Method of treating acute and chronic wounds

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to purulent surgery, and can be used to treat acute and chronic septic wounds. That is ensured by pre-measuring patient's capillary wall resistance on the involved body area, which is covered with a vacuum dressing, underneath which a low pressure within the range of 50-200 torr is generated for a period of time being no more than 20 times greater than the resistance time. Once this period of time expires, the wound is drained and bathed at the above low pressure by administering an antiseptic, which is presented by an anolyte with hydrogen concentration pHan falling within the range of 2≤(pH)an≤4, and the oxidation-reduction potential (Eh)an ranging from [1,000≤(Eh)an≤1,200] mV. The drainage and bathing procedures last for 5-10 minutes. That is followed by 3-5-minute pressure reset, and the anolyte supply is shut off; the anolyte with the wound discharge is evacuated until the pressure underneath the vacuum dressing re-drops to 50-200 torr. Thereafter, the anolyte is re-supplied to the wound through a drain tube. The cycles are alternated for 5-8 times. The vacuum dressing is removed from the septic wound, and the necrotic tissue areas are covered with pepsin powder and dressed or drained through anolyte gauze drain sponges. A 4-6-hour break is followed by replacing the anolyte dressing with pepsin by the vacuum dressing, and the similar alternating process mentioned above is repeated. The procedure is performed 2 or 3 times a day for 3 or 5 days within the therapeutic course. As the wound heals, and the local oedema and bacterial content decrease, the above therapeutic cycle is to be repeated. The flushing drainage and bathing therapy involves replacing the anolyte by catholyte, the hydrogen concentration pH of which lies in the range of 8≤(pH)an≤13, whereas the oxidation-reduction potential (Eh)cat varies within [-820≤(Eh)cat≤-300] mV. As the catholyte flows to the wound, infrasonic vibrations of the power of 10-2 to 1 W/cm2 continuously and periodically varying within the range of 10 to 30 Hz and back are excited. The drainage and bathing procedure with the periodic ultrasound in the above frequency range lasts for 15-20 minutes. The ultrasound is switched off, the catholyte supply is shut off from the wound until the pressure underneath the vacuum dressing re-drops to 50-200 torr. The catholyte flows to the wound again, and infrasonic vibrations of the power of 10-2 to 1 W/cm2 continuously and periodically varying within the range of 10 to 30 Hz and back are excited. The cycles are alternated for 5-8 times. Once the catholyte evacuation from the wound is terminated, the last cycle of the alternating process involves removing the dressing from the healing wound, however tissues impregnated with the catholyte are left in the wound. The above procedure is performed 4-6 hours later, up to 2 or 3 times a day until the therapy is completed.

EFFECT: method provides the effective treatment of the septic wounds at the various stages by pathogenetically substantiated target in the polymicrobial wound contamination.

2 tbl

 

The invention relates to the field of medicine, namely to surgery of wounds and wound infection treatment of purulent wounds.

There are many ways of treatment of purulent wounds, for example, by treatment of trypsin [1], by applying to the wound a proteolytic enzyme in the form of tripleline or proteasome [2]. However, these methods can be achieved mainly only nekroliticescoe effect.

Known wound cleansing 30% aqueous solution of urea and a solution of proteolytic enzyme in 30% urea [3]. This method provides a good effect only with the active drainage. In addition, in severe injuries, for example, mine-explosive injuries, has insufficient dehydration effect.

Known method of treatment of purulent wounds, described in [4].

This method is carried out by the debridement with excision of necrotic tissue and then applying to the wound a single layer of bandage from multiple gauze soaked in multicomponent water-soluble ointment on the basis of type "Leonore" or "levomekol" that affects the main etiopathogenetic mechanisms of the inflammatory process. Ointment if required, in a heated state is injected into purulent cavity in liquid form.

However, a significant portion applied on the wound hydrophilic ointment evaporated�Xia, when absorbed by the superficial layers of gauze and bandages, having defilee structure. This reduces the pharmacological activity of the drug. In this case, adjacent to the wound layers of gauze, due to well-developed porous fibrous structure and high specific surface, adsorbing and binding of organic components purulent wound exudate (which also defilee structure), losing 4-6 hours drainage function, turn into a tube. In the treatment of wounds with extensive areas of nonviable tissue using water-soluble ointments (levorsen, levomekol, levosin, mafenide acetate), nekroliticescoe effect is insufficient. In addition, the polyethylene glycol, which is main used water-soluble ointments, in the second phase of wound process has a pronounced unwanted dehydrating effect on granulation tissue.

A method of treating infected wounds of the lower extremity using a surgical vacuum pump, create a vacuum to 0.4-0.5 kg/cm2with a special head that has a bell diameter of 30 mm and "decompression" hole in the handle to prevent the suction effect. When the vacuum processing tip is tightly pressed against the walls of the wound and by moving it, produce the suction of detritus, ne�free and suboficiales tissue, foreign particles and microkeratom. At the same time, irrigate the wound with antiseptic solution or pulsating stream of liquid to remove all nonviable tissue from the cavity of the wound. Visual criterion for the effectiveness of treatment is the disappearance of visible contamination and the appearance of diffuse capillary bleeding [5] aspiration Procedure lasts from 5 to 10 min and can reduce bacterial contamination of the wound by 1-2 orders of magnitude compared with that after surgical treatment. The aspiration procedure lasts from 5 to 10 min and can reduce bacterial contamination of the wound by 1-2 orders of magnitude compared with that after surgical treatment.

However, necrotic wounds, especially in patients with chronic arterial insufficiency, due to the lack of a clear demorali between necrotic and ischemic tissue is not always possible to perform a radical necrectomy for fear of progression of ischemia and loss of limbs. At the same time, such as wounds of the foot, have a complex configuration, numerous pockets along the tendons and muscles, making it difficult to summarize the wound surface of the aspiration tube and the holding of adequate aspiration.

Known method of treatment of purulent wounds that combines vacuum suction and ultrasonic cavitation races�thief of ionized silver or antibiotics inserted into the cavity of the wound [6].

However, the method is not effective enough, especially in the treatment of ischemic limbs, because not prevents possible deterioration of the microcirculation in the wound.

A method of treating infected wounds of the lower extremity [7], including vacuum wound drainage with the device for vacuum drainage of wounds, allowing you to create sufficient negative pressure in the drainage system. After primary surgical processing of a wound, excision potentially nonviable tissue and autopsy purulent streaks the entire wound surface is thoroughly washed with antiseptic solutions. In sloping places the wounds are installed perforated drain tube for aspiration of wound. The wound on tubes or closed by primary sutures, or leave open depending on the initial state of the tissues. Drainage tubes are connected to the device for vacuum drainage. The mode of drainage and its duration depend on the course of wound healing.

However, the full aspiration of the whole surface of the wound drainage and suction systems impossible. In the wound areas are formed, is not available for aspiration, which certainly lengthens the course of wound healing. Extremely difficult adequate vacuum aspiration or open wounds due to constant�steering suction in the drainage system of atmospheric air, what reduces the effectiveness of treatment.

Closest to the claimed method is a method described in [8].

