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DMSO i MSM – jaką rolę odgrywają w leczeniu ran? Wywiad z ekspertką

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DMSO i MSM to preparaty o 99,99-proc. stężeniu siarki, które posiadają wiele zastosowań w medycynie. W procesie leczenia ran zmniejszają ból, wspierają regenerację tkanek i zmniejszają widoczność blizn. O tym, jak stosować DMSO i MSM, mówi w rozmowie z FLR Elżbieta Szkiler, ekspertka w dziedzinie leczenia ran.

– MSM (metylosulfonylotlenek) i DMSO (dimetylosulfonylotlenek) są preparatami naturalnymi, wytworzonymi w procesie destylacji drewna. DMSO powstaje w laboratorium i jest o połowę silniejszy od MSM. Oba preparaty przede wszystkim zmniejszają ból, co w leczeniu ran jest bardzo trudnym zadaniem. Rozszerzają także tętnice i poprawiają perfuzję tkanek. Stosowane na skórę ułatwiają syntezę kolagenu, czyli uszeregowanie bezładnie rozłożonych włókien, które tworzą bliznowce i kelogi – mówi w rozmowie z Forum Leczenia Ran mgr Elżbieta Szkiler, pielęgniarka specjalizująca się w leczeniu ran.

Oba preparaty są nośnikami substancji aktywnych, przyspieszają i stymulują działanie innych środków. DMSO i MSM są z powodzeniem używane w leczeniu ran, odleżyn, owrzodzeń, schorzeń układu moczowego, RZS, a w USA i w Wielkiej Brytanii w leczeniu nowotworów.

W jaki sposób DMSO i MSM wspomagają leczenie ran?

  1. Działanie przeciwbólowe

Jak wskazuje Elżbieta Szkiler, DMSO może być stosowany miejscowo w leczeniu bólu reumatycznego, nowotworowego czy kostno-stawowego i mięśniowego. Ekspertka dodaje, że korzysta z DMSO również w przypadkach bardzo silnego bólu łożyska rany. Według specjalistki najlepsze efekty przeciwbólowe uzyskuje się w połączeniu preparatu DMSO z podchlorynami w celu łagodzenia bólu spowodowanego hipoksją w ranach niedokrwiennych, czy z miodem Manuka, zwłaszcza w ranach pokrytych biofilmem. DMSO stosowany jest w medycynie również jako nośnik leków, dlatego można go łączyć np. z maścią przeciwbólową, by wzmocnić jej działanie.

  1. Stosowanie na odleżyny i owrzodzenia

DMSO jest w szczególności zalecany pacjentom, u których proces gojenia ran jest utrudniony. Preparat zapobiega procesom gnilnym, dlatego może być stosowany miejscowo w leczeniu owrzodzeń i odleżyn.

  1. Właściwości przeciwzapalne

DMSO ma zdolność hamowania stanów zapalnych poprzez wyłapywanie wolnych rodników, uwalnianie histaminy czy ograniczanie migracji komórek zapalnych. DMSO zmniejsza obrzęk, a także poprawia dyfuzję tlenu i zmniejsza agregację trombocytów, poprawiając zaopatrzenie tkanek w tlen i środki odżywcze.

  1. Stymulacja procesów regeneracyjnych i działanie przeciwdrobnoustrojowe

DMSO i MSM wspierają regenerację i tworzenie się tkanek, dzięki czemu przyspieszają gojenie ran. Oba preparaty mają również zdolność do zmniejszania widoczności blizn poprzez ich zmiękczenie i rozpuszczenie kolagenu, dlatego ranę warto smarować preparatami aż do zakończenia procesu powstawania blizn.

DMSO i MSM wykazują również działanie przeciwwirusowe, przeciwgrzybicze oraz bakteriostatyczne dla drobnoustrojów z grupy Pseudomonas, gronkowca i bakterii coli. Ponadto działają rozluźniająco, odwadniająco, przeciwmiażdżycowo (rozszerzają naczynia), a także modulują układ immunologiczny.

Jak stosować DMSO i MSM?

DMSO ma formę kryształu, który ulega rozpuszczeniu w temperaturze powyżej 19 st. Celsjusza. Preparat najczęściej stosuje się w postaci płynu, który jest bezbarwny, lekko pachnący czosnkiem i delikatnie oleisty. W takiej postaci można przyjmować go doustnie lub bezpośrednio na skórę. DMSO jest również dostępny w formie maści czy żelu. MSM ma postać proszku do podawania doustnego. Z proszku można również przygotowywać preparat do podawania na skórę.

