Skin damage and wounds are always unpleasant. What can we say about trophic ulcers - companions of severe varicose veins, which are characterized by very sluggish and slow healing due to impaired tissue nutrition. Solcoseryl can help heal such difficult lesions, as well as burns, frostbite, and eye damage.
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In what forms is the drug available?
The manufacturer produces Solcoseryl in the form of ointment and gel for external use, as well as ophthalmic gel. In addition, this drug is available in injection form.
The active substance in all cases is calf blood extract - hemoderivat. Auxiliary components for each of the release forms are individual. Thus, in addition to the active substance, the solution contains only water for injection, and, for example, the manufacturer adds a number of ingredients to the ointment: white petrolatum, methyl parahydroxybenzoate, cetyl alcohol, etc.
The uniqueness of the composition of solcoseryl
The ointment has a uniform, greasy texture; the color can vary from deep white to yellow, with a characteristic odor of broth and petroleum jelly.
The active components of solcoseryl include deproteinized (removal of proteins) hemoderivat from the blood of 3-month-old calves at a concentration of 2.07 mg/g. Auxiliary components are represented by methyl parahydroxybenzoate and propyl parahydroxybenzoate (preservatives), palmitic alcohol (emulsifier), white petrolatum (ointment base), water for injection (dissolution of dry dialysate).
An analogue of the drug is Actovegin ointment. These drugs appeared on the pharmaceutical market almost simultaneously and differ only in the manufacturer and price.
The main active ingredient of solcoseryl is a deproteinized hemoderivat, which is obtained by dialysis and subsequent ultrafiltration. During the production process, high molecular weight proteins are removed (deproteinization). This is a complex compound that includes natural low-molecular substances with a molecular weight of up to 5000 Da.
Such a unique composition cannot be reproduced in laboratory conditions. Basically, these are electrolytes, amino acids, nucleotides, nucleosides. The effectiveness of only some of these substances has been described and proven from a pharmacological point of view. However, in vitro tests have proven the effectiveness of solcoseryl in the treatment of damaged tissues and wound surfaces.
What kind of medicine is Solcoseryl?
The drug has a beneficial effect on tissue metabolic processes. It improves tissue nutrition in case of damage, and also activates repair and regeneration processes.
Solcoseryl in injection form is used for extensive circulatory disorders (diseases of peripheral veins and arteries, strokes), ointment and jelly are used to treat ulcerative lesions and slow-healing wounds, and the gel is an ophthalmic agent. Thus, each of the release forms performs its own task of restoring damaged tissue.
The rate of absorption and distribution of the drug in the body, as well as the route of its elimination, cannot be determined by methods usual in pharmacology due to the characteristics of the active substance.
According to the results of a study of the drug on animals, the pharmacological effect develops within half an hour after the bolus injection. The therapeutic effect lasts for 3 hours.
Indications
For each release form of Solcoseryl there are individual indications.
In the form of injections, the drug is prescribed when a patient is diagnosed with:
- occlusive peripheral artery disease grade 3 or 4;
- disturbances of venous blood flow with trophic lesions;
- strokes and traumatic brain injuries, which led to disruption of metabolic processes in the brain.
Ointment and gel for external use are used in complex treatment:
- minor abrasions and wounds;
- mild to moderate burns, frostbite;
- difficult-to-heal skin lesions: trophic ulcers, bedsores.
Ophthalmologists recommend the use of Solcoseryl eye gel to patients for the treatment of:
- injuries of the cornea and conjunctiva, their erosive lesions;
- scars after ophthalmological operations;
- eye burns of various types;
- dystrophic lesions of the cornea.
In addition, this gel is indicated for use in case of discomfort when wearing contact lenses and to reduce the time of getting used to them.
Side effects
The use of an injection solution in rare cases can lead to the development of allergic reactions, including anaphylactic shock. In this situation, you should immediately stop using the drug and prescribe symptomatic therapy in the form of antihistamines.
In addition, the process of performing the injection itself can be painful for the patient due to the potassium it contains.
When using the ointment, some patients may experience a burning sensation at the site of application.
Solcoseryl eye gel may cause short-term irritation, which is not an indication to discontinue treatment. The development of allergic reactions when using external forms of the drug is extremely rare.
Branch
An anal fissure is a defect in the form of a tear or open wound (ulcer) in the lining of the anal canal.
The anal canal is the final part of the large intestine, located between the rectum (the reservoir of stool) and the anus, through which stool passes out.
Symptoms of anal fissure
The most common symptoms are:
- acute pain at the time of defecation, which is accompanied by burning pain and can last for several hours.
