Treatment of trophic ulcers and nonhealing wounds

 

(57) Abstract:

The invention relates to medicine, magnitolazeroterapii. Carry out reorganization of the ulcer or wound with chlorhexidine. On the surface of the defect impose a sterile gauze pad, place two emitters with magnetic nozzles. Carry out the irradiation of the infrared pulse laser radiation of a wavelength of 0.89 μm, a frequency of 2 Hz to 12 kHz for 5 minutes Then from a distance of not more than 5 mm perform remote irradiated simultaneously by laser radiation in the visible range of the spectrum and infrared pulsed radiation in the frequency range from 18 to 30 kHz. The wavelength of the used laser radiation of the visible range of the chosen phase of the process. After exposure to the ulcer or wound surface cause a wound covering. During this phase of necrosis and inflammation cause “liposorb” or “eleven”, in the phase of purification and regeneration cause “digimon”, and in phase epithelialization and scar - “gerison”. Treatment of patients with venous ulcers spend on a background of reception of Detralex. In patients with nonhealing wounds concurrently use “NEOT NA”. The method reduces the time of treatment. 3 C. p. F.-ly.

The invention otnes and medicines.

The results of the treatment of trophic ulcers and nonhealing wounds of the lower extremities using known methods to date has not been satisfactory. This is associated with delayed repair of damaged tissues, duration and wave-like course of the ulcer or wound healing, as well as frequent recurrence of venous ulcers of different etiology and nonhealing wounds.

The prototype of the method of treatment of trophic ulcers and nonhealing wounds is exposure to low-intensity infrared laser radiation remotely or contact through sterile dressings in combination with the static magnetic field using a laser therapeutic apparatus (Sergeev, N. A. The effectiveness of laser device “Scalar-1/40” in the treatment of trophic ulcers of the lower extremities. In the book: Actual problems of experimental and clinical medicine. - Tver. - 2001. - S. 99-101).

When remote irradiation of objects infrared laser emitter is placed perpendicular to the treated surface at a certain distance from the latter. At the contact method the emitter fixed to it a magnetic on the full or wound surface. Laser irradiation (wavelength 0,81-0.89 microns) modified tissue is carried out in continuous or pulse modes (in the frequency range from 0.4 to 40 kHz).

The known method has a number of disadvantages. Laser or laser therapy of trophic ulcers and nonhealing wounds is carried out without taking into account the phases of the ulcer or wound healing process, and this method of treatment using infrared laser radiation does not provide for concurrent use of low-intensity laser radiation in the visible range of the spectrum and medication, used primarily depending on the phases of the ulcer or wound healing.

The objective of the invention is to increase the effectiveness of conservative treatment of trophic ulcers and nonhealing wounds of the lower extremities by taking into account the phases of the ulcer or wound healing, changes the frequency range of infrared laser radiation (from 2 Hz to 30 kHz); the simultaneous application of a constant magnetic field, infrared pulse (wavelength of 0.89 μm) and continuous laser radiation in the visible range of the spectrum (wavelength 0,44-0,64 μm), and concurrent use of General and local medicalfield non-healing wounds, including the effects of low-intensity laser radiation in combination with a constant magnetic field and held during 12-15 sessions, according to the invention the treatment is divided into 3 periods, depending on the phases of peptic ulcer or wound healing process, and during each period of treatment the ulcer or wound initially affected simultaneously by infrared laser radiation and a constant magnetic field, and then hold the remote laser irradiation simultaneously in the visible (continuous radiation) and infrared ranges of the spectrum with the use of ultrasonic frequencies, in the first period of treatment after exposure to ulcer or wound surface applied draining the sorbent liposorb” or “eleven”, in the second period - impose wound covering “digimon”, the third “gerison”. Treatment periods correspond to the phases of peptic ulcer or wound process, where the first phase is necrosis and inflammation”, the second phase is the purification and regeneration”, the third - epithelialization and scar”. The laser radiation of the visible spectrum (wavelength 0,44 - 0,64 microns) should be applied in a differentiated way: in the first period of treatment to affect the ulcer or wound izlucheniya trophic ulcers of appropriate conduct on the background of General medical therapy Detralex 1 tablet 2 times a day during meals, and nonhealing wounds in parallel with the local drug therapy by injection of 40 μg per one introduction recombinant drug, “NEOTOMA NA” subcutaneously in the vicinity of the defect within range of trophic disorders of soft tissues. If this course of treatment “NEOTOMA the national Assembly consists of 5-10 injections.