DMSO można rozpuścić w wodzie destylowanej lub płynnej glicerynie, a MSM w wodzie destylowanej lub soli fizjologicznej. Wskazane jest stężenie 60 proc. w przypadku stosowania na nieuszkodzoną skórę oraz i 30-60 proc. w przypadku uszkodzeń skóry. Przed aplikacją DMSO na skórę należy dokładnie oczyścić dłonie oraz miejsce, gdzie będzie nakładany środek.

– Osobiście najczęściej stosuję DMSO do pędzlowania łożyska rany i/lub skóry przed założeniem opatrunków u chorych z objawami niedokrwienia łożyska lub tkanek okalających – wyjaśnia Elżbieta Szkiler.

DMSO w leczeniu ran nowotworowych

DMSO znajduje zastosowanie w leczeniu chorób nowotworowych – zarówno w procesie gojenia ran, przerzutów nowotworowych, jak i w łagodzeniu bólu.

U pacjentów z chorobą nowotworową, jak wyjaśnia Elżbieta Szkiler, zarówno w przypadku MSM, jak i DMSO rekomendowane jest stosowanie doustne, z kolei miejscowo można używać preparatu w formie płynu do łagodzenia dolegliwości bólowych, a także do przymoczki. DMSO o 100-procentowym stężeniu, jak zaznacza Elżbieta Szkiler, jest rekomendowany w polskim piśmiennictwie w leczeniu uszkodzeń po wynaczynieniu cytostatyków podczas chemioterapii nowotworów.

– DMSO można wykorzystać do wykonywania opatrunków w ranach nowotworowych i w przerzutach nowotworów do skóry. Tu stosuję opatrunki nasączone preparatem w formie okładów. Wykorzystuję do tego opatrunek, który jest nieprzywierający, chłonny i wykonany z celulozy w dwustronnie perforowanej folii – wyjaśnia ekspertka.

Z czym nie łączyć DMSO i MSM?

– Należy pamiętać o tym, że DMSO jest nośnikiem leków i nie wolno go łączyć z większością preparatów stosowanych w leczeniu ran, a na pewno nie z metalami, srebrem, oktenidyną, PHMB i związkami jodu. Zdolność przyłączania DMSO bezwzględnie wszystkich cząstek, nawet barwników z tkanin, i wprowadzania wszystkiego do tkanek, wymusza daleko idącą ostrożność. Stosowany miejscowo w leczeniu bólu reumatycznego czy też nowotworowego musi się wchłonąć, a skóra musi wyschnąć przed założeniem ubrania – wyjaśnia ekspertka. – Okresowo pojawiają się doniesienia o śmierci pacjentów po podaniu DMSO w kroplówce. To niedopuszczalny sposób aplikacji preparatu, ponieważ powoduje rozpad erytrocytów, a takie praktyki są wysoce naganne. DMSO i MSM nie wolno podawać w postaci iniekcji, a także w przypadku ran krwawiących, unikać należy w ranach zakażonych, chociaż preparaty posiadają właściwości bakteriostatyczne – dodaje Elżbieta Szkiler.

Jakie są niepożądane działania i przeciwwskazania DMSO i MSM?

– Przeciwwskazaniem do stosowania DMSO i MSM jest przede wszystkim alergia na metale i nietolerancja na ten preparat. U chorych z alergią na metale może wystąpić pieczenie i ból po aplikacji na skórę czy na ranę. Niektórzy pacjenci nie mogą stosować tych preparatów, dlatego zawsze przed aplikacją i zleceniem choremu DMSO wykonuję test skórny np. na przedramieniu – podkreśla Elżbieta Szkiler.

DMSO i MSM mogą również powodować działania niepożądane: dolegliwości ze strony układu oddechowego, działanie neurotoksyczne, podrażnienia, świąd i pieczenie skóry, bóle i zawroty głowy, niestrawność, nudności, wymioty, biegunkę, zaparcia czy utratę apetytu. W niewielkich ilościach preparaty nie są toksyczne, jednak każdorazowo dawkowanie środków powinno być ustalone przez specjalistę prowadzącego leczenie.

 

 

mgr Elżbieta Szkiler, pielęgniarka specjalizująca się w leczeniu ran

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