Prototype method consists in the use of vacuum dressings - method of Vacuum-assisted closure (VAC® therapy), the principle of Topical negative pressure (TNP), under which in the wound area, creating a vacuum of 50 to 200 Torr in continuous or intermittent vacuum effects on the wound with a combination of drainage and leaching leaching therapy (Vacuum Instillation Therapy), when additionally to the VAC system is supplied supply and drainage. With flat surface the defects to improve the reliability of the sealing system can be applied around the perimeter of the wound paste, Stomahesive (or its equivalent). Topically used vacuum dressings in the General view are composed of hydrophilic polyurethane (PU) sponges with pore size of from 400 to 2000 micrometers, transparent adhesive coating, raspadayuschejsya drainage tube and the vacuum source to the container for collecting the liquid. In certain cases, there may be used polyvinyl (PVA) sponge with pore size of 700-1500 μm, there are mentions of PVA-sponge with pore size of 60-270 micrometers. Special vacuum apparatus has an external control device that supports a wide range of values of underpressure and able to ensure the continuous and intermittent vacuum near�action on the wound. With flat surface the defects to improve the reliability of the sealing system can be applied around the perimeter of the wound paste, Stomahesive (or its equivalent). In pronounced cases of infected wounds, purulent cavities, osteomyelitis washing is carried out with antiseptic solutions and solutions containing antibiotics; in severe contact painful wounds anesthetics are used; for the purpose of creating a moist environment in aseptic wounds - ringer solution.

As antiseptics typically use the following chemicals:

- aldehydes, formaldehyde solution, tsiminal, etc.;

- Halogens and halogenated compounds - solution iodopironi, chloramine B, chlorhexidine, etc.;

- acids and bases: boric acid, ammonia, etc.;

- oxidants, potassium permanganate, hydrogen peroxide, etc.;

- phenols, carbolic acid, resorcin etc.

Many of these antiseptics are quite expensive, unsafe for humans and ineffective.

Often, for the treatment of purulent wounds in conjunction with vacuum therapy use additional remedies for the treatment of purulent wounds, representing water-soluble ointment base (levsin, levomekol, mafenide, toxicol), it is also known the use of powdered pepsin.

The disadvantage is that they require complex industrial�of manufacture, their high cost, inability to use, to wash purulent cavities, active washing wounds. Although chloramphenicol is active against non-spore forming anaerobes, but at the same time, the group Bact. fragilis secretes an enzyme that breaks down the chloramphenicol that requires the use of additional other antibacterial drugs.

Sometimes in conjunction with vacuum therapy is also used agent for the treatment of purulent wounds, for example, an aqueous solution of chlorhexidine digluconate. The disadvantages of this use are low efficiency and relatively high toxicity of the drug.

In view thereof, the aggregate of the disadvantages of the prototype method is the need to use expensive chemical preparations, in particular chemical antiseptics, dear microbicides, sometimes unsafe for humans which complicates and increases the cost of treatment. In addition, the use of the prototype method in a small degree reduces the time of treatment of wounds.

The object of the invention is the implementation of the simplification and cheapening of the way, as well as reducing the duration of treatment of wounds.

The stated technical problem is solved in that in the method of treatment of acute and chronic wounds, comprising applying to the wound vacuum dressing, in creation under vacuum bandage over sooner� dilution in the range of 50 to 200 Torr, and in carrying out supply and drainage-leaching of therapy, the patient pre-determine the resistance of the capillary walls on the affected area of the body, and under the vacuum bandage creates a vacuum in the range of 50-200 Torr over a period of time not exceeding the time of resistance more than 20 times, after which if the specified vacuum is carried out drainage and leaching therapy, which in the early stages of treatment through the drain tube down to the wound antiseptic, which is used as the anolyte, the pH where pHENlies in the range 2≤pHEN≤4, and redox potential (Eh)ENlies in the range [600≤(Eh)EN≤1200] mV, and drainage procedure-wash therapy is carried out for 5-10 min, after which the pressure to normalize source for 3-5 min, after that time the flow of anolyte into the wound area stop and pump out the mentioned liquid mixture of anolyte together with secretions from the wound from the wound area until such time as the pressure under the vacuum bandage again drops to between 50 and 200 Torr, and then through the drain tube to the wound returned anolyte, and this alternating process is repeated 5-8 times, then after pumping said mixture in the last cycle of alternating process take vacuum bandage with purulent wounds, areas of necrotic tissue, nanosats� powdered pepsin and additionally apply a dressing or is loose gauze drainage turundas with the anolyte, then, after a break of 4 to 6 hours superimposed replace the bandage anolyte with pepsin to vacuum bandage and repeat a similar alternating the above-mentioned process, and carry out this procedure 2-3 times a day for 3 -5 days for a course of treatment, then in the process of wound healing with decreasing local edema and the reduction of microbial contamination, the above-mentioned cycle of treatment is repeated, but in the process of supply and drain-cleansing therapy instead of anolyte catholyte used, pH of which lies in the range 8≤(pH)EN≤13, and redox potential (Eh)catlies in the range [-820≤(Eh)cat≤-300] mV, and in the process of supplying the catholyte to the wound in the catholyte excited infrasonic vibrations that are generated infrasound emitter and continuously and cyclically change is often in the range of 10 to 30 Hz back with an average power flux of 10-2to 1 W/cm2and the specified procedure drainage and leaching therapy catholyte cyclic infrasound in it, in mentioned range of frequencies and capacities is carried out for 15-20 minutes, after that time infrasound disable, stop the flow of catholyte into the wound area and pump out the mentioned liquid mixture of the catholyte with non-viable branches from the wound area to those� long until the pressure under the vacuum bandage again drops to between 50 and 200 Torr, and then through the drain tube to the wound again fail catholyte, which once again excite infrasonic vibrations ranging from 10-2to 1 W/cm2continuously and cyclically varying in the range from 10 to 30 Hz back, and this alternating process is repeated 5-8 times, after the pumping of the catholyte in the last cycle of alternating process take vacuum bandage with non-healing wounds, and left in the wound with gauze soaked in the catholyte, then after 4-6 hours the specified procedure is carried out again 2-3 times a day until the completion of treatment.

The method is as follows.

After thorough debridement of the wound and taking a smear on flora, the wound thoroughly oosevelt sterile towels. Then, the patient away from the wound on the skin of the injured body part, determine the resistance of capillary walls by the time of appearance 2-3 petechiae under a special bell base diameter of 1.3 cm and height 1 cm reduced pressure of 200 Torr, thus creating a suction to the skin. Normally this time does not exceed 13-14 C. the magnitude of the generated negative pressure in the wound area under the vacuum bandage should not exceed the resistance of the capillary wall is more than 20 times, i.e., not to exceed 20-280 C. The patient is placed in a chair or on the couch in half upright position and applied to the wound vacuum dressing. The bandage consists of up to the wound through kontraperturu drainpipe with additional sections for better drainage from the wound, a foam sponge which is placed into the wound with two layers to cover the entire surface of the wound and the drainage is located between the layers of foam (another option - one layer of sponge on the wound to summing drainage to the surface with a flexible flat adapter). Then you proceed to close the wound film to the surgical field of the company "3M". The drain pipe is connected to a medical suction IN-40A (Belarus) for active aspiration in the mode pop stop.This exhaust is virtually silent and allows you to set the level of reduced pressure from 25 to 200 Torr (8 gradations). In some cases, when a large volume of the wound cavity, the sponge is placed in several layers to fill in. In the presence of long and narrow wound channel or a deep cavity with a narrow entrance sponge is wrapped and fixed around the drainage. The apparatus IN-40A under vacuum bandage creates a vacuum in the range of 50-200 Torr over a period of time not exceeding the time of resistance more than 20 times, after which if the specified reduced pressure is carried out drainage and leaching t�therapy. For that 1st early stages of treatment through the drain tube down to the wound antiseptic, which is used as the anolyte, the pH where pHENlies in the range 2≤pHEN≤4, and redox potential (Eh)ENlies in the range [1000≤(Eh)EN≤1200] mV, and drainage procedure-wash therapy is carried out for 5-10 min. after this time, the pressure under the vacuum bandage to normalize the source, and incubated for the indicated initial pressure of 3-5 min. after the mentioned time stop the flow of anolyte into the wound area and from the area suctioned by the vacuum device IN-40A liquid mixture of anolyte together with secretions from the wound until then, until the pressure under the vacuum bandage is again reduced to 50-200 Torr. Then through the drain tube to the wound returned to the anolyte. This alternating process (creating a vacuum under the vacuum bandage over the wound, drain, rinse the wounds with anolyte and the suction of the anolyte with the secretions from the wound) repeat 5-8 times. Then after pumping anolyte with secretions from the wound in the last cycle of alternating process take vacuum bandage with purulent wounds, areas of necrotic tissue is applied powdered pepsin and additionally apply a dressing or is loose gauze drainage turundas with anoli�ohms. As is known, the use of pepsin in the treatment of purulent wounds requires the inclusion of drugs with acidic pH, as it is only active at pH values equal to 3.0 and below, but not above a 4.0. Therefore, for activation of pepsin, a selected range of pH of the anolyte pHENlies in the range 2≤pHEN≤4. The combination of anolyte and pepsin does not require the use of additional funds. The combination of them, enhances the activity of the drugs. The anolyte in combination with pepsin is used to complete cleansing the wound of necrotic tissue and filling with granulation. Pepsin, in comparison with other proteolytic drugs, cheap, available, non-toxic, even when used in large doses up to 1 g or more. The anolyte is prepared on a standard handset ECHO cancellation-30 in automatic mode. The use of anolyte supply drainage with vacuum-cleansing therapy for the initial 1st stage of the treatment when it is applied directly to the wound bed (on the bottom of the wound), due to the fact that the anolyte is considered one of the most powerful antiseptics, detrimental impact on many types of microorganisms, leading to inflammation of the wound [9]. We apply the anolyte in this modification the vacuum bandage wash the tissue of the wound bed, all the layers of sponge and then spirituosa. The validity of the use of ANO�ITA is its multi-component action in the polymicrobial aerobic-anaerobic bacterial count in wounds, and this effect of the anolyte more pernicious acts polymicrobial contamination of the wound, the higher oxidation-reduction potential (redox potential (Eh)EN). Therefore, the specified range of the redox potential of the anolyte preferably should lie in the range [1000≤(Eh)EN≤1200] mV. The value of (Eh)ENfor the region below 1000 mV, reduces its effectiveness. The value of the redox potential of the anolyte above (Eh)EN=1200 mV to create the handset ECHO cancellation-30 difficult. Effective impact of the anolyte by polymicrobial contamination of wounds is associated with a high redox potential (Eh)EN(redox potential), and low pH lying in the range of 2.0-4.