A distinctive feature of the proposed method of treatment of trophic ulcers and nonhealing wounds is mandatory divide treatment into three periods depending on the phases of the ulcer or wound healing process, and during each of these are affected tissue in a specific mode. High intensity treatment is achieved by simultaneous contact of the effects of low-intensity infrared laser radiation and a constant magnetic field with subsequent beam radiation modified tissue by laser radiation simultaneously in the visible and infrared ranges of the spectrum with the use of ultrasonic frequencies. The effect on the ulcer or wound defect must be performed in strict sequence.

The modes of operation of the laser apparatus, including selecting the wavelength of the laser slottabevent, phases of the process, as well as the size of trophic ulcers or nonhealing wounds and depth of tissue damage. It is known that increasing the wavelength of laser radiation is gradually reduced its sterilizing effect. Therefore, to achieve adequate exposure to laser radiation on the so-called “microbial factor in the process of natural change of the phases of the ulcer or wound healing, accompanied by a decrease microbial contamination affected tissues, it is advisable sequential irradiation of ulcers or wounds laser radiation of the visible spectrum with different wavelengths from 0.44 to 0.64 μm.

Treatment of trophic ulcers and nonhealing wounds was carried out as follows.

Originally defined the phase currents of trophic ulcers or nonhealing wounds, where the first phase is necrosis and inflammation”, the second “purification and regeneration, and the third - epithelialization and scar”. Depending on the phase conducted appropriate treatment.

During the next ligation after rehabilitation sores or long-unhealed wounds of 0.02% chlorhexidine on the surface of the defect imposed sterile UNC laser radiation (wavelength of 0.89 μm) was performed for 5 minutes in the frequency range from 2 Hz to 12 kHz. Then for 5 min was performed distance (object distance not more than 5 mm) simultaneous irradiation of the ulcer or wound surface continuous laser radiation in the visible range of the spectrum with wavelengths from 0.44 to 0.64 μm and an infrared pulsed ultrasonic radiation in the frequency range from 18 to 30 kHz.

Sessions magneto-laser therapy was performed every other day, and the number of sessions held during one course of treatment ranged from 12 to 15. At the end of the next session of laser therapy in the first phase of the ulcer or wound process on the surface of the defect caused the powder draining sorbent “eleven” or “liposorb”, in the second phase of the ulcer or wound superimposed wound covering “digimon”, in the third phase - wound coating gerison”. After applying draining sorbents or wound coverings on trophic ulcer or nonhealing wound, put a sterile gauze pad that was fixed with a bandage. The treatment of venous trophic ulcers was carried out on the background of General medical therapy Detralex (1 tablet twice a day during meals) until complete epithelialization of the defect. The lack of effect from the ongoing necrovile 1-2 days subcutaneously in the immediate vicinity of the wound within range of trophic disorders of soft tissues (40 μg per one introduction). Treatment consisted of 5-10 injections.

Examples of the method

Example 1.

Patient B., 69 years of age.

Diagnosis: Postthrombotic syndrome of the left lower limb.

Chronic venous insufficiency on the left.

Extensive trophic ulcer of the left tibia. The dermatitis.

Essential hypertension.

Chronic disorders of cerebral circulation.

Gall-stone disease.

Chronic calculous cholecystitis. Chronic pyelonephritis.

Obesity 3 degrees.

Complaints: in the presence of extensive trophic ulcer of the medial surface of the left tibia with abundant serous discharge, moist skin of the left tibia, itching.

History: Considers herself a patient in the course of 33 years. Trophic ulcer of left tibia appeared after scratches (1 month before the start of treatment), in subsequent ulcer progressed rapidly increased in size. Treatment of trophic ulcers in the conditions of policlinic gave no effect.

The patient's General condition moderate. It is noted overweight. Locally: On the medial surface of the left tibia in distal segments has a trophic ulcer size 9,54,00,3-0.4 cm (square is. The skin in the lower third of the leg inbrisbane and hyperpigmentation to a considerable extent. Along with this, a marked phenomenon weeping dermatitis medial surface of the left tibia.

Bacteriological examination of the biopsy specimen taken from the bottom of the defect prior to the treatment allocated Staphylococcus aureus, and 1 g of biopsy material contained 5,3107microbial phone

Out-patient course of laser therapy, consisting of 15 sessions running through the day.

