Treatment standard atrophic scars mechanical dermabrasion combined with collagen coating with antimicrobial agent

 

(57) Abstract:

The invention relates to medicine, in particular to laboratory diagnosis. The method provides high efficiency of treatment standard atrophic scarring of the skin. Conduct complex preoperative events and dermabrasion, while an outpatient basis under sterile conditions low operating expose an area of the surgery, skin treatment twice butola to 10 ml with gauze napkins, capturing more than 2-3 cm of the operating zone, and produce anaesthesia topical lidocaine, then using a rotary apparatus produce dermabrasion and treat the skin surface, applying a gauze pad moistened with pre-butola, surgical wound is treated with butola twice 10-15 ml plastic syringe without a needle, and after 3-5 minutes after the disappearance of the patient's feelings of burning delete Corcega gauze, after dermabrasion on the operating surface impose collagen coating that exceeds the operating area of 1-2 cm, and surgical wound twice without interruption process butola 10-15 ml plastic syringe without needle and the operating surface is irradiated with infrared emission is gauze bandages by butala, until the healing of the epidermis and inadvertent removal of the scab.

The invention relates to medicine, namely to cosmetology.

Standard atrophic scars are cosmetic defects of the skin (do not violate the functions of organs and skin tissues). Scar formation is older than six months form the formed patterns, which are not subject to treatment due to poor performance. When the treatment standard atrophic scarring is considered the most effective combined surgical and therapeutic methods. Chemical peels can smooth out the upper layers of the epidermis, but do not affect scar patterns, so their use is impractical. Traditionally for the treatment of norm-atrophic scars used mechanical dermabrasion. Healing is protracted. Lack of alignment is associated with shortages in the local place of collagen. This circumstance in 47% of cases leads to the need for repeat surgery and 15% - to the subsequent conduct of dermabrasion. This has led to the rapid development of the green, accelerating the healing of extensive surfaces of the skin through the use grown in vitro keratinocytes. The pioneer method is priority help 99111224 from 24.05.1999,). This method is adopted for the prototype.

In the case of a polished surface planted culture autologous keratinocytes, pre-grown on the porous film. This culture is obtained by selection of keratinocytes using precollegiate from hydrobionts of the patient's skin. Then the culture is grown to a certain thickness of the layer of keratinocytes on film POLYPHOR in F12 medium with added 10% serum of calves by cholera toxin and isoproterenol with appropriate humidity and temperature. After alignment of the scar with the surrounding tissue and hemostasis operating surface is washed with saline and dried. The presence of positive charge on the film allows to make reliable contact operated on the skin and not to use additional clamps. Under the film begin the process of aseptic inflammation, metabolism and repair skin structures. Reparation processes and the creation of new structures in the skin occur throughout the year, which does not differ from the usual course of events when dermabrasion. After 5-12 days (individually) is spontaneous rejection of the film. Note that the porosity of the film does not prevent gas exchange. The leveling effect of microrelief of the skin the month. Erythema lasts for 3 months, and quite significantly (as with conventional dermabrasion) in the first month.

Therefore, the disadvantage of the prototype is that in this way retains a high level of risk of infectious complications in the postoperative period for a very long time. Used traditionally antiseptic (5% solution of potassium permanganate, tetracycline ointment) do not provide 100% antimicrobial protection. The next example, also adopted for the prototype, taken according to Udotova Acting, Kovalkova E. Erbium laser as a tool cosmetic surgery //Cosmetics and Medicine, 2000. No. 2. - S. 55-62. After laser dermabrasion erbium laser is applied spray “Panthenol and collagen film with metiluratsilovoy ointment or ointment containing gentamicin or erythromycin. But the next day after surgery and in the following days every day this band changed to a new, as there has been a significant lapse of lymph mixed with ichor and there is a risk of infection in the operating zone. Typically prescribe antibiotics “Macropen” inside and “Baktroban” locally. However, when such massive attacks on infection observed the formation of atrophic scars. Similar results are noted when dermabrasion wrinkles CO2laser (Eremeev, B., Kalayjian K. Lasers anti-wrinkle //Cosmetics and Medicine, 2000. No. 2. - S. 5-17). Therefore, the problem of combat wound infection continues to retain all its relevance and objectively caused by the following circumstances. On the one hand, wound infection has pronounced polymicrobial in nature, i.e. can be called many different sensitivity to chemotherapy aerobic and anaerobic bacteria. On the other hand, any chemotherapeutic agent inevitably has a relatively narrow spectrum of antimicrobial action, because in the interests of safety for somatic cells it (as antimetabolite) focused on selective interaction mainly with only some of the biochemical structures of the germ. In such a situation the high efficacy of chemoprophylaxis and chemotherapy of wound infection can be ensured only if truly etiotropic treatment. In other words, chemoprophylaxis is effective if used antimicrobial drugs will be made taking into account the preliminary microbiological rasshifrovyvalas to the hair. But full microbiological analysis of this kind very long time, and the effectiveness of suppression of wound infection depends on the date of application of antimicrobial agents. In such a situation to improve the efficiency and effectiveness of chemoprophylaxis and chemotherapy polymicrobial wound infection after surgery, dermabrasion can be achieved by combined application of antimicrobial agents with a broad spectrum of activity and contains several chemically and physically compatible antiseptics that can, in combination enhance the activity and to broaden the spectrum of antimicrobial action. This product is obtained Tolstov A. C. (patent RF №2115418 from 23.01.98, "Combined chemotherapeutic agent BUTAL for local treatment of wound infections and inflammatory diseases"). Given its high antibacterial activity, invented “a Method for the prevention and treatment of infectious complications during the operation of dermabrasion using antiseptic” (Glubokov I. B., Tolstov A. C., Faizullin N. And. The application for the invention of the Russian Federation. The priority number reference number 2001114571/14(015296) 18.06.2001 year). This method is also adopted for the prototype. However, in this prototype otsutstvie the proposed method is that used in mechanical dermabrasion by a particular method combined collagen coating with antimicrobial agent BUCAL. The coating used on polietilenoksidnoy basis. As antiseptic drug use BUCAL. After applying collagen covering the patient several times a day irrigates 10-15 ml solution Butola area of operation for the extension of antimicrobial action during the first 10-15 days, until the spontaneous healing of the epidermis. To improve the efficiency of Butola operating surface is irradiated with infrared radiation of low power (infrared lamp) several times a day.