The use of anolyte pathogenetically justified in the treatment of commonly occurring non-clostridial anaerobic infections, since its development the optimal condition is weakly positive or negative redox redox potential, pH, oxygen-free environment.

This treatment procedure described above is repeated 2-3 times a day for 3-5 days per treatment.

Local treatment of purulent wounds anolyte in combination with pepsin allows earlier to arrest the inflammatory process, to clear away necrotic tissue, reduces degenerative vocalite�phase and its transition to the regenerative. In the regenerative phase of the process is carried out similarly to that described above, but with some differences.

2nd stage of treatment at which the process of wound healing with decreasing local edema and the reduction of microbial contamination, the above-mentioned cycle of treatment is repeated, but in the process of supply and drain-cleansing therapy instead of anolyte catholyte used, the hydrogen index (pH)CAt of which lies in the range 8≤(pH)cat≤13, and redox potential (Eh)catlies in the range [-820≤(Eh)cat≤-300] mV. Under these values ≤(pH)catand ≤(Eh)catit has regenerative properties. If (pH)catless than 8, its effectiveness is reduced. The value of (pH)catmore than 13 get in the cell of ECHO-30 is impossible. The value of (Eh)catbelow -820 mV difficult, and at values above -300 mV decreases therapeutic efficacy of the catholyte. The use of catholyte for drainage wound healing because it stimulates the immune system, detoxifying effect, accelerates the regeneration of tissues and is therefore effective in many chronic diseases associated with weakened immune reactivity, nonhealing wounds and ulcers. Catholyte is most powerful antioxidant of the currently known, stimulates Pro�assy reparative regeneration, exhibits detoxifying and biostimulating effect. In applying the catholyte accelerate the process of physiological regeneration of cells, stimulates the synthesis of DNA. This water has immunocorrective effect; enhances the detoxifying function of the liver; stabilizes membrane permeability of cells; normalizes the energy potential of the cells.

As a stimulant of biological processes, catholyte directs them along the optimal path. He is a carrier of useful body components (activated molecules and trace elements), carrying with them the energy, the lack of which is felt during illness. This water quickly heals wounds, stimulates the metabolism in the body, increases blood pressure in hypotensive patients, improves appetite and digestion.

It should also be noted that the composition of both catholyte and anolyte close to your natural body fluids - blood, lymph and intercellular fluid. Because of this the body does not need to finish it and waste energy. And catholyte and the anolyte is activated charge of the water, which are directly involved in active metabolism, accelerate and normalize it and thereby eliminate the causes of many diseases. This was an additional argument in favor of choosing these modifications of water for use in the treatment of the claimed�.

In the further implementation of the inventive method in the process of supplying the catholyte to the wound in the catholyte excited infrasonic vibrations ranging from 10-2to 1 W/cm2continuously and cyclically varying in the range from 10 to 30 Hz back, and the specified procedure drainage and leaching therapy catholyte cyclic infrasound in it, in the mentioned frequency range is carried out for 15 to 20 minutes, after that time infrasound disable, stop the flow in the wound area and catholyte pump out the mentioned liquid catholyte mixture together with the secretions from the wound area is not viable tissues until then, until the pressure under the vacuum bandage again drops to between 50 and 200 Torr, and then through the drain tube to the healing wound again fail catholyte, which once again excite infrasonic vibrations ranging from 10-2to 1 W/cm2continuously and cyclically varying in the range from 10 to 30 Hz back, and this alternating process is repeated 5-8 times. Then after pumping of the catholyte in the last cycle of alternating process take vacuum bandage with non-healing wounds, and left in the wound with gauze soaked in the catholyte. After 4-6 hours the specified procedure is carried out again 2-3 times a day until the completion of treatment.

Positive frequency near�the effect on healing of purulent wound due to the following factors. For all non-equilibrium processes, including those taking place in various parts of the human body there are fluctuating with time-varying amplitude and frequency, the processes which have received the name of flicker noise. Flicker noise (PN) (eng. flicker-flicker) one of the universal phenomena of nature is characteristic of all without exception of nonequilibrium processes [9 p. 140-154]. Spectra frequency and power normal Biosystems, whether individual cells, organs, etc., have photoshop - nature. The redox potential of the catholyte contains time-varying component of PN, in which you can distinguish three phases: - the first and third slow growth (Eh)catin time, and the second is the relatively rapid growth (Eh)catin time. With slow growth (Eh)catsuperimposed relatively quick elf CNC) PN oscillations, an upper frequency not exceeding 1 Hz. Similar ELF FSH - generate oscillations, in particular, biologically active points (BAP) and biological membranes. This is due to the chosen lower frequency range of 0.1 Hz, as successive cyclic change of frequency from 0.1 Hz to 30 Hz at a certain frequency resonance occurs at the frequency of the membranes of the patient, which leads to the intensification of the processes of regeneration of a wound.

The range of the average power of infrasound oscillations� due to the following factors. The upper limit of 1 W/cm2is the line above which it begins to overheat the tissue. The lower limit is selected by 14 orders of magnitude above the sensitivity threshold of nonequilibrium systems, including biological membranes, electromagnetic and acoustic fields (up to 10-16W/cm2and 6 orders of magnitude higher than the average density of power flow, which can create fields of natural origin. At the lower threshold of the average power flow, smaller than 10-2W/cm2required time for effective influence on the organs, systems of the body and healing the wound can be several hours, which is unacceptable both for the patient and for the doctor, since increasing the duration of medical procedures.

