Method for treating finger's purulent disease

FIