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Для чего мазь линимент бальзамический по вишневскому

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17 августа 2019

Бальзамический линимент разработан русским и советским хирургом А. А. Вишневским как средство борьбы с раневой инфекцией. Препарат использовался в терапии плохо заживающих язв, ожогов. Дата официальной регистрации состава как лекарственного средства: 10 марта 1971. Реестровый номер – 71/145/18. С 14 февраля 2007 года не числится в фармакологическом реестре РФ. Считается устаревшим препаратом, однако продолжает применяться.

Что такое линимент бальзамический по Вишневскому

Лекарство представляет собой бурую или серо-зелёную субстанцию. Консистенция полужидкая, текучая. Обладает специфическим запахом, напоминает несвежую рыбу, что отталкивает пациентов и заставляет их искать другие лекарства. Несмотря на неприятный аромат, линимент – это средство, способное справиться порой с тяжёлыми, резистентными к большинству антибиотиков, инфекциями. Мазь ускоряет «вызревание» прыщей и гнойников, избежав при этом их хирургического вскрытия.

Состав препарата

Линимент является многокомпонентным. Один грамм лекарства включает следующие составные части:

  • Дёготь берёзовый (30 мг) – с умеренным антисептическим и местнораздражающим действием, стимулирует кожные регенеративные процессы.
  • Ксероформ (30 мг) – противомикробное и подсушивающее влияние.
  • Аэросил – стабилизатор.
  • Касторовое масло (до 1 грамма) – наполнитель, мазевая основа, восстанавливающее средство.

Стабилизирующий компонент стали добавлять в линимент не сразу. Оригинальный рецепт состоял из трёх веществ: дёгтя, ксероформа и жирной основы.

Выпуск

Препарат распространяется в алюминиевых тубах, по 30 и 40 граммов. Производители для расфасовки используют банки тёмного стекла, вес лекарства в которых может составлять 5, 10, 15, 20, 25, 30 граммов. Для применения в стационарах используются упаковки объёмом до 1 литра. С каждой ёмкостью бальзамического линимента предлагается инструкция по его медицинскому использованию. Лечение следует производить, придерживаясь приведённых в ней рекомендаций.

От чего помогает, показания к применению

Состав обладает противовоспалительным, антибактериальным, местнораздражающим действием. Способствует прогреванию поражённого участка, ускоренному выходу гноя наружу, стимулирует процессы заживления. Показания к применению:

  • Подкожные абсцессы.
  • Лимфадениты.
  • Фурункулы.
  • Язвы трофического происхождения.
  • Ожоги и обморожения.
  • Плохо заживающие, инфицированные раны.

Теоретически мазь может использоваться для лечения ушибов и синяков, а также в терапии грибка дерматоидной локализации. Практическая польза подобных мер не доказана.

Противопоказания

Единственным ограничением, приведённым в аннотации, является индивидуальная непереносимость пациентом компонентов, входящих в состав лекарственной формы. Кроме того, линимент не рекомендуется наносить на участки раздражения, аллергические высыпания. Отдельные источники приводят – невскрывшиеся абсцессы. Однако, практика доказывает, что состав прекрасно справляется с такими заболеваниями.

Побочные эффекты

При длительном применении линимента возможно развитие местной аллергической реакции. Она проявляется в форме гиперемии, отёчности, локального зуда, фотосенсибилизации. При возникновении подобных симптомов лечение следует отменить. Подбирать аналог препарата должен врач.

Присутствуют данные о том, что мазь содержит канцерогенные вещества и способна вызывать злокачественные опухоли кожи. В реальности подобного не происходит. Чтобы канцерогенный эффект линимента проявился, потребуется ежедневно наносить состав на один и тот же участок кожи на протяжении нескольких лет.

Инструкция по применению

Оптимальный способ использования мази – нанесение под повязку. Для этого марлю складывают в 5–6 слоёв, пропитывают лекарством и фиксируют пластырем на рану. Перевязка: 1 раз в 2–3 дня. При открытом способе средство мажут дважды или трижды в сутки, стараясь избегать его истирания об одежду. Длительность лечебного курса – до полного очищения раны или 20–25 суток при массивных поражениях.