The frequency range of 10 to 30 Hz due to the following. When selecting frequencies below 10 Hz, to improve the efficiency of the impact on wound healing requires a sufficiently large time, which increases the duration of medical procedures. The choice of an upper frequency range 30 Hz, due to the fact that most of the vibrational physico-chemical processes in biological objects occurs at frequencies below 30 Hz, and therefore the greatest therapeutic efficacy in the healing of purulent wounds is observed at frequencies below 30 Hz.

An example of a specific implementation

Using the inventive�about the way produced treatment of purulent wounds with the use of anolyte in combination with pepsin used in 24 patients.

To compare the results of treatment of 48 patients with purulent wounds were divided into 2 groups of 24 people in each. Age, gender and the nature of the wounds of the patients in both groups was almost identical. One group of 24 people was a control and was treated by the traditional method adopted in the clinic by washing the wounds of a 30% aqueous solution of urea and a solution of proteolytic enzyme in 30% urea, with application in active drainage. Another group was treated according to the claimed method. Vacuum under the bandage vacuum created by the machine-40A and ranged from 100 to 200 Torr. The anolyte and catholyte were received on the device ECHO-30. The pH value of the anolyte (pH)ENin all sessions of treatment for all patients was equal to 3, and its redox potential (Eh)EN=l150 mV. The pH value of the catholyte in all sessions were equal (pH)cat=8, and redox potential (Eh)cat=-750 mV. For the excitation of infrasound in the second phase of treatment was used as an acoustic frequency generator FG-100 is designed to produce harmonic and periodic stress triangular and rectangular from 0.1 Hz to 100 kHz. A generator of low frequency signals simultaneously generates three types of signals: rectangular, triangular and sinusoidal voltages and selects any of the signals and ranges �of astate. The exact frequency of oscillation is achieved by establishing an appropriate control voltage output from 0 to 10 V at a load of 8 Ohms.

In the catholyte excited infrasound vibrations ranging from 10-2to 1 W/cm2continuously and cyclically varying in the range from 10 to 30 Hz back, and the specified procedure drainage and leaching therapy catholyte cyclic infrasound in it, in the mentioned frequency range is carried out for 15 to 20 minutes, after that time infrasound disable, stop the flow in the wound area and catholyte pump out the mentioned liquid catholyte mixture together with the secretions from the wound area is not viable tissues until then, until the pressure under the vacuum bandage again drops to between 50 and 200 Torr, and then through the drain tube to the healing wound again fail catholyte, which once again excite infrasonic vibrations ranging from 10-2to 1 W/cm2continuously and cyclically varying in the range from 10 to 30 Hz back, and this alternating process is repeated 5-8 times. Then after pumping of the catholyte in the last cycle of alternating process take vacuum bandage with non-healing wounds, and left in the wound with gauze soaked in the catholyte. After 4-6 hours the specified procedure is carried out again 2-3 times �tier until the completion of treatment.

The acoustic frequency generator FG-100 is designed to produce harmonic and periodic stress triangular and rectangular from 0.1 Hz to 100 kHz. A generator of low frequency signals simultaneously generates three types of signals: rectangular, triangular and sinusoidal voltages and selects any of the signals and frequency ranges. The exact frequency of oscillation is achieved by establishing an appropriate control voltage output from 0 to 10 V at a load of 8 Ohms.

For the excitation of infrasound in the second phase of treatment was used as an acoustic frequency generator FG-100 is designed to produce harmonic and periodic stress triangular and rectangular from 0.1 Hz to 100 kHz. A generator of low frequency signals simultaneously generates three types of signals: rectangular, triangular and sinusoidal voltages and selects any of the signals and frequency ranges. The exact frequency of oscillation is achieved by establishing an appropriate control voltage output from 0 to 10 V at a load of 8 Ohms.

In the catholyte excited infrasound vibrations ranging from 10-2to 1 W/cm2continuously and cyclically varying in the range from 10 to 30 Hz back, and the specified procedure drainage and leaching �ERPII catholyte cyclic infrasound in it, in the mentioned frequency range is carried out for 15 to 20 minutes.

Characteristic clinical observations. Material for the study was the analysis of the results of examination and treatment of 120 patients about nonhealing wounds and trophic ulcers, which in the vast majority of clinical observations localized on the foot and lower leg (92,7%).

The majority were men (56,3%). The age of patients ranged from 18 to 81 years and the average amounted to 54.1±1,7. Among the pathological conditions that preceded the formation of chronic wounds, the most frequently met purulent-necrotic lesions of the soft tissues in the form of erysipelas, the consequences of mechanical trauma, thermal injuries (57.1 percent). In other cases the cause of formation of the defect served as a circulatory disorder. According to the international classification CEAP [Rayes N., 1995], we observed patients with chronic venous insufficiency were 6 stage of the pathological process In atherosclerotic vascular lesions of the legs, based on the classification of chronic arterial insufficiency of the leg vessels proposed by A. V. Pokrovsky (1979), local changes of the soft tissues in all patients with this pathology were consistent with the third degree of limb ischemia.

According to the classification KRD�quarter of the RAS at Knighton [OEG Tapp V. et al., 2000], in most cases, the bottom of the wound defect was presented destructively modified subcutaneous fat (87,5%), which corresponds to the second stage of the lesion. 4.5% of cases the depth of the process was limited to the third stage, extending to the fascia. Deeper distribution process corresponding to the fourth and fifth stages with involvement in the destruction of tendons, ligaments, bones, was recorded in 8% of cases.

At 36.6% of cases the patients had comorbidities. Among them the most frequent lesions of the cardiovascular system (21,6%), diseases of the respiratory system was observed in 9.9% of cases.

Based on the goals and objectives of the present research, we have formed three groups of 40 people. In the first group - the comparison group (GS), for the treatment of chronic wounds - used traditional method. In the second control group (CG), which in the complex treatment of trophic ulcers and nonhealing wounds used a vacuum therapy according to the method prototype. In the third main group (DG), which in the complex treatment of trophic ulcers and nonhealing wounds used a vacuum therapy according to the claimed method. By sex, age, comorbidity, cause of chronic wounds and other characteristics of the compared groups had no sudetendeutsche, except for the depth of the lesion of soft tissue, which was more marked in patients in which treatment used a vacuum therapy according to the claimed method.

The methods of treatment. Treatment of chronic wounds in 40 patients, formed the comparison group (TOS), conducted in the traditional way. It included the surgical treatment of purulent focus with excision of necrotic tissue, possibly radical destruction of the existing Slough and fibrin raids, often covered with granulation tissue. In the future, to cleanse the wound topically used antiseptics, including solutions furatsilina 1:5000, 3% hydrogen peroxide, 0.1% of potassium permanganate, 1% dioksidina or boric acid. They irrigated the wound surface during surgery and with daily dressings. Then put gauze sterile dressing with a 0.1% solution of itaperuna or ointment with products containing water-soluble base (levosin, levomekol). In 71% of cases in patients of the comparison group used anti-biochemotherapy wearing mostly manufacter.

The second group - the control group (CG) were treated with the use of vacuum therapy in the method prototype with the use of vacuum dressings. Topically used vacuum dressings consisted of hydrophilic polyurethane (PU) sponges with pore size of from 400 to 2000 MICR�meters transparent adhesive coating, raspadayuschejsya drainage tube and the vacuum source to the container for collecting liquid Special vacuum apparatus had an external control device that supports a wide range of values of reduced pressure and was able to ensure the continuous and intermittent vacuum effect on the wound. With flat surface the defects to improve the reliability of system tightness was applied around the perimeter of the wound paste, Stomahesive (or its equivalent). Used reduced pressure of 50 to 200 Torr. Optimal was considered as the level of reduced pressure in the wound 125 Torr.

Also used a combination of drainage and leaching and vacuum systems - vacuum-wash therapy (Vacuum Instillation Therapy), when additionally to the VAC system is supplied supply and drainage. In cases expressed in infected wounds, purulent cavities, osteomyelitis lavage was carried out by a chemical antiseptic solutions and solutions containing antibiotics; in severe contact painful wounds anesthetics are used; for the purpose of creating a moist environment in aseptic wounds - ringer solution.

Patients received comprehensive treatment, including antibiotics based on the sensitivity of pathogens, the correction of volemic disorders, protein and electrolyte imbalance, acid-sche�full-time status. Conducted adequate drug therapy aimed at maintaining functional status of the major organs and life support systems.

From supplies used: foam with pore sizes from 500 to 1500 micrometers in thickness from 10 to 15 mm, transparent, durable and visokoaktivnie coverage of the company "3M" (Bioclusive and Tegaderm) for sealing wounds and nezadouci PVC drainage tube from a disposable system for intravenous infusion. Sterilization of foam produced by the method of autoclaving.

The third main group (DG), which in the complex treatment of trophic ulcers and nonhealing wounds used a vacuum therapy according to the claimed method. After thorough debridement of the wound and taking a smear on flora, the wound thoroughly oosevelt sterile towels. Then, the patient away from the wound on the skin of the injured body part, determine the resistance of capillary walls by the time of appearance 2-3 petechiae under a special bell base diameter of 1.3 cm and a height of 1 cm under reduced pressure of 200 Torr, thus creating a suction to the skin. Normally this time does not exceed 13-14 C. the magnitude of the generated negative pressure in the wound area under the vacuum bandage should not exceed the resistance of the capillary wall thickness is greater than 20 RA�, i.e. not to exceed 260-280 C.

After this the patient the patient have used the method of vacuum therapy. The patient is placed in a chair or on the couch in half upright position and applied to the wound vacuum dressing. The bandage consists of up to the wound through kontraperturu drainpipe with additional sections for better drainage from the wound, a foam sponge which is placed into the wound with two layers to cover the entire surface of the wound and the drainage is located between the layers of foam (another option - one layer of sponge on the wound to summing drainage to the surface with a flexible flat adapter). Then you proceed to close the wound film to the surgical field of the company "3M". The drain pipe is connected to a medical suction IN-40A (Belarus) for active aspiration in the mode pop stop. During ligation of the "naked" ulcerative defect was treated with low-dose reduced pressure using a sterile tip, connected to a vacuum source IN-40A. The optimal dilution was considered low blood pressure in the range (50-200 Torr).

In some cases, when a large volume of the wound cavity, the sponge was placed in several layers to fill in. In the presence of long and narrow wound channel or a deep cavity with a narrow entrance sponge turned around and was recorded around others�of Nha. The apparatus IN-40A under the vacuum bandage, as noted above, creating a low pressure in the range of 50-200 Torr over a period of time not exceeding the time of resistance more than 20 times, after which if the specified reduced pressure was carried out drainage and leaching therapy. For that 1st early stages of treatment through the drain tube to the wound failed antiseptic, which used the anolyte, the pH where pHENin all cases lying in the range 2≤pHEN≤4, and redox potential (Eh)ENlying in the range [1000≤(Eh)EN≤1200] mV. The exposure of drainage and leaching therapy on chronic wound under vacuum was performed for 5-10 min. That was enough to, not forcing events, "sanitize" the soft-tissue defect, to remove relatively loose necrotic fragments, fibrin and purulent exudate. During this procedure, the patient felt slight pain, which was evaluated at 0 or 1 point of subjective perception of pain. None of the observations have not needed any pain medication.

After this time, the pressure under the vacuum bandage normalized to baseline, and was kept for a specified initial pressure of 3-5 min. after that time has stopped the supply of anolyte in the area�ü wounds and from the area suctioned by the vacuum device IN-40A liquid mixture of anolyte together with secretions from the wound until until the pressure under the vacuum bandage is again reduced to 50-200 Torr. Then through the drain tube to the wound again let the anolyte. This alternating process (creating a vacuum under the vacuum bandage over the wound, drain, rinse the wounds with anolyte and the suction of the anolyte with the secretions from the wound) was repeated 5-8 times. Then after pumping anolyte with secretions from the wound in the last cycle of alternating process removed the vacuum bandage with purulent wounds.

In areas with necrotic tissue was applied powdered pepsin and additionally overlap the bandage is wetted by the anolyte, or was loose gauze drainage turundas with the anolyte. As is known, the use of pepsin in the treatment of purulent wounds requires the inclusion of drugs with acidic pH, as it is only active at pH values equal to 3.0 and below, but not above a 4.0. Therefore, for activation of pepsin, a selected range of pH of the anolyte pHENlies in the range 2≤pHEN≤4. The combination of anolyte and pepsin does not require the use of additional funds. The combination of them, enhances the activity of the drugs. The anolyte in combination with pepsin is used to complete cleansing the wound of necrotic tissue and filling with granulation. Pepsin, in comparison with other proteolytic drugs� cheap, available, non-toxic, even when used in large doses up to 1 g or more. The anolyte was prepared on a standard handset ECHO cancellation-30 in automatic mode. The use of anolyte supply drainage with vacuum-cleansing therapy for the initial 1st stage of the treatment when it is applied directly to the wound bed (on the bottom of the wound), due to the fact that the anolyte is considered one of the most powerful antiseptics, detrimental impact on many types of microorganisms, leading to inflammation of the wound [9]. We apply the anolyte in this modification the vacuum bandage wash the tissue of the wound bed, all the layers of sponge and then spirituosa. The validity of the use of anolyte is its multi-component action in the polymicrobial aerobic-anaerobic bacterial count in wounds, and this effect of the anolyte more pernicious acts polymicrobial contamination of the wound, the higher oxidation-reduction potential (redox potential (Eh)EN). Therefore, the specified range of the redox potential of the anolyte preferably should lie in the range [1000≤(Eh)EN≤1200] mV. The value of (Eh)ENfor the region below 1000 mV, reduces its effectiveness. The value of the redox potential of the anolyte above (Eh)EN1200 mV to create the handset ECHO cancellation-30 difficult. Effective impact of the anolyte by polymicrobial contamination of wounds associated � high redox potential (Eh) EN(redox potential), and low pH lying in the range of 2.0-4.

The use of anolyte pathogenetically justified in the treatment of commonly occurring non-clostridial anaerobic infections, since its development the optimal condition is weakly positive or negative redox redox potential, pH, oxygen-free environment.

This treatment procedure described above was repeated 2-3 times a day for 3-5 days per treatment.

Local treatment of purulent wounds anolyte in combination with pepsin allows earlier to arrest the inflammatory process, to clear away necrotic tissue, reduces degenerative inflammatory phase and its transition to the regenerative. In the regenerative phase of the process is carried out similarly to that described above, but with some differences.

2nd stage of treatment at which the process of wound healing with decreasing local edema and the reduction of microbial contamination mentioned above, the treatment cycle was repeated, however, the supply drain-cleansing therapy instead of anolyte was used catholyte, the pH value (pH)catwhich lay in the range 8≤(pH)cat≤12, and redox potential (Eh)catlies in the range [-820≤(Eh)cat≤-300] mV. Under these values ≤(pH) catand ≤(Eh)catit has regenerative properties. If (pH)catless than 8, its effectiveness is reduced. The value of (pH)catmore than 13 get in the cell of ECHO-30 is impossible. The value of (Eh)catbelow -820 mV difficult, and at values above -300 mV decreases therapeutic efficacy of the catholyte. The use of catholyte for drainage wound healing because it stimulates the immune system, detoxifying effect, accelerates the regeneration of tissues and is therefore effective in many chronic diseases associated with weakened immune reactivity, nonhealing wounds and ulcers. Catholyte is most powerful antioxidant of the currently known, stimulates reparative regeneration, exhibits detoxifying and biostimulating effect. In applying the catholyte accelerate the process of physiological regeneration of cells, stimulates the synthesis of DNA. This water has immunocorrective effect; enhances the detoxifying function of the liver; stabilizes membrane permeability of cells; normalizes the energy potential of the cells.

As a stimulant of biological processes, catholyte directs them along the optimal path. He is a carrier of useful body components (activated molecules and trace elements), n�things with them energy, the lack of which is felt during illness. This water quickly heals wounds, stimulates the metabolism in the body, increases blood pressure in hypotensive patients, improves appetite and digestion.

It should also be noted that the composition of both catholyte and anolyte close to your natural body fluids - blood, lymph and intercellular fluid. Because of this the body does not need to finish it and waste energy. And catholyte and the anolyte is activated charge of the water, which are directly involved in active metabolism, accelerate and normalize it and thereby eliminate the causes of many diseases. This was an additional argument in favor of choosing these modifications of water for use in the treatment of the claimed method.

In the further implementation of the inventive method in the process of supplying the catholyte to the wound in the catholyte excited infrasonic vibrations ranging from 10-2to 1 W/cm2continuously and cyclically varying in the range from 10 to 30 Hz back. For the excitation of infrasound in the second phase of treatment was used as an acoustic frequency generator FG-100 is designed to produce harmonic and periodic stress triangular and rectangular from 0.1 Hz to 100 kHz. A generator of low frequency signals simultaneously generates three types of signals: pramogos�tion, triangular and sinusoidal voltages and selects any of the signals and frequency ranges. The exact frequency of oscillation is achieved by establishing an appropriate control voltage output from 0 to 10 V at a load of 8 Ohms.

The specified procedure drainage and leaching therapy catholyte cyclically changing in him infrasound in the frequency range was carried out for 15 to 20 minutes, after that time, the infrasound was turned off, has stopped the supply to the wound area of the catholyte and siphoned mentioned liquid catholyte mixture together with the secretions from the wound area is not viable tissues until then, until the pressure under the vacuum bandage again drops to between 50 and 200 Torr, and then through the drain tube to heal the wound had again failed catholyte, which again aroused infrasonic vibrations ranging from 10-2to 1 W/cm2continuously and cyclically varying in the range from 10 to 30 Hz back, and this alternating process is repeated 5-8 times. Then after pumping of the catholyte in the last cycle of alternating process removed the vacuum bandage with non-healing wounds, after 4-6 hours the specified procedure is carried out again 2-3 times a day until the completion of treatment.

Positive frequency effect on the healing of purulent RA�in due to the following factors. For all non-equilibrium processes, including those taking place in various parts of the human body there are fluctuating with time-varying amplitude and frequency, the processes which have received the name of flicker noise. Flicker noise (PN) (eng. flicker-flicker) one of the universal phenomena of nature is characteristic of all without exception of nonequilibrium processes [9 p. 140-154]. Spectra frequency and power normal Biosystems, whether individual cells, organs, etc., have photoshop - nature. The redox potential of the catholyte contains time-varying component of PN, in which you can distinguish three phases: - the first and third slow growth (Eh)catin time, and the second is the relatively rapid growth (Eh)catin time. With slow growth (Eh)catsuperimposed relatively quick elf CNC) PN oscillations, an upper frequency not exceeding 1 Hz. Similar ELF FSH - generate oscillations, in particular, biologically active points(BAP) and biological membranes. This is due to the chosen lower frequency range is 10 Hz, as in consistent cyclical variation of the frequency from 10 Hz to 30 Hz at a certain frequency resonance occurs at the frequency of the membranes of the patient, which leads to the intensification of the processes of regeneration of a wound.

The range of the average power of infrasound oscillations �of bulblin the following factors. The upper limit of 1 W/cm2is the line above which it begins to overheat the tissue. The lower limit is selected by 14 orders of magnitude above the sensitivity threshold of nonequilibrium systems, including biological membranes, electromagnetic and acoustic fields (up to 10-16W/cm2and 6 orders of magnitude higher than the average density of power flow, which can create fields of natural origin. At the lower threshold of the average power flow, smaller than 10-2W/cm2required time for effective influence on the organs, systems of the body and healing the wound can be several hours, which is unacceptable both for the patient and for the doctor, since increasing the duration of medical procedures.

The frequency range of 10 to 30 Hz due to the following. When selecting frequencies below 0.1 Hz, to improve the efficiency of the impact on wound healing requires a sufficiently large time, which increases the duration of medical procedures. The choice of an upper frequency range 30 Hz, due to the fact that most of the vibrational physico-chemical processes in biological objects occurs at frequencies below 30 Hz, and therefore the greatest therapeutic efficacy in the healing of purulent wounds is observed at frequencies below 30 Hz.

Evaluation of the effectiveness of all three treatments were carried out on �warping of the clinical manifestations of the pathological process, the dynamics of microbial contamination of wounds (Lg total number of microorganisms in colony forming units (CFU) in terms of 1 g of tissue), cellular composition of the wound-prints, the phagocytic activity of neutrophils (FA), phagocytic number (FC), index of completion of phagocytosis (ISF). The study was performed according to standard techniques.

Statistical processing of results was performed by determining the arithmetic mean value (M) and its error (t). Significant difference of mean values was determined using student's criterion.

The use of vacuum therapy according to the method prototype (KG group), compared with the traditional method of treatment (group HS), led to a marked cleansing of wounds of overlapping sites of fibrin and necrosis, reduction of the area and depth of the wound, the formation of healthy pink granulation tissue and accelerated regional epitelizacii. Treatment of the claimed method (group B) compared with the treatment by the method prototype (KG group) showed a significantly greater improvement all of the above mentioned indicators of purulent wounds. This allowed to reduce the period of hospital treatment period. Thus, the average duration of inpatient treatment of patients of the group treated according to the claimed method was (group B) of 15.3±2,9 treated by the method prototype (KG group) was 19.7±3.1 days vs. group (TOS), lachiusa�Xia according to the traditional technology of 24.3±3.9 nights. Constant, prolonged vacuum therapy caused no pain from wounds or other complications. The use of vacuum therapy in the mode of 50-200 Torr had an impact on the speed of elimination of microflora in the focus of infection and provided a statistically significant (P<0.05) reduction in total number of bacteria in wounds on day 11 of treatment (table. 1).

Note:* - reliability of differences P<0,05 between indicators in different groups; n - number of patients.

The results of cytological studies (tab. 2) showed that the use of vacuum therapy has contributed to the decline in smears fingerprints RAS content of the cells, determining the acute phase of inflammation (neutrophils, lymphocytes, monocytes) and the increase in the number of cells that form reparative processes (macrophages, fibroblasts, Poliplast).

Note: the accuracy of the difference P between indicators in different groups: *-<0,05; **-<0.01;***-<0,001, n is the number of patients.

So, on day 5 after the start of the vacuum therapy was statistically significant (P<0.01 and P<0.05) reduction in the content of neutrophils and lymphocytes, and 10 - all cells of acute phase of inflammation (P<0,05). And, on the contrary, already on day 5 of treatment was significant (P<0.05 and P<0.001) increase otnositelnogo fibroblasts and Poliplast, while 10 - Poliplast (P<0.01).

The use of vacuum therapy as in the method prototype and the claimed method was reflected in the restoration of the General immune status. So, for 10 days of treatment parameters FA, FC and ISF showed a tendency to increase compared with their initial values, among which the levels of FA and ISF were statistically significantly (P<0.05 and P<0,001) lower than the control. In this case the treatment by the claimed method, the growth trend of these parameters was significantly higher than that of the prototype method. Especially important is the increased level ISF, especially in the application of the proposed method, which indicates the normalization of functional activity of neutrophils in the final stages of phagocytosis - killing.

