Experimental Validation of the Use of Immobilized Form of Miramistin in the Treatment of Advanced Peritonitis

Introduction. Mortality in generalized peritonitis ranges from 16% to 30%. The aim of research was to experimentally study the effect of the immobilized form of 0.01% miramistin on the basis of sodium salt of carboxymethylcellulose on the course of the inflammatory process in generalized purulent peritonitis. Materials and methods. The experimental study included 288 male Wistar rats, divided into 3 groups, 96 animals each. Animals of the 1st group (control) were exposed to laparotomy and lavage of the abdominal cavity with saline under aseptic conditions 24 hours after the introduction of fecal suspension into the abdominal cavity. Simultaneously, animals of the 2nd group (comparison) underwent a thorough sanitation of the abdominal cavity with saline with removal of purulent effusion and fibrin films at the first stage, and at the second stage, they were injected 5 ml of an aqueous solution of 0.01% miramistin. In animals of the 3rd (experimental) group, 5 ml of 0.01% miramistin gel was evenly distributed over the entire surface of the peritoneum after laparotomy and sanitation of the abdominal cavity with saline solution. The anti-inflammatory activity of the dosage forms was assessed by the dynamics of leukocytosis and the leukocyte index of intoxication, and the anti-inflammatory activity was assessed by the dynamics of the number of microorganisms in the abdominal exudate. The lethality of animals in each group was estimated. The following areas were taken for histological examination: small and large intestine, parietal peritoneum, pancreas, liver. Results. The anti-inflammatory activity of the immobilized form of 0.01% miramistin on the basis of sodium carboxymethylcellulose was superior to the aqueous solution of miramistin 0.01% on the 1st day - 1.3 times, on the 3rd day - 1.6 times, on the 7th day - 1.5 times. Antimicrobial activity in animals of the experimental group was 1.3 times higher on the 1st day, 1.9 times higher on the 3rd day, and 1.7 times higher on the 7th day than in the comparison group. The mortality rate in animals of the experimental group was 1.5 times lower on the 1st day, and 1.4 times lower on the 3rd and 7th days than in animals of the comparison group. On the first day, the morphological picture of peritonitis in animals of the experimental and comparison groups had no significant differences. On the 3rd day in animals of the comparison group, the inflammatory process in the abdominal cavity was pronounced, and in the experimental group, the intensity of peritonitis began to decrease, and by the 7th day it was completely eliminated. Conclusion. The results of the study allow recommending the use of the immobilized form of 0.01% miramistin based on sodium carboxymethylcellulose in the treatment of generalized peritonitis.