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Введение антибиотиков под струп
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Введение антибиотиков под струп

Warning: file_put_contents(): Only 0 of 1344 bytes written, possibly out of free disk space in /var/www/filosof/data/www/medservices.info/wp-content/plugins/wp-optimize-by-xtraffic/Application/Service/PepVN_Cache.php on line 684 Warning: file_put_contents(): Only 0 of 128 bytes written, possibly out of free disk space in /var/www/filosof/data/www/medservices.info/wp-content/plugins/wp-optimize-by-xtraffic/Application/Service/PepVN_Cache.php on line 684 Warning: file_put_contents(): Only 0 of 115 bytes written, possibly out of free disk space in /var/www/filosof/data/www/medservices.info/wp-content/plugins/wp-optimize-by-xtraffic/Application/Service/PepVN_Cache.php on line 684 Warning: file_put_contents(): Only 0 of 128 bytes written, possibly out of free disk space in /var/www/filosof/data/www/medservices.info/wp-content/plugins/wp-optimize-by-xtraffic/Application/Service/PepVN_Cache.php on line 684 Warning: file_put_contents(): Only 0 of 110 bytes written, possibly out of free disk 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by admin13.07.2015
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Введение антибиотиков под струп, как это предложил делать С. Baxter (1974), должно контролироваться биопсией ожоговой раны. Если определяется более 100 ООО микробных тел в 1 г ткани, то это значит, что бактерии стали активно размножаться в глубоких, не пораженных ожогом тканях. Под струп чаще всего вводят гентамицин, тобрамицин и канамицин в максимально переносимой дозе с помощью длинных игл для спинномозговой пункции. Антибиотики разводят в 0,25-0,45% растворе хлорида натрия. Раствор Рингера-Локка-лактата для этой цели лучше не применять, поскольку в нем содержится , несовместимый с некоторыми антибиотиками. Иглу вкалывают в непораженную кожу рядом со струпом, продвигают ее в глубжележащие под струпом ткани и вводят до 200-250 мл раствора антибиотика. Следующий вкол иглы делают по периметру струпа, отступя от первого на 10-15 см. С. Artz суточную дозу подобранного антибиотика смешивает с 0,45% раствором хлорида натрия и вводит под струп капельно. Выбор антибиотика зависит от результатов биопсии и проверки чувствительности микрофлоры к имеющимся препаратам.

Из других новых антибактериальных средств для местного лечения ожогов довольно широкое распространение получил один (называемый еще бетаизодоном или бетадином). Он оказался активным в борьбе с синегнойной инфекцией, но неэффективным против штаммов стафилоккока. Недостатком бетадина является болезненность при наложении мази на рану, что ограничивает его использование Е. Hirsch, С. Blanco предложили использовать бетадин на новой эмульсионной пенистой основе (он лучше переносится больным, его легко наносить на рану).

I. Svab сообщил о первом опыте успешного применения 0,05-0,2% водного раствора перуксусной кислоты, a J. Fearn -1% раствора уксусной кислоты для контроля раневой микрофлоры, в первую очередь синегнойной палочки и протея. Если лечебное действие перуксусной кислоты нигде не описано, то уксусной кислотой ранее широко пользовались для борьбы с раневой инфекцией. По данным I. Svab, перуксусная кислота ускоряла отторжение некротических тканей, способствовала росту грануляций и эпителизации.

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