The dynamics of the clinical condition and the course of wound healing was assessed by the duration of the phases of necrosis, suppuration, regeneration, biochemical, hematological parameters and General condition of the patient depending on the applied method of treatment.

The obtained data indicate a significant improvement of the wound process in the treatment by the method of vacuum therapy according to the method prototype, which allowed the plastic stages of wound closure in almost 1.5-2 times faster than when using the traditional method of treatment. When using the proposed method improved�e course of wound healing was faster than in the method prototype, which allowed the plastic stages of wound closure in almost 2.5 - 4 times faster than when using the traditional method of treatment. The inventive method compared to the prototype method reduces the number of planned necrectomy, increases the elimination rate of pyogenic flora almost double that promotes faster readiness of the wound to reparative processes.

As a result of therapy according to the inventive method, compared to the prototype method, the obtained reduction of terms of treatment of purulent wounds by 6-8 days, confirmed by laboratory and clinical data. Complications due to the use of drugs were observed.

The use in the 1st phase of wound process, ECAS-anolyte in combination with pepsin has the following advantages:

a) space and cheapness of manufacture, ECAS-anolyte,

b) the ECAS-anolyte is an effective bactericide, necroticism dehydration, pathogenetically justified the means in terms of polymicrobial infection of wounds,

b) the application of the proposed method reduces the time of wound treatment, increases the effectiveness of treatment of purulent wounds.

The use in the 2nd phase of treatment wash drainage therapy catholyte is accelerating in a 4-5-fold increase in the number of cells that form reparative processes (macrophages, Fi�of fibroblasts, Poliplast).

In addition, explaining the clinical efficacy of vacuum therapy in the inventive method, it should be borne in mind that in the disclosed method, the influence of micromechanical forces on a wound accelerates its healing. This is because any irritating tissue exposure promotes oxidative processes in it.

Under the influence of low-dose vacuum is stretched into most cellular elements by 5-20%. As a consequence, the implemented lattice strain of each individual cells that promotes the acceleration of cell proliferation in the wound area. The use of infrasonic vibrations ranging from 10-2to 1 W/cm2continuously and cyclically varying in the range from 10 to 30 Hz back even more effectively affects cells in wound healing and speeds up the process (10-15%) Thus, the use of the claimed method of treatment of chronic purulent wounds is a useful method of stimulating wound healing, contributing to the acceleration of cell division, angiogenesis, and local elaboration of growth factors.

Bibliography

1. A. S. 1121005, IPC AC 37/48.

2. A. S. 936919, IPC AC 37/48.

3. A. S. 1163863, IPC AC 37/48.

4. B. M. Datsenko, etc. "Local treatment of purulent wounds", Surgery, 1984, 1. P. 136-141.

5. M. I. Kuzin, B. M. Kostyuchenok. Wounds and wound inform�tion. -M.: Medicine, 1990, pp. 244-245.

6. A. S. No. 587941, CL. AM 1/00, 1978

7. A. S. No. 1044288, CL A61M 1/00, 1983.

8. Obolensky, V. N., Seedy, A. Yu., Nikitin V. G., D. V. Sychev Vacuum therapy in the treatment of wounds and wound infection. Russian medical journal. Surgery. Urology, August 03, 2010 # 17 - prototype

9. Activated fluids, electromagnetic fields and flicker noise. Their application in medicine and agriculture: monograph / O. A. Pasko, V. A. Semenov, G. V. Smirnov, D. G. Smirnov. - Tomsk: Tomsk. state University of control systems and Radioelectronics, 2007, pp. 159-209.

A method for the treatment of acute and chronic wounds, comprising applying to the wound vacuum dressing, creating under vacuum bandage over the wound with reduced pressure, carrying out supply and drainage-leaching of therapy, characterized in that the patient pre-determine the resistance of the capillary walls on the affected area of the body, and under the vacuum bandage to create negative pressure in the range of 50-200 Torr over a period of time not exceeding the time of resistance more than 20 times, after which if the specified reduced pressure is carried out drainage and leaching therapy, which in the early stages of treatment through the drain tube down to the wound antiseptic, which is used as the anolyte, the pH where pHENlies in the range 2≤pHEN≤4, and redox�the potential (Eh) ENlies in the range [1000≤(Eh)EN≤1200] mV, and drainage procedure-wash therapy is carried out for 5-10 min, after which the pressure to normalize source for 3-5 min, after that time the flow of anolyte in the wound area is stopped, and pump out the mentioned liquid mixture of anolyte together with secretions from the wound from the wound area until such time as the pressure under the vacuum bandage again drops to between 50 and 200 Torr, and then through the drain tube to the wound returned anolyte, and this alternating process is repeated 5-8 times, then remove the vacuum bandage with purulent wounds the areas of necrotic tissue is applied powdered pepsin and additionally apply a bandage or hold loose gauze drainage turundas with the anolyte, after the break 4-6 hours superimposed replace the bandage anolyte with pepsin to vacuum bandage and repeat a similar alternating the above-mentioned process, and carry out this procedure 2-3 times a day for 3-5 days per treatment, then in the process of wound healing with decreasing local edema and the reduction of microbial contamination mentioned above, the treatment cycle is repeated, however, the supply drain-cleansing therapy instead of anolyte catholyte used, pH lying in the range 8≤(pH)EN≤13, and redox-�the potential (Eh) catlies in the range [-820≤(Eh)cat≤-300] mV, and in the process of supplying the catholyte to the wound in the catholyte excited infrasonic vibrations ranging from 10-2to 1 W/cm2continuously and cyclically varying in the range from 10 to 30 Hz and back, the specified procedure drainage and leaching therapy catholyte cyclically changing it in the infrasound in the frequency range is carried out for 15-20 minutes, after that time infrasound disable, stop the flow in the wound area of the catholyte, and pump out the mentioned liquid mixture of the catholyte from the wound area until such time as the pressure under the vacuum bandage again drops to between 50 and 200 Torr, and then through the drain tube to the wound again fail catholyte, which once again excite infrasonic vibrations ranging from 10-2to 1 W/cm2continuously and cyclically varying in the range from 10 to 30 Hz and back, and this alternating process is repeated 5-8 times, then after the pumping of the catholyte in the last cycle of alternating process take vacuum bandage with non-healing wounds, and left in the wound with gauze soaked in the catholyte, after 4-6 hours the specified procedure is carried out again 2-3 times a day until the completion of treatment.



 

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7 cl, 18 dwg

FIELD: medicine.

SUBSTANCE: group of inventions refers to medicine. Described is a negative pressure wound therapy device comprising a material for air-tight coating of the wound area, optionally a negative pressure source connector and a wound dressing containing open-pore polyurethane foam with the latter having tensile strength of 80 kPa to 300 kPa according to DIN 53571 after three-day storage in bovine serum. Described is using open-pore polyurethane foam as the wound dressing in the negative pressure wound therapy.

EFFECT: method prevents foam particle deposition in the wounds.

13 cl, 6 dwg, 3 ex

FIELD: medicine.

SUBSTANCE: group of inventions refers to medicine, particularly to using a sub-atmospheric pressure as a factor of body tissue exposure. That is ensured by the presented versions of a method of treating an injured cardiac tissue by the local exposure to the sub-atmospheric pressure. A porous material compatible with biological media is placed between the tissue and a source of the pressure below atmospheric. That is positioned so that to provide a gas communication between one or more pores of this material and the cardiac tissue. Additionally, a coating integrated into the biological media is placed above the porous material. The porous material and coating is packed above the injured tissue. The source of the pressure below atmospheric is functionally connected with the porous material to provide a gas connection for generating the sub-atmospheric pressure within the cardiac tissue. There are presented versions of the method of treating a kidney. For this purpose, the kidney is enclosed in an air-tight chamber; the sub-atmospheric pressure is generated around the kidney and maintained for a period of time adequate to improve the kidney function and size. There are also disclosed devices for treating the injured cardiac tissue, degradable or absorbable vacuum device and device for treating organs.