При беременности и лактации

Исследований, подтверждающих безопасность использования мази при вынашивании и грудном вскармливании ребёнка, не проводилось. С учётом минимального системного всасывания компонентов, средство применяется в случаях, когда ожидаемая польза для матери превышает риски для плода.

Цена и аналоги

Стоимость мази в аптеках Москвы от 30 до 46 рублей. Цена зависит от объёма потребительской упаковки. К числу аналогов линимента по Вишневскому относят:

  • Левомеколь – антисептическое средство для борьбы с гнойными ранами. Подходит для заполнения внутренних полостей. Стоимость начинается от 97 рублей.
  • Ихтиоловая мазь – противомикробное, кератолитическое, лёгкое анестезирующее вещество. Цена – 112 р.
  • Цинк – подсушивающее, абсорбирующее, противовоспалительное влияние. В аптеках Москвы за препарат придётся отдать 21–45 рублей.

Другие средства, действие которых направлено на уничтожение бактерий в ране – водный раствор йода, хлоргексидин, мирамистин). Однако эти препараты выпускаются в жидкой форме и больше подходят для первичной обработки травматизированных зон. Их длительная экспозиция затруднена даже при нанесении на компресс. Последний быстро высыхает. Мази лишены этого недостатка и могут сохраняться в ране на протяжении нескольких суток.

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Отзывы

За время своего существования мазь Вишневского приобрела множество сторонников и противников.

Антон, водитель, 46

Не так давно поранил палец во время ремонта машины. Травма была незначительная, поэтому обрабатывать её не стал, продолжил заниматься своим делом. Через неделю на месте травмы образовался гнойник, вскрывать который у хирурга мне не хотелось. Да и времени для посещения врача не было.

Знакомый посоветовал применять мазь Вишневского. Наносил под повязку, всего потребовалось 3 дня, чтобы абсцесс вскрылся, гной остался на марле, а палец быстро зажил. Через неделю на месте пореза – только шрам без признаков воспаления. Вывод – линимент хорошо помогает при поверхностных нагноениях. Минус – противный запах, к которому я за три дня так и не привык.

Ирина, 34, страховщик

Несколько лет назад я неудачно выдавила прыщ на лице. Он распух, загноился, вокруг образовалась красная кайма. Врач посоветовал наносить мазь Вишневского. Сначала сомневалась, так как средство устаревшее, да и пахнет неприятно. Но болезнь не проходила, размер гнойника увеличивался. Решила попробовать. Средство наносила на ночь, днём закрывала ранку чистой повязкой. Не могла допустить, чтобы на работе от меня пахло тухлой рыбой. Наверно, поэтому для достижения эффекта понадобилось много времени.

Гнойник вскрылся только через 5 дней. Вытекло большое количество гноя. После этого я продолжила накладывать линимент, включила в схему лечения антибиотики. Ещё пару раз находила на повязке следы гноя. Потом рана очистилась и начала быстро заживать. Сейчас на её месте остался только небольшой шрам, напоминающий о прошлых неприятностях.

Игорь, 52, врач-хирург

Вишневского активно применяли лет 20 назад. Сегодня это средство считается устаревшим и от него постепенно отказываются. Разработано немало других, не менее эффективных препаратов, не обладающих неприятным запахом и прекрасно справляющихся с раневой инфекцией. Пациенты продолжают использовать линимент. Это скорее обусловлено его низкой ценой, чем высокой эффективностью. Однако отзывы наших больных о мази только положительные.

Светлана, 40 лет, врач-дерматовенеролог

В моей специализации линимент не используется. Но мне известны случаи, когда состав Вишневского применяли для лечения прыщей на коже. На мой взгляд, этот подход к терапии не совсем верен, потому что устраняют причину сыпи, а не её симптоматику. Пациенты считают иначе. По утверждениям людей, опробовавших на себе такой способ лечения акне, мазь действительно помогает ликвидировать высыпания. Однако при отмене препарата они вновь появляются через 1–3 месяца. Это закономерный исход всех попыток устранить симптом, а не причину.

Заключение врача

Мазь Вишневского – старое, надёжное средство для лечения септических болезней кожи. Однако его нельзя применять при любых дерматологических и хирургических болезнях. Препарат высокоэффективен только при использовании по показаниям, указанным в официальной инструкции по применению. Перед началом терапевтического курса лучше посетить врача и получить консультацию относительно своего заболевания и методов борьбы с ним.

Линимент бальзамический по Вишневскому — антисептик раздражающего типа. Обладает очень резким запахом (благодаря включению в состав дегтя), темноватым оттенком, отлично способствует заживлению ран. Назначается для поверхностного использования при накожных язвах, пролежнях, абсцессах, ожогах, лимфаденитах. Обладает подсушивающим действием на ороговелые части кожи, за счет чего может применяться для лечения бородавок (снижения скорости их роста), других доброкачественных новообразований в верхних слоях эпителия.

История создания

Автором линимента бальзамического является хирург А.В. Вишневский, который в 1927 году опытным путем создал смесь из березового дегтя, ксероформа и касторового масла. Согласно его же утверждениям, именно эти ингредиенты им были включены по следующим причинам:

  • ксероформ обладает антисептическим действием;
  • касторовое масло упрощает процесс поглощения верхним слоем эпителия питательных и регенерирующих компонентов;
  • березовый деготь нормализует кровоток к поврежденным мягким тканям, тем самым ускоряя процесс их восстановления.

Полученная смесь является линиментом, то есть, производной мазью, однако с большим коэффициентом вязкости. За счет этого ее намного удобней наносить на рану или язву, растирать до однородного слоя. Препарат довольно быстро обрел свою популярность ввиду эффективности и низкой стоимости. В будущем хирург закрепил за ним название линимент бальзамический по Вишневскому, под которым его можно приобрести и сейчас. Средняя стоимость препарата — 30 рублей (флакон 30 г). На данный момент препарат также пользуется широким спросом, хоть и считается условно устаревшим. Врачи его назначают все реже, отдавая предпочтение антибиотикам, но те, в свою очередь, могут снижать скорость регенерации эпителия, так как вместе с инфекцией уничтожают и полезные бактерии, снижают общий уровень иммунитета.

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Фармакологическое действие лекарства

Бальзамический линимент по Вишневскому обладает противомикробным, вяжущим и заживляющим эффектом. Бактерицидное действие осуществляется за счет ксероформа, который входит в его состав и способен окислять сульфитные группы многих групп микроорганизмов, вызывающих внешние накожные воспаления, нагноение. Препарат делает для них среду обитания ненадлежащей для последующего размножения.

Березовый деготь, как известно — прекрасный антисептик. Этот ингредиент используется в производстве аспирина, который тоже обладает сосудорасширяющим действием, что увеличивает приток крови.

Кстати, не так давно российские ученые сделали открытие, согласно которому ксероформ может соединяться с органическими белками, после чего происходит процесс коагуляции, образование альбуминов. Те, в свою очередь, трансформируются в микроскопическую защитную пленку, что защищает рану от проникновения инфекции извне, как и попадание грязи в нее (в глубокие поры). За счет этого тоже значительно ускоряется заживление ран.

Мазь Вишневского практически не имеет противопоказаний. В инструкции к ней указано лишь то, что следует прекратить ее использование при обнаружении индивидуальной непереносимости одного из компонентов препарата, а также при наличии острого гнойного воспаления. Что касается последнего, то речь, вероятней всего, идет о том, что при наличии быстро увеличивающегося в размерах фурункула все же следует обратиться за помощью к врачу. Однако следует понимать, что использование мази может ускорить процесс нарыва раны и ее последующей очистки (если очаг заражения скрыт в верхних слоях эпителия).

Использование мази

Показания к применению линимента Вишневского следующие:

  • термические ожоги;
  • химические ожоги;
  • поверхностное отморожение, сопровождающееся некрозом мягких тканей;
  • воспаление эпителия, за исключением инфекционного воздействия;
  • ускорение процесса регенерации кожи за счет стимуляции репарации;
  • бактерицидная обработка кожи.

По назначению врача мазь может использоваться и в других случаях, однако только под его строгим контролем. Еще линимент применяется для лечения лимфангоитов, лимфаденитов, влажных мозолей, порезах. Что касается гнойных ран, то далеко не во всех случаях допускается использование мази. Например, если речь идет о закрытых комедонах, то применение линимента может только навредить, так как из-за своей консистенции он может провоцировать дальнейшее закупоривание волосяных фолликул.

Еще мазь Вишневского довольно часто используется для профилактики кератоза. Считается, что касторовое масло ускоряет процесс отслаивание ороговелой кожи, которая и приводит к возникновению папул. Однако врачи сетуют, что линимент ни в коем случае не применяется при его себорейном типе, то есть, когда появляются бородавчатые новообразования. В них мазь тоже провоцирует закупоривание пор, что только провоцирует в дальнейшем активизацию воспалительных процессов (так как оставшиеся бактерии начинают активное размножение).

Показания к применению линимента Вишневского включают в себя пролежни на любых стадиях их развития. Врачи рекомендуют делать повязки сразу же, как только вы заметите покраснения у лежачего больного. Длительность перевязки — от 12 до 24 часов. Благодаря антисептическому действию и подсушиванию кожа быстро восстанавливает свой питательный баланс, избавляется от излишка влаги. При возникновении некроза обязательно нужно обратиться к врачу.

Очень хорошо мазь помогает при затвердении места, где был сделан укол (из-за переохлаждения). Благодаря стимуляции кровообращения папула вскоре просто рассасывается без каких-либо побочных эффектов.

Возможные побочные действия

Инструкция по применению для препарата составлялась по результатам клинического исследования. Согласно полученным данным, у некоторых пациентов мазь вызывала покраснение кожи, зуд, ангионевротический отек. Однако все эти симптомы полностью исчезали, как только прекращалось использование линимента. Здесь можно судить об индивидуальной непереносимости некоторых компонентов препарата или же атипичных физиологических процессах в период регенерации кожи. Статистика указывает, что подобные симптомы встречались только у 0,2% пациентов.

Еще мазь при длительном использовании может вызывать раздражение, сопровождающееся чувством жжения. Это объясняется воздействием ксероформа, который частично подсушивает кожу и вместе с этим ускоряет процесс отмирания ороговелых клеток.

Правила нанесения и дозировка

Инструкция по применению указывает на то, что мазь Вишневского используется по назначению врача. При этом состав наносится на пораженную кожу или рану тонким слоем, без массирования. В том случае, если это сделать по каким-то причинам невозможно (болевые ощущения при ожоге), то используется повязка — на марлю, сложенную в 5-6 раз наносится состав и прикладывается непосредственно к пораженной коже. Повязку обязательно следует зафиксировать, так как препарат благодаря высокому показателю диффузии может частично прилипнуть. В таких случаях для съема повязки изначально ее размачивают кипяченной водой с добавленной в нее несколькими кристалликами марганцовки (KMnO4).

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Использование препарата для внутреннего применения категорически запрещено и может вызывать сильнейшую интоксикацию человеческого организма. Однако благодаря тому, что линимент обладает специфическим запахом и горьким привкусом, вероятность его глотания маловероятна, даже если речь идет о маленьких детях. У самого Александра Васильевича Вишневского инструкция также давала такое утверждение.

А вот при обморожениях повязки накладываются сразу на несколько дней без последующих перевязок. При этом кожа полностью заживает без образования грубого рубца. Отмершие ткани при этом плотно соединяются с линиментом и убираются при снятии марлевого тампона. То же самое относится и к термическим ожогам 1-2 степени (при 3-4 использование мази категорически запрещено, так как там уже идет речь о некрозе мягких тканей, помимо эпителия).

