The way dermatosurgical treatment gipotermiceski scars

 

(57) Abstract:

The invention relates to medicine, namely to surgery, and may be applicable for dermatosurgical treatment gipotermiceski scars from surgical and/or therapeutic resurfacing. Previously the patient take a biopsy - a piece of the healthy section of the epidermis separated from his culture of living keratinocytes. Then perform surgery grinding gipoteticheskogo scar to the basal layer of the epidermis, and then on the polished surface gipoteticheskogo scar put the pre-prepared chilled dermal equivalent, made in the form of a mixture of fibroblasts with collagen growth and the environment, in repolimerizovanny form to fill micro-polished surface gipoteticheskogo scar. Then after polymerization of the dermal equivalent to the cured surface of the dermal equivalent impose the culture of keratinocytes. In the particular case, the culture of keratinocytes impose a suspension. In the particular case, the culture of keratinocytes impose in the form of a multilayer flat seams without substrate. In the particular case, the culture of keratinocytes put in wideface. 3 C.p. f-crystals.

The invention relates to the field of dermatosurgical cosmetology and can be used in the treatment of complicated skin pathologies associated with the presence of gipotermiceski scars.

The treatment of such skin defects is a complex issue, not with still satisfactory resolution. Gipoteticheskie scars - these scars are located below the skin, creating a certain decrease in skin texture. They can be formed after the destructive inflammation that destroys the deeper layers of the skin, such as, for example, in severe forms of acne or as a result of any injury, leading to the destruction of the mesoderm and hypodermis (middle and deep layers of the skin). Correction of such scars by achieving a good cosmetic effect is a difficult task for dermatophilus.

For the assessment of novelty and inventive step of the claimed solution consider a number of known technical devices of similar purpose.

Known mechanical methods aligning of relief and eliminate the skin problems that involve the use of a rotary grinding disk to smooth out problem areas on the skin, 8, 241-245. This skin resurfacing refers to mechanical surgical dermabrasion performed in the operating conditions, and is characterized by a superficial level, removing the skin.

In dermato-surgical practice gipoteticheskie scars treated with various methods of dermabrasion, i.e., different treatment of the skin: sandblasting, milling Schumann, using cautery, electrocoagulator or different types of laser, see E. Laputin "current understanding of dermabrasion" J. nouvel Les Esthetigues 1, 1999

By the greatest number of similar features and achieved when using the result of this technical solution is chosen as the prototype of the claimed invention.

The disadvantages of the prototype, which does not allow us to achieve our goal, is that this method is ineffective in the treatment of gipotermiceski scars, i.e., scarring, which is located below the level of the skin, make the skin relief deepening the depression or "minus-fabric". Such scars can be formed after the destructive inflammation that destroys the deeper layers of the skin, for example in severe forms of skin diseases (acne) or as a result of any injury, leading to the destruction of the mesoderm and the ISU is over with the surrounding skin, but to even out your skin with a good cosmetic effect with deep defects is not possible.

The claimed invention solves the difficult problem gipotermiceski scars with good cosmetic effect. The need for this type of dermatosurgical treatment is quite high.

The essence of the invention is expressed in the following essential features sufficient to achieve the above technical result.

According to the invention the method dermatosurgical treatment gipotermiceski scars, including surgical and/or therapeutic resurfacing of scars, characterized by the fact that the pre for a few days before surgery the patient take a biopsy - a piece of the healthy section of the epidermis separated from his culture of living keratinocytes, and then produce the grinding operation scar under local or General anesthesia to the basal layer of the epidermis, and then on the polished surface of the scar is applied pre-prepared chilled dermal equivalent, made in the form of a mixture of fibroblasts with an albuminous substance, such as collagen, growth and the environment, in repolimerizovanny form on the of ivalent under the influence of temperature for some time on the cured surface of the dermal equivalent impose any floor with its culture of keratinocytes.

This is a set of essential features that provide technical result in all cases to which the requested amount of legal protection.

In addition, the claimed solution has optional features that characterize its special cases, the specific form of its material embodiment or special conditions of its use, namely:

- culture of keratinocytes impose on the cured surface of the dermal equivalent in the form of a suspension,

- culture of keratinocytes impose on the cured surface of the dermal equivalent in the form of a multilayer flat seams without backing,

- culture of keratinocytes impose on the cured surface of the dermal equivalent in the form of a multilayer planar layers with the substrate.

The claimed technical solution is new, as is characterized by the presence of a new set of features missing for all we know the technical objects of similar purpose.