EFFECT: inventions provide minimising the cell death and injury, stimulating the function and growth of the tissues and organs.

90 cl, 14 dwg, 4 tbl, 5 ex

FIELD: medicine.

SUBSTANCE: invention refers to a vacuum extractor (2) put on user's body for medical applications, particularly for vacuum wound healing on human or animal body, comprising a vacuum extracting unit and a disposable container (10) for body fluids, particularly wound effluents absorbed from the wound. To make the device more comfortable to use, it is configured so that body segments (4, 8) can be detachably attached to each other by means of latching, fixing or other locks or gates (34) actuated to form a closed geometrical boundary.

EFFECT: structural improvement.

32 cl, 27 dwg

FIELD: medicine.

SUBSTANCE: biological fluid aspirate is taken from the anterior nasal cavity by placing a 7-8 mm stopper on a soft catheter by means of a mm-ruler. Air 1 ml is taken into a syringe; the catheter is inserted into the anterior nasal cavity at 7-8 mm, and the biological fluid is taken. The catheter is removed, and the biological fluid with the air is ejected from the syringe into test tube No.1. The catheter is washed with 0.85% sodium chloride 5 ml. That is followed by placing a 20 mm stopper on the soft catheter, and the air 1 ml is taken into the syringe, and the catheter is inserted into the deep nasal pharynx at 20 mm. The biological fluid is taken; the catheter is removed, and the biological fluid with the air is ejected into test tube No.2. The concentration of average-molecular peptides (AMP) is measured in test tubes No.1, No.2. If the AMP difference in test tubes No.1 and No.2 makes 0.009±0.001 absorbance units, the mature newborn infant is considered to be healthy. If the AMP difference in test tubes No.1 and No.2 makes 0.018±0.001 absorbance units, respiratory distress syndrome is diagnosed in the newborn infant.

EFFECT: technique provides the most effective diagnosing of the given pathology in the mature newborn infants, including in the meconium-contaminated amniotic fluid aspiration.

4 tbl, 3 ex

Suction apparatus // 2539900

FIELD: medicine.

SUBSTANCE: invention refers to medical equipment. A suction apparatus comprises a body involving combined handle and tip, ducted and piped blind, a vacuum line connection tube and an anticoagulant supply tube. A tip end comprises an extending portion with a blind belt. From an outer side, the blind has two connectors, one of which is connected through a first blind duct with the inner cavity of the body, while the other one - through the second blind duct with the third inner pipe connected to a vacuum tube. The second blind duct together with its connector is connected to supply the anticoagulant into the inner cavity for vacuum supply. On the surface, the tube comprises the vacuum line connection tube controlling a suction value and provided with a skewed end hole. A ratio of the inner diameter of the vacuum tube to the inner diameter of the tip end makes no more than 1:2.5.

EFFECT: invention provides the reliable anticoagulant supply leaving the suction cavity open.

5 cl, 6 dwg

FIELD: medicine.

SUBSTANCE: invention refers to medical equipment, to vacuum generating user's portable device for medical applications, particularly for vacuum healing of wounds on human or animal body. The above device (2) comprises a vacuum generating device and a disposable container (10) for collection of body fluids, particularly wound effluents absorbed from the wound, and a connector (12) for an absorbent tube used to this effect. The vacuum generating device is arranged in a first portion (4) of the body. The container (10) forms a second portion (8) of the body. The portions (4, 8) of the body are detachably fastened in relation to each other. Assembling the first and second portions (4, 8) of the device together is combined with establishing a vacuum connection of the container (10) and vacuum-generating device. The device (2) is provided with fasteners so that it can be settled on the user's body and portable thereon. The first portion (4) of the body comprises the vacuum-generating device in the form of an air pump, as well as electric and electronic components controlling the device including the battery supplies or chargeable accumulators. A bearing surface of the device (2) for placing the device (2) on a horizontal support in the stationary operating conditions is formed by the first portion (4) of the body. The first portion (4) of the body applied on the user's body in the mobile operation faces from the body. The second portion (8) of the body faces towards the body. Both portions (4, 8) of the body are substantially disk-shaped and adjoin each other in substantially vertical parting plane (14). The first portion (4) of the body closes the second portion (8) of the body on looking at a visible side (38) facing from the body of the first portion (4) of the body by at least 90% of the visible surface of the second portion (8) of the body in the same direction. The visible side (38) facing from the body of the first portion of the body comprise control elements presented in the form of a sensor screen, and indicator elements (42) for the vacuum-generating device.

EFFECT: invention provides the much more comfortable manipulations and control of the device.

31 cl, 7 dwg

FIELD: medicine.

SUBSTANCE: vacuum-assisted wound healing device comprising an air-tight closing material (1), a functional wound chamber sealing (4) to an outside closing material by a vacuum source, as well as at least one activated adsorbent washing body (3) accommodating at least one superadsorbent polymer.

EFFECT: improvement of the device.

23 cl, 8 dwg, 1 tbl, 7 ex

FIELD: medicine.

SUBSTANCE: surgical cartridge is configured to engage with a number of peristaltic pump carriers and comprises a plate and a substrate connected to the plate. The plate and substrate form at least two pump segments configured to engage with the number of the peristaltic pump carriers. The pump segments are configured to engage with one peristaltic pump carrier head comprising the number of the carriers. One of the two pump segments is configured to profile a flow, wherein the maximum pumping action from the pump segment is displaced in a phase from the maximum pumping action from at least one another pump segment from the above at least two pump segments, when the above pump segments engage with the single carrier head. There are disclosed an intraoperative fluid supply system and a method for the intraoperative fluid supply, both with the use of the surgical cartridge.

EFFECT: avoiding undesired pumping actions when supplying fluids.

15 cl, 9 dwg

FIELD: medicine.

SUBSTANCE: invention relates to a device for vacuum-therapy of wounds, which contains a covering material (2) for airproof closing of a wound and the wound surrounding area (1); a means (7), suitable for the creation of vacuum in the wound zone, in particular to functional connection of the wound zone with the placed outside covering material vacuum source, to make it possible to create vacuum in the zone of the wound and suck out liquid from the wound zone; and an overlay onto the wound (3), and the overlay onto wound contains a foam-material with open pores based on cross-linked polyorganosiloxane, where the foam-material (c) can be obtained by reaction of the hardened mixture, which contains components: (i) polyorganosiloxane, which contains one or several groups with C2-C6-alkenyl group, preferably containing one or several vinyl groups, (ii) polyorganosiloxane, which contains one or several Si-H groups, (iii) pore-former, which contains one or several OH-groups and (iv) metalorganic catalyst. The invention also relates to the use of the foam-material with the open pores based on cross-linked polyorganosiloxane for the application in vacuum-therapy of wounds, in particular, in patients with the body mass index lower than 18.

EFFECT: device contributes to effective and sparing wound treatment.

14 cl, 3 dwg

Wound shield // 2554805

FIELD: medicine.

SUBSTANCE: invention refers to medicine, more specifically to a wound shield for wound healing in a humid or humid-moist medium containing a suction and washing body made of a fibre nonwoven fabric, wherein a superabsorbent material is distributed; during the process, the suction and washing body is impregnated with a saline solution, particularly Ringer's solution, preferentially until saturated, and a coating forming outer visible sides of the wound shield; a film layer can be applied from the side of the suction and washing body. The wound shield comprises a cationic substance of microbial action, which is attracted by negative groups of the anionic superabsorbent material, and thereby has antimicrobial action inside the suction and washing body; from the side facing the wound, the coating is provided with an outer partial structured non-traumatic coating (16) having the coverage of no more than 70%.

EFFECT: wound shield prolongs the replacement-free period.

14 cl, 3 dwg

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