Treatment of ingrown nail

 

(57) Abstract:

The invention relates to medicine, physical therapy, and can be used for the treatment of ingrown nail. Remove the inflamed tissue of the nail fold and ingrown edge of the nail plate longitudinal evaporation focused laser beam. Excised nail bed under the nail plate by focused laser beam. Excised bed matrix and the matrix of the focused laser beam, which is parallel to the nail phalanx. Affect the periosteum defocused laser light. Put perforating holes in the nail plate by a laser beam. In the preoperative and postoperative periods spend 2-5 sessions, magnetic pulse therapy, including the use of antiseptic wipes from dialdehydes with immobilized trypsin containing Mexidol or Mexidol and copper, moistened with saline. Cloth put on the area of the ingrown nail and the influence of pulsed magnetic field induction 0.5 to 1.0 Tesla. The method allows to increase the effectiveness of treatment of ingrown nail.

The invention relates to medicine, specifically to surgery, namely the way radical surgery ingrown nail.

rhodoline dissection ingrown nail, retreating to 2-3 mm from the ingrown edge. Isecheno plate nail twisting, the incision is deepened through the nail bed to the periosteum. The second arcuate slit through the side cushion to the periosteum, connecting the top and bottom longitudinal cut, excised semilunar flap. The wound edges pull together a bandage or stitches passing through the edge of the nail (the Great medical encyclopedia): Mr. And "Soviet encyclopedia", 1961, T. 21, S. 62).

The disadvantage of this method is the frequent splitting of the nail platinum after surgery, and infectious complications, which increase the healing of wounds.

Known for radical treatment of ingrown nail with preservation of the nail plate, including the removal of the inflamed tissues of the nail fold and the effect on the nail plate, excision of nail bed under the nail plate, the subsequent impact on the periosteum, causing the perforating holes in the nail plate, the imposition on the wound sutures with the leading edge of the soft tissue under the nail plate and the imposition of antiseptic dressings (E. A. Gorokhov and other "Surgical treatment of ingrown nail. Plastic surgery in traumatology and orthopedics". St. Petersburg, 1995, pp. 93-94).

N. the surgical needle and postoperative complications.

Known is the closest to the claimed method of radical treatment of ingrown nail, including the removal of the inflamed tissues of the nail fold, the effect on the nail plate, excision of nail bed under the nail plate, the subsequent impact on the periosteum, causing the perforating holes in the nail plate, the imposition on the wound sutures with the leading edge of the soft tissue under the nail plate and the imposition of antiseptic dressings, according to which the inflamed tissue of the nail fold and ingrown edge of the nail plate remove longitudinal evaporation focused laser beam, excision of nail bed under the nail plate conduct a focused laser beam, the bed of the matrix and the matrix is evaporated focused laser beam, running parallel to the nail phalanx, the impact on the periosteum spend defocused laser light, perforated holes in the nail plate is applied with a laser beam, and as an antiseptic dressings used napkins from dialdehydes containing copper and antioxidant of plant origin "Tykveol" (EN 2155013 C1, 27.08.2000).

The disadvantages of the method include pain treatment in the preoperative and posleoperazionny pain syndrome, edema reduction and reduction of exudation from the nail bed.

The problem is solved due to the fact that in the treatment of ingrown nail, including the removal of the inflamed tissues of the nail fold and ingrown edge of the nail plate longitudinal evaporation focused laser beam, excision of nail bed under the nail plate by focused laser beam, evaporation of the bed matrix and matrix focused laser beam, which is parallel to the nail phalanx, the impact on the periosteum defocused laser light, causing the perforating holes in the nail plate by a laser beam with the subsequent imposition of antiseptic dressings, as antiseptic dressings used napkins from dialdehydes with immobilized trypsin containing Mexidol or Mexidol and copper, and in the preoperative and postoperative periods spend 2-5 sessions, magnetic pulse therapy, including the imposition of antiseptic dressings moistened with saline solution, the area of the ingrown nail and the influence of pulsed magnetic field induction of 0.5-1.0 T.

Getting napkins with immobilized trypsin containing Mexidol, hold the patent of the Russian Federation 2149648, MCI And, washed with distilled water and treated with 0.4 to 0.6% aqueous solution of Mexidol to the content of Mexidol 1.8 to 2.2 mg on 1 cm2material.

Napkins from dialdehydes with immobilized trypsin containing Mexidol and copper, receive treatment wipes with immobilized trypsin containing Mexidol, 2% aqueous solution of the complex of copper (II) with trioxymethylene, when the mass ratio of the carrier and mortar of 1: 4, for 24 hours at room temperature.

The method is as follows.

On the area of the ingrown nail impose an antiseptic wipe from dialdehydes with immobilized trypsin containing Mexidol or Mexidol and copper, pre-moistened with saline. Then on the area of the ingrown nail effect of pulsed magnetic field within 5 minutes using the apparatus "Set-1 by the induction of a magnetic field of 0.5-1.0 Tesla. Depending on the condition of the patient in the preoperative period spend 2-3 session magnetic pulse therapy.