The method is as follows.

Conduct complex preoperative measures, including psychological preparation and traditional cosmetic preparation of the skin of the patient. The operation is carried out by the doctor-cosmetician on an outpatient basis, under sterile conditions, a small operating room. Reveal zone operations. Skin treatment twice Butola (10 ml) using gauze napkins, capturing more than 2-3 cm of the operating zone. Anesthesia produced locally with lidocaine. Using rotec is highlighted by Butala. Alcohol and metal-containing drugs are not used. Put a gauze pad moistened with pre-Butola. Surgical wound treatment twice Butola (10-15 ml) from a plastic syringe without a needle. After 3-5 minutes after the disappearance of the patient's feelings of burning delete Corcega gauze. After dermabrasion on the operating surface impose collagen coating. Additional fixing this coating is not required. The size of the collagen coating to exceed the operating area by 1-2 cm surgical wound twice without interruption process Butola (10-15 ml) from a plastic syringe without a needle. Patient provide Butola in the amount of not less than 200 ml and instructions on its use. In the postoperative period within 7-10 days the patient at home sprintout several times a day, gauze bandages, until healing of the epidermis - the spontaneous removal of the scab. To improve the efficiency of Butola operating surface is irradiated with infrared radiation low power is 5-8 times a day. Next, perform a traditional skin care.

Effective therapeutic action is shown in the following example.

Patient A., W.R., 36 Le is plagued preparation of the skin treatment of acne and the appropriate psychological preparation for surgery. Dermabrasion is conducted as described above 31.01.2002, Further treatment included two daily douching imposed collagen coating Butola and application of the infrared emitter. On the 8th day - the complete rejection of the scab. Erythema was observed within 1 month. In the future - without complications and traditional management of the care of the skin of the patient.

The above example allows you to clearly see the approver fact the advantages of using collagen coating Butola. In any case, not been a recurrence of abscess of skin in the postoperative period. Observation 27 patients revealed the following regularities. The reaction temperature did not exceed subfebrile figures. Swelling in the area of operations was small (no more than 1 point), which is less than 3-4 times in comparison with traditional dermabrasion. Erythema determined by the method of " C. R. (FCFS S. R. New optical methods of diagnostics and therapy in dermatology //abstract of Diss. D. M. N., M., 1998. - 36 S.), intensity and duration was less than 2.4 and 3.1 times, respectively. Smoothing of the microrelief of the skin occurred 2-3 weeks after surgery. Integral indicators body the traditional dermabrasion, and the risk of infectious complications is reduced by 2.3 times.

Thus, the clinical observations confirm the high effectiveness of the proposed method. Developed by the authors of the method, as claimed in the invention may be recommended for implementation in modern cosmetology.

Treatment standard atrophic scarring of the skin through a set of preoperative events and dermabrasion, characterized in that an outpatient basis under sterile conditions low operating expose an area of the surgery, skin treatment twice butola to 10 ml with gauze napkins, capturing more than 2-3 cm of the operating zone, and produce anaesthesia topical lidocaine, then using a rotary apparatus produce dermabrasion and treat the skin surface, applying a gauze pad moistened with pre-butola, surgical wound is treated with butola twice 10-15 ml plastic syringe without needle, and after 3-5 min after the disappearance of the patient's feelings of burning delete Corcega gauze, after dermabrasion on the operating surface impose collagen coating that exceeds the operating area is s and the operating surface is irradiated with infrared radiation low power is 5-8 times a day, and in the postoperative period within 7-10 days sprintout several times a day, gauze bandages by butala until healing of the epidermis and inadvertent removal of the scab.

 

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