In the first phase of ulceration laser therapy was performed according to the following procedure. After rehabilitation ulcer surface was initially conducted radiation ulcers contact through a dry sterile cloth two infrared pulsed laser emitters (wavelength of 0.89 μm, a frequency of 1500 Hz) magnetic nozzles for 5 min, then ulcer remotely (distance 5 mm) was irradiated simultaneously continuous laser radiation in the visible blue range of the spectrum (wavelength of 0.44 µm) and infrared (wavelength of 0.89 μm) pulsed radiation (frequency of 18 kHz) for 5 minutes using this technique conducted 3 sessions. Similarly performed 2 sessions of laser therapy, during which ispoljzovalosj laser dressings on necrotic tissue ulcers caused liposorb, the remaining sections of the bottom of the defect “powder” elevina.

In the second phase of ulcerative process applied 3 sessions of laser therapy, as in the first phase, but with the wave length of the visible part of the spectrum of 0.57 μm (yellow light). Along with this made 2 similar treatment using red light (wavelength of 0.63 µm). At the end of the sessions on the wound superimposed plates digipan.

In the third phase applied 1 session of laser therapy by analogy with the previous two (the wavelength of red light 0.63 µm) and 4 sessions, during which used continuous laser radiation in the visible red spectral range (wavelength of 0.64 μm). Laser ligation ended with the imposition gerison on the wound surface.

It is noteworthy that 2 weeks after start of treatment in 1 g of the biopsy specimen taken from the bottom of the healing trophic ulcers, contained 3,7103germs (Staphylococcus aureus), which is significantly less than the so-called “critical level” (1,0105microbial bodies).

A course of laser therapy extensive trophic ulcers was conducted on the background of treatment Detralex (1 tablet 2 times a day during meals). 1 month after the start of the conservative Leche is Ana.

Example 2.

Patient T., 72 years of age.

Diagnosis: diabetes mellitus type 2, moderate.

Diabetic neuropathy, microangiopathy of the lower extremities.

Nonhealing wound 1 finger of his left foot.

Atherosclerosis of cerebral vessels.

Symptomatic hypertension. Ischemic heart disease.

Paroxysmal form of atrial fibrillation.

Complaints: pain in region 1 toe of the left foot, the presence of wounds on the plantar surface of the finger with purulent discharge, swelling 1 finger of his left foot.

History: nonhealing wound there for 6 months, came after wear. Treatment in a doctor's surgery clinic was ineffective.

The General condition at the beginning of treatment moderate, then satisfactory.

Locally: on the plantar surface of the nail phalanx 1 toe of the left foot has a nonhealing wound size 0,50,50,3 cm with scanty purulent hemorrhagic discharge (defect area of 0.2 cm2). Finger swollen, the skin of his cyanation. On the radiograph of the left foot of the signs of destruction of the phalanges 1 finger no.

Applied following treatment, consisting of 15 sessions mammals was conducted by irradiation of the finger projection wound contact through a dry sterile cloth two infrared pulsed laser emitters (wavelength of 0.89 μm, frequency 600 Hz) with magnetic nozzles for 5 min, then wound remotely (distance to the object 3 mm) was irradiated simultaneously continuous laser radiation in the visible blue range of the spectrum (wavelength of 0.44 µm) and infrared (wavelength of 0.89 μm) pulsed radiation (frequency 24 kHz) for 5 minutes using this technique conducted 3 sessions. Similarly performed 2 sessions of laser therapy, during which the used laser radiation in the green region of the spectrum (wavelength of 0.52 μm) with all equal other conditions. During laser bandaging the wound was pripudrival” elevina.

The second phase of wound process applied 3 sessions of laser therapy, as in the first phase, but with the wave length of the visible part of the spectrum of 0.57 μm (yellow light). Along with this made 2 similar treatment using red light (wavelength of 0.63 µm). At the end of the sessions on the wound superimposed plates digipan.

In the third phase applied 1 session of laser therapy by analogy with the previous two (the wavelength of red light 0.63 µm) and 4 sessions, during which used continuous laser radiation in the visible red spectral range (length vo month from the beginning of the treatment of nonhealing wound 1 finger of his left foot significantly decreased in size, it was superficial, completely stopped discharge from the wound, after the first sessions, the swelling of the finger, and pain. For complete epithelialization of the wound defect is additionally applied topical treatment “NEOTOMA NA”. Made 10 injections of the drug every other day for 40 mcg on one introduction to soft tissue anterior of the left foot. As a result of this 50 days from the beginning of the treatment of nonhealing wound plantar surface of the nail phalanx 1 toe in elderly patients with insulin-dependent diabetes mellitus in the stage of decompensation and other concomitant diseases completely and permanently healed.