The operation was performed under local anesthesia (4-6 ml of 2% solution of novocaine by A. I. Lukashevich). The laser beam longitudinally evaporated ingrown KRA is size. The nail bed ingrown edge of the nail bed matrix and the matrix is evaporated beam, which is parallel to the nail phalanx, with the direction of the beam under the rear cushion nail preserving the past. A narrow strip of vapor soft tissue, involved in the inflammatory process, subject to the periosteum, without damage at this point of the matrix. The periosteum in the field of continuing the nail plate and the side of the growing process defocused laser light. Put 2-3 perforating holes by a laser beam in the nail plate at a distance of 2-3 mm from the resection margin, sutured the wound with silk on the atraumatic needle from the side of the nail plate with the creation of the soft tissue under the nail plate. Finish the operation by imposing on postoperative wound wipes from dialdehydes with immobilized trypsin containing Mexidol or Mexidol and copper.

In the postoperative period, depending on the condition of the patient spend 3-5 sessions of pulsed magnetic therapy as described above. Healing by primary intention. Sutures are removed in 5 to 7 days.

The invention is illustrated by examples.

Example 1.

Patient S., 19 years old, was admitted to the surgical Department of ice right foot swelling, purulent discharge from under the nail plate.

When viewed on organs and systems of pathological changes it is not revealed, locally-cushion nail of the first finger of the right foot swollen, hyperemia, painful on palpation, there is ingrowth of the nail plate from the inner side, a slight serous-purulent discharge from under it.

Diagnosis: ingrown nail of the first finger of the right foot

In the preoperative period patient initiated physiotherapy sessions using napkins from dialdehydes with immobilized trypsin containing Mexidol and copper, and apparatus "Set-1".

On the area of the ingrown nail impose a napkin from dialdehydes with immobilized trypsin containing Mexidol, moistened with saline. Then conduct the impact on the area of the ingrown nail pulsed magnetic field with use of "Set-1". The inductors are placed from the medial and lateral sides of the nail phalanx contact, exposure parameters:

the repetition rate of the series of impulses per minute - 45,

- the interval between pulses in the series is 10 msec,

- magnetic field induction "INT" - 0.5 T the first two procedures, 1,0 T is ecene is 3. After the 2nd session pain disappeared after the 3rd - edema slept, serous-purulent discharge no.

The operation was performed under local anesthesia (5 ml of 2% solution of novocaine by A. I. Lukashevich). The laser beam longitudinally evaporated ingrown edge of the nail plate, as well as hypergranulation lateral nail fold to restore it to its original size. The nail bed ingrown edge of the nail bed matrix and the matrix is evaporated beam, which is parallel to the nail phalanx, with the direction of the beam under the rear cushion nail preserving the past. A narrow strip of vapor soft tissue, involved in the inflammatory process, subject to the periosteum, without damage at this point of the matrix. The periosteum in the field of continuing the nail plate and the side of the growing process defocused laser light. Put 2 perforating holes by a laser beam in the nail plate at a distance of 2 mm from the resection margin, sutured the wound with silk on the atraumatic needle from the side of the nail plate with the creation of the soft tissue under the nail plate. Finish the operation by imposing on postoperative wound wipes from dialdehydes with immobilized trypsin, maderaspatana napkins from dialdehydes with immobilized trypsin, containing Mexidol. The parameters of the first two sessions similar to those described above, with the third, fourth and fifth sessions of the induction magnetic field of 1 Tesla. The postoperative period was uneventful, healing by primary intention. Postoperative complications were observed. Sutures were removed after 5 days.

Example 2.

Sick W, age 22 years, was admitted to the surgical Department with the diagnosis: ingrown nail of the first finger of the right foot.

Complaints when it arrives at the pain in the first finger of the right foot swelling.

When viewed on organs and systems of pathological changes it is not revealed, locally-cushion nail of the first finger of the right leg swollen, hyperemia, tenderness to palpation, there is ingrowth of the nail plate from the outside.

Initiated physiotherapy sessions using napkins from dialdehydes with immobilized trypsin containing Mexidol and apparatus "Set-1".

On the area of the ingrown nail impose a napkin from dialdehydes with immobilized trypsin containing Mexidol, moistened with saline. Then spend impact on the ingrown nail pulsed magnetic field used is, the exposure parameters:

the repetition rate of the series of impulses per minute - 45,

- the interval between pulses in the series is 10 msec,

the induction of a magnetic field of 0.5 T, the first two procedures,

- duration of exposure - 5 minutes. The total number of procedures in the course of treatment is 2.

After the second session disappeared pain, swelling slept, detachable none

The operation of example 1.

In the postoperative period spend 3 sessions of pulsed induction therapy using napkins from dialdehydes with immobilized trypsin containing Mexidol. The parameters of the first two sessions similar to those described above, 3rd session carried out with the intensity of the magnetic field "INT" to 1.0 Tesla. Preoperative and postoperative period pass painlessly, the sutures were removed on the 5th day.

Method of radical treatment of ingrown nail, including the removal of the inflamed tissues of the nail fold and ingrown edge of the nail plate longitudinal evaporation focused laser beam, excision of nail bed under the nail plate by focused laser beam, the excision bed matrix and the matrix of the focused laser beam, which is parallel to the nail file is the first plate by a laser beam with the subsequent imposition of antiseptic dressings, characterized in that as an antiseptic dressings used napkins from dialdehydes with immobilized trypsin containing Mexidol or Mexidol and copper, and in the preoperative and postoperative periods spend 2-5 sessions, magnetic pulse therapy, including the imposition of antiseptic dressings. moistened with saline, on the area of the ingrown nail and the influence of pulsed magnetic field with an intensity of 0.5 to 1.0 Tesla.

 

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