Direct technical result that can be obtained when implementing the claimed combination of features is significantly improved by the technical solution meets the criterion of "inventive step"

The method is implemented as follows.

Patients take a biopsy - a piece of skin from the inner surface of the shoulder a few days before the operation, after which mechanically and/or enzymatically isolated from the epidermis culture of keratinocytes. After multilayered culture of keratinocytes reaches the optimum thickness, the patient is prescribed the day of surgery, when under local or General anesthesia depending on the area of the scar to perform the operation of grinding scar by any known means and methods.

Then on the polished surface of the scar is applied pre-prepared chilled dermal equivalent, made in the form of a mixture of fibroblasts with an albuminous substance, such as collagen, growth and the environment, in repolimerizovanny form to fill micro-polished surface of the scar, i.e., in a sufficiently liquid form. After polymerization of the dermal equivalent under the influence of the body temperature of the patient for some time on the cured surface of the dermal equivalent impose any floor with its culture of keratinocytes.

Further management treated in this alberino relation to the transplanted cells.

After 7-12 days coverage with the culture of keratinocytes removed independently of any effort of the doctor. After removing the cover in place venutolo scar visible smoothed with the surrounding skin surface in the form of adequate skin surface. Within 2-6 months, the skin pales. The scar surface is nearly flush with the surrounding skin.

This is because the implanted on the outer surface of the dermal equivalent keratinocytes secrete biologically active molecules - cytokines that promote optimal recovery and the creation of a new layer of skin that practically allows you to save people from disfiguring their scars-presses. In turn, the fibroblasts of the dermal equivalent of creating a new connective tissue middle layer of the dermis, which after resorption of protein substance (collagen) dermal equivalent fills "minus-fabric". The result of this treatment differs from the treatment using traditional means (dermabrasion, gel and ointment formulations, collagen and other films).

The industrial applicability of the claimed technical solution is confirmed by the successful results of its experimental use in p is on the way.

1. Olga M, 20 years. Inverted gipotermiceski scar in the lower third of the forearm length of 4 cm and a width of 2.5 cm, formed after a cut glass three years ago. The wound was not sewn after injury.

Had surgery dermabrasion metal cutter under local anesthesia with 2% lidocaine. Wound treatment with natural solution tripe was filled with liquid cooled dermal equivalent (fibroblasts with collagen). After 10 minutes occurred polymerization of the dermal equivalent and on its surface was superimposed film with keratinocytes.

After 10 days the film independently moved. On the site of the former venutolo scar formed smoothed surface pink.

After 3 months, the color changed to normal. The former site of the scar looks aligned, the patient is satisfied with the treatment outcome.

2. Oksana T, 24 years. Oval inverted scar on his left cheek the size of 23 cm, formed after the treatment of inflammatory infiltrate cryosurgery.

The scar surface was polished. Then after processing the sanded surfaces with natural solution to put it chilled liquid dermal equivalent (fibroblasts with collagen). After the polymerase is it the film was self-deleted by patient. On the site of the former venutolo scar has formed a smooth surface with a bright pink color.

After 3 months skin color has changed to normal, the scar is almost gone. The result of the operation is evaluated by the patient as very good.

Using the stated solution compared with all known means of similar purpose provides the following benefits:

- the ability to treat a variety of complex and deep cutaneous pathology (all types gipotermiceski scars, characterized by the deepening of the skin and the appearance of "negative tissue").

- improving the quality of the skin, the optimal elimination and healing of deep skin defects.

1. The way dermatosurgical treatment gipotermiceski scars, including operative and/or therapeutic resurfacing of scars, characterized in that before the operation the patient take a biopsy - a piece of the healthy section of the epidermis separated from his culture of living keratinocytes, and then produce the grinding operation gipoteticheskogo scar to the basal layer of the epidermis, and then on the polished surface gipoteticheskogo scar put the pre-prepared chilled dermal equivalent, is made in it to fill the micro-polished surface gipoteticheskogo scar, then after polymerization of the dermal equivalent to the cured surface of the dermal equivalent impose the culture of keratinocytes.

2. The method according to p. 1, characterized in that the culture of keratinocytes impose a suspension.

3. The method according to p. 1, characterized in that the culture of keratinocytes impose in the form of a multilayer flat seams without substrate.

4. The method according to p. 1, characterized in that the culture of keratinocytes impose in the form of a multilayer planar layers with the substrate.

 

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