Рецепты народной медицины

Довольно продолжительное время линимент Вишневского являлся одним из ключевых препаратов, который использовался для лечения ран, порезов и ожогов. Поэтому не удивительно, что его начали широко применять в нетрадиционной медицине, в частности, в период Великой Отечественной Войны. Например, утверждалось, что смесь мази с древесным пеплом позволяла прекратить кровотечение, предотвратить заражение крови при рваной ране. И это заявление неоднократно было подтверждено на практике. Дело в том, что при соединении с пеплом получалась быстрозастывающий материал, который при нанесении на кожу образовывал своего рода защитную пробку. В будущем удалить ее можно было только механическим воздействием или размачиванием. Этот метод быстрого устранения кровотечения неоднократно использовался военными медиками.

А еще считается, что смесь мази в сочетании с соком чистотела ускоряла заживление раны и оказывала противомикробное действие. Однако современная медицина рекомендует не пользоваться подобным советом и помнить, что чистотел — ядовитое растение, которое может вызывать тяжелейшею интоксикацию, вплоть до летального исхода. Если наложить такой состав на глубокую рану, то не сложно догадаться, какой будет результат.

Еще считается, что линимент помогает при кожных гнойных высыпаниях. Нанесенная даже на 2 часа мазь значительно ускоряет прорыв фурункулов (прыщей, угрей), предотвращает повторное образование нагноения. Однако следует быть осторожным — ускоренное кровообращение может спровоцировать попадание в лимфу ороговелых клеток.

Кстати, все чаще можно встретить отзывы молодых людей, которые утверждают, что при помощи мази Вишневского им удалось избавиться от назойливых прыщей. Здесь следует сделать отступление и пояснить, что это вполне реально только с угрями, открытыми комедонами. Они возникают при избыточной секреции накожного жира, а ксероформ частично подсушивает верхний эпителий. Березовый деготь тем временем восстанавливает нарушенный кровоток. Для лечения же инфекционных прыщей линимент Вишневского практически беспомощен, так как он действует только на верхнюю часть кожи без проникновения в глубокие поры. Поэтому первым делом записываемся на консультацию врача и только после этого занимаемся лечением.

Целебные свойства состава

Линимент бальзамический по Вишневскому — это своего рода визитная карточка советскому прогрессу в познании медицины. Практически каждый из нас хотя бы раз в жизни ею пользовался, и многие еще помнят ее резкий и неприятный запах. Однако мазь (именно так чаще называется линимент по Вишневскому в народе) оказалась очень эффективной, но самое главное — безопасной. Ее ключевое назначение — ускорение регенерационной функции эпителия, предотвращения некроза поврежденных мягких тканей. Кроме этого, линимент способствует скорейшему прорыву воспаленному новообразованию, предотвращает заражение открытой раны. И при всем этом — доступен каждому ввиду своей низкой стоимости. Все это в совокупности и помогло мази Вишневского стать одной из самых используемых в 30-80 гг. прошлого столетия.

Мазь Вишневского, или линимент бальзамический по Вишневскому (иногда лат. Linimentum balsamicum Wishnevsky ), — линимент раздражающего действия, устаревшее средство [1] , широко использующееся в постсоветском пространстве для лечения ран, ожогов, кожных язв и нагноений [2] . Было изобретено в 1927 году советским хирургом Александром Васильевичем Вишневским в качестве антибактериального и вяжущего средства, ускоряющего процессы регенерации [2] . 1 г линимента содержит берёзовый [en] дёготь (30 мг), ксероформ (трибромфенолат висмута; 30 мг) и касторовое масло (до 1 г). Обладает сильным характерным запахом.

Мазь Вишневского широко использовалась в советской армии во время Второй мировой войны [2] . В дальнейшем показано, что длительное использование мази Вишневского для лечения хронических кожных язв, ран или ожогов можно связать с повышенным риском рака кожи, гематологических и других заболеваний [2] .

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