The invention differs from previously known methods of treatment of trophic ulcers and nonhealing wounds of the fact that it involves the simultaneous action on the affected tissue three physiotherapeutic factors (low-intensity laser radiation, ultrasonic vibrations and a constant magnetic field) with regard to the phases of the ulcer or wound healing process and in combination with drug treatment. Thanks to specially selected modes greatly increases bioeffectives laser stimulation. In particular, this leads to BYU whom the disease is accompanied by severe pain. The application of this complex of physical factors in the affected tissue, carried out against the background of treatment with Detralex (in patients with venous trophic ulcers) and in combination with topically applied draining sorbents (elevina and liposorber) and wound coverings (digipanel and getspnam), and in some cases (patients with nonhealing wounds) “NEOTOMA NA”, accompanied by a significant reduction in the time required to achieve complete epithelialization of trophic ulcers and nonhealing wounds. In other words, this unique feature of the proposed method, which is implemented taking into account the phases of the ulcer or wound healing, contributes to a significant increase in the rate of healing of trophic ulcers of different etiology and nonhealing wounds. This effect cannot be achieved when using each of these methods separately in the treatment of low current processes with delayed repair of damaged tissues.

This method of treatment can be applied in any clinic with appropriate laser equipment.

1. Treatment of trophic ulcers and nonhealing wounds, including the effects of low-intensity therapy after recovery ulcers or wounds of 0.02% chlorhexidine solution on the surface of the defect impose a sterile gauze pad, on which are placed two emitters with magnetic nozzles, and spend irradiation for 5 min infrared pulsed laser radiation in the frequency range from 2 Hz to 12 kHz with a wavelength of 0.89 microns, then within 5 min from a distance of not more than 5 mm at the same time perform remote continuous irradiation of the laser radiation in the visible range of the spectrum and infrared pulsed radiation in the frequency range from 18 to 30 kHz, moreover, in the phase of necrosis and inflammation on the ulcer or wound surface exposed to laser radiation in the visible range of the spectrum with a wavelength of from 0.44 to 0.52 μm and then applied draining the sorbent liposorb” or “eleven”, in the phase of purification and regeneration effect of laser radiation in the visible range of the spectrum with a wavelength of from 0.57 to 0.63, then impose wound covering “digipan” phase epithelization and scarring effect of laser radiation in the visible range of the spectrum with a wavelength of 0.63 to 0.64 μm, then impose wound covering “gerison”, after you close the defect sterile gauze cloth.

2. The method according to p. 1, characterized in that the treatment of patients with venous ulcers conducted against the backdrop of the total medicamentonline nonhealing wounds are conducted in parallel with drug therapy by 5-10 injection 40 MGK on one drug “NEOT NA” subcutaneously in the immediate vicinity of the wound within range of trophic disorders of soft tissues.

4. The method according to p. 1, characterized in that the treatment is carried out every other day for 12-15 sessions.

 

Same patents:
The invention relates to medicine, namely to physical therapy and urology
The invention relates to medicine, namely to methods for treating optical radiation

The invention relates to medicine, namely to pulmonology, otolaryngology, and can be used for the treatment of polypous rhinosinusitis in patients with bronchial asthma

The invention relates to medicine, namely to Phthisiology

The invention relates to medicine, and is intended for the treatment of acute and chronic sinusitis

The invention relates to medical equipment, namely to methods of control physiotherapeutic effects of infrared laser pulse incident on an internal tissue of a biological object
The invention relates to ophthalmology and is designed for the differential diagnosis of blepharoptosis and selection of surgical treatment method
The invention relates to medicine, and is intended for the treatment of peritonitis

The invention relates to medicine, and is intended for the treatment of acute laryngeal stenosis in children

The invention relates to medicine, and is intended for direct endolymphatic laser therapy on Shulyak-Shuliak
The invention relates to medicine, namely to physical therapy and urology

The invention relates to medicine, and is intended for direct endolymphatic laser therapy on Shulyak-Shuliak
The invention relates to medicine and can be used to treat long-term unhealed erosion and ulceration of the cornea

The invention relates to medicine, and is intended for the treatment of purulent wounds in the experiment
The invention relates to medicine, gastroenterology, Oncology
The invention relates to medicine and can be used to treat endourethral warts, localized in the posterior third of the hanging part of the urethra

The invention relates to medicine

The invention relates to the field of health and can be used for non-contact massage body tissues, prevention and treatment of diseases of the joints, skeletal system, muscles, blood vessels, etc
The invention relates to medicine, and is intended for the treatment of psoriatic arthritis

The invention relates to medicine, and is intended for the treatment of chronic adnexitis

The invention relates to medicine and veterinary medicine and is aimed at expanding Arsenal of wound healing materials
Up!