane.

Some herbal remedies have the effect of drying and creating a medicinal film, such as thickening myrrh, jute, cajeput, tea ... and especially burn medicine made from the bark of the oval tree. tea.

Cocoa bark has a density of d: 1,22-1,24, viscosity n = 5.36 poises, pH: 7, tannin: 32.1%, resin 14%, flavone 5.4%, 1.37% fatty oils ...

Dry powder, brown colour, quickly dissolves in hot water (powder B76)
Indications: For new burns, superficial burns, burns not infected

Contraindications:

Burns deep.

The burn was infected or heavily polluted.

Burns in the joint area.

Burns on the face, neck, perineal, and genital area.

Burns caused by hot lime:

Usage: B76 powder is sprinkled on the burn after being treated aseptically at the first stage of the wound, cut the dome of the burn, burn the limb without covering the circumference, apply the front and back of the limb.

Note: The drug causes pain for 15-30 minutes after spraying, so it must be good pain relief for patients.

Follow-up after drug application:

Dry with a lamp or dryer.

Cut the drug membrane when there are signs: oedema, compression of the first limb circulation or pus under the drug membrane.

If it goes well, 10-15 days the membrane will flake off and the burn heals.