- bleeding after bowel movements, which most people characterize as a small amount of scarlet blood in the stool or traces of blood on toilet paper.
When to go to the doctor
Go to the doctor if you think you have an anal fissure. Put aside the embarrassment, the problem of anal fissure is the third most common problem in the structure of diseases of the colon.
In most cases, anal fissures do not require any specialized treatment. However, contacting a specialized specialist will help rule out other diseases that occur under the guise of an anal fissure.
The doctor will also provide recommendations for individual treatment that will help relieve your symptoms and reduce the risk of relapse of the disease.
How is an examination performed for anal fissure?
The doctor will ask you about your symptoms and find out the nature of your pain. He may ask you about the frequency and nature of bowel movements. And, for sure, the doctor will need to examine the crack itself, by carefully spreading the buttocks.
When diagnosing an anal fissure, digital examination of the rectum is not always performed, as it can be painful.
If, in the opinion of a coloproctologist, an anal fissure is a manifestation of any of your other diseases, he can expand the examination and involve other specialists in consultation.
An extended examination may include a more detailed examination of the anus using an anesthetic to reduce pain.
In some cases, with fissures that are not amenable to conventional treatment, it is necessary to assess the tone of the anal sphincter (the sphincter is a muscular ring that opens and closes the anus).
What causes anal fissure?
— Constipation is the most common cause. Hard or large-volume fragments of feces damage the lining of the anal canal.
Other possible causes of anal fissures include:
- prolonged diarrhea.
- inflammatory diseases of the colon such as Crohn's disease and ulcerative colitis.
- pregnancy and childbirth.
- in some cases, sexually transmitted infections such as syphilis and herpes.
- a state of strong contraction (spasm) of the anal sphincter, leading to increased pressure in the anal canal, which contributes to its damage.
In many cases, the cause of an anal fissure is difficult to determine.
Who gets sick?
Every tenth person will develop anal fissure at one time or another in their lives.
Men and women of all age groups are equally prone to the formation of anal fissures. However, in most cases, cracks occur in children and young people aged 10 to 30 years.
Treatment and prevention of anal fissures.
Anal fissures usually heal within a few weeks or more without any treatment. However, the relapse rate is very high if the underlying cause of their occurrence, constipation, persists.
In some patients, symptoms of anal fissure may persist for 6 weeks or more (chronic form of the disease).
Measures taken independently by patients aimed at making stool easier can speed up the healing of existing cracks and reduce the risk of developing new cracks in the future.
To reduce pain, you can take regular painkillers (paracetamol or ibuprofen). Take warm baths for the perineum several times a day, preferably immediately after bowel movements during bowel movements.
Your doctor may recommend additional medications that will reduce the severity of your symptoms and help speed up the healing process.
The treatment regimen may also include pain-relieving ointments and laxatives, which make bowel movements easier.
Surgical treatment may be recommended for long-term non-healing cracks that are not amenable to conservative measures.
Surgery is an effective treatment for anal fissure in most cases. But, like any other operation, it can lead to complications, such as temporary or permanent loss of bowel control (incontinence of stool and gas).
Treatment of anal fissures.
Like any minor cuts or breaks in the skin, anal fissures often heal on their own within a few weeks.
However, if you have an anal fissure, it is better to consult a doctor who will prescribe you the necessary treatment, which will help you quickly get rid of the symptoms of the disease and make a full recovery.
Most anal fissures can easily recur after conservative treatment if you do not follow the recommendations below.
Independent activities.
There are several independent measures to relieve constipation, which in turn helps reduce pain with anal fissures.
Eliminating constipation allows you to heal an anal fissure and reduce the risk of its further development in the future.
Self-help measures to relieve constipation:
- Increase your daily dietary fiber intake by including high-fiber foods such as fruits, vegetables and whole grains.
- Avoid dehydration, drink more fluids and just water.
- Get more exercise. For example, take a daily walk or jog.
- Choose a convenient place and time when you can comfortably go to the toilet to have a bowel movement.
- Don't put off going to the toilet if you feel the urge to defecate.
- If you use wet wipes, make sure they do not contain fragrances or alcohol, which may cause discomfort or itching. If you use toilet paper, choose a soft variety and avoid using too much pressure when wiping.
- Take warm perineal baths several times a day, especially after bowel movements. This helps relieve spasm of the anus muscles.
Drugs.
There are a number of different medications that can be recommended by your doctor to reduce the symptoms of an anal fissure and speed up its healing.
Laxatives
Laxatives are a group of medications that promote freer passage of stool.
Adult patients with anal fissure are prescribed drugs that increase the volume of intestinal contents and osmosis.
Children with anal fissure are prescribed liquid forms of osmotic laxatives.
As a rule, treatment begins with small doses of laxatives. If necessary, the dose of the drug is increased every few days until loose, soft stools are established with a frequency of 1 time per day or 1 time every 2 days.
Attention! Without dieting, laxatives only help for a limited period of time. Do not use them for more than 7-10 days.
Painkillers
If you have prolonged burning pain after bowel movements, your doctor may recommend regular over-the-counter pain relievers such as paracetamol or ibuprofen.
But remember that some painkillers can cause constipation. Read the instructions carefully.
Ointment with nitroglycerin (glyceryl trinitrate)
If your symptoms do not go away within a week or two, you may be prescribed a topical ointment containing nitroglycerin. The ointment is applied directly to the crack area, usually 2 times a day.
Glycerin ointment promotes the expansion of blood vessels in the tissues surrounding the anus, which promotes better blood supply to the tissues in the fissure and, as a result, faster healing.
The use of these ointments leads to a decrease in pressure in the anal canal by relieving muscle spasms, which helps reduce pain.
Most acute anal fissures that last less than 6 weeks are cured with nitroglycerin ointment. In approximately seven cases of chronic anal fissure out of ten, with the correct use of nitroglycerin ointment, recovery occurs.
A common side effect of using nitroglycerin ointment is headache, occurring in 50% of patients.
Some patients experience dizziness or slight disturbances of consciousness after applying nitroglycerin ointment. Therefore, the ointment should be used with caution in children, pregnant and lactating women.
If you are bothered by headaches, you should reduce the amount of ointment applied. Using a small amount of ointment 5-6 times a day may be more effective than applying a large amount of ointment twice.
Apply the ointment only to the skin around the anus. Avoid getting the ointment into the anal canal.
As a rule, the duration of treatment with nitroglycerin ointment is approximately 6 weeks or continues until the crack is completely healed.
Local anesthetics
If you are experiencing severe pain, you may be advised to use a local anesthetic to reduce the sensitivity of the anus before bowel movements.
Local anesthetics are applied directly to the affected area. Their use does not have a direct therapeutic effect, but helps relieve pain.
The most commonly used anesthetic to treat anal fissure is lidocaine. Used as an ointment or gel. The duration of treatment is 1-2 weeks. As a rule, healing occurs within this time frame.
Calcium channel blockers
Calcium channel blockers, such as Diltiazem, are drugs commonly used to treat high blood pressure (hypertension).
At the same time, the effect of calcium channel blockers extends directly to the tissues around the anus, providing a proven positive effect in the healing of anal fissure in some patients.
Topical use of calcium channel blockers helps relax the anal sphincter muscles and improve blood flow in the tissues surrounding the anal fissure.
Side effects of calcium channel blockers include headache, dizziness, itching and burning at the site of application. All side effects of the drug disappear within a few days after use.
Topical calcium channel blockers are as effective as nitroglycerin ointments and are prescribed when other drugs do not help.
The duration of treatment with topical calcium channel blockers, as well as nitroglycerin ointment, lasts on average 6 weeks or until complete healing.
Botulinum toxin injections
The use of botulinum toxin in the treatment of anal fissure is a relatively new method of treatment. The method is used when other treatment methods are not effective. Botulinum toxin is a strong poison that is safe to use in small doses.
Botulinum toxin injections for anal fissure are performed in order to achieve paralysis of the anal sphincter muscles. This prevents muscle spasm, relieves pain and promotes healing of the crack. Currently, evaluation of the effectiveness of botulinum toxin in the treatment of anal fissure is ongoing.
The effect of botulinum toxin lasts for 2-3 months. This time is usually enough for the anal fissure to completely heal.
Observation
After several weeks of treatment, you should visit your doctor again. He will objectively assess the dynamics of the disease.
If the crack has completely healed, your doctor will schedule a follow-up examination in a few weeks.
If your anal fissure is a complex case and does not respond to treatment within 8 weeks, a consultation with a coloproctologist is necessary. He will assess the presence of indications for surgical treatment.
Operation
Surgical treatment is recommended if conservative treatment methods are ineffective.
Surgery is considered the most effective method for anal fissure, allowing to achieve good long-term results in 90% of cases. At the same time, there is a risk of complications.
There are a number of surgical operations used for anal fissure.
Lateral sphincterotomy
The lateral sphincterotomy technique involves making a small incision in the circular muscles of the anal sphincter, which reduces tension in the anal canal. Reducing stress promotes healing of the damage and reduces the chances of cracks reoccurring.
This is a relatively simple operation that is performed under general or epidural anesthesia. This means that you do not feel pain during the operation. Most often, the patient is in the hospital for the duration of the operation and a short period after the operation.
Lateral sphincterotomy is one of the most effective surgical methods for treating anal fissure with good long-term results. Most operated patients recover completely within 2-4 weeks.
Some patients (about 5%) who have undergone such an intervention are faced with the problem of incontinence of loose stools and gases as a result of damage to the muscular structures of the anal sphincter. Sphincter function recovers on its own within a few weeks.
Replacement of the defect with a skin flap
Skin flap surgery involves moving a piece of blood-supplied skin from another area of your body to the site of the anal defect to improve blood circulation in the tissues surrounding the crack.
This operation is recommended for the treatment of long-term anal fissures caused by pregnancy or trauma to the anal canal.
Mode of application
Solution
Solcoseryl in the form of a solution is recommended to be administered intravenously slowly in the form of an injection or by drip, having previously diluted it with saline solution or 5% glucose solution. If intravenous administration is difficult, intramuscular injection is allowed.
For the treatment of venous insufficiency, the drug is prescribed for up to a month, combining it with the application of an external gel or ointment to the area of trophic ulcers.
Patients who have suffered a stroke are prescribed a course of treatment with Solcoseryl for 5 weeks. When treating traumatic brain injuries, short courses lasting 5 days are prescribed.
Ointment and gel
Ointment and gel for external use are applied directly to the wound. Before using them, the wound surface is thoroughly disinfected. In the presence of purulent discharge, surgical treatment may be required.
The gel is used to treat wet, fresh wound surfaces. When the affected area begins to epithelialize, granulation tissue appears and the wound dries out, you should switch to using Solcoseryl in the form of an ointment.
The course of treatment with external forms of the drug is carried out until the wound surface is completely healed and a scar is formed.
Ophthalmic gel
The eye gel is instilled into the conjunctival cavity 3-4 times a day, one drop at a time. In some cases, it is possible to use the drug hourly. The course of treatment lasts until complete recovery.
Pharmacological action of the ointment
The pharmacological properties of the drug have not been fully studied. However, during the studies it was proven that solcoseryl has the following properties:
- in case of oxygen deficiency, its delivery to damaged cells is ensured;
- glucose transfer in metabolic disorders;
- is a catalyst for the formation of intracellular ATP;
- ensures the storage of energy in mitochondria generated during the transformation of nutrients;
- supports cells during nutritional deficiencies by supplying high-energy phosphates;
- prevents or prevents atypical changes with minor cell damage;
- “launches” the process of natural restoration of cells and tissues;
- activates the proliferation (division and formation) of fibroblasts that form the framework of connective fibers, and the formation of collagen filaments in the walls of blood vessels.
The ointment is widely used in cosmetology, gynecology, ophthalmology, and dentistry.
Main indications for use of the product
Ointment with solcoseryl is recommended for:
- minor skin damage in the form of abrasions;
- burns (except chemical) 1-2nd degree, which occur without the formation of exudate;
- frostbite of the 1st-2nd degree in the absence of wound weeping;
- psoriasis;
- to eliminate dry calluses and corns;
- to prevent the formation of scars after laser removal of warts or moles;
- atopic and seborrheic dermatitis;
- “sticking” in the corners of the mouth;
- drying of the nasal mucosa;
- in the treatment of wounds that heal poorly, including trophic ulcers and bedsores, after removal of dead tissue.
As a rule, a gel with solcoseryl is first applied to treat the wound surface with the separation of exudate. After the first signs of wound granulation appear, therapy is continued with the drug in the form of an ointment.
Differences between the ointment form of solcoseryl and the gel form
Pharmacies offer 2 forms of the drug intended for external local use. How do they differ and is it necessary to pay attention to such nuances?
The main differences between the forms are due to the excipients. Thus, solcoseryl gel does not contain fatty bases, which is why it is quickly washed off with warm water and removed from the surface of the skin. Due to this, it is the gel form that stimulates the formation of granulation tissue and the elimination of wound exudate.
When the wound dries out and signs of granulation appear, it would be more appropriate to use ointment. The fatty base of the drug forms a protective film on the surface of the wound, so the healing process is noticeably faster. In addition, solcoseryl ointment softens the surface of the wound, thereby avoiding the appearance of scars and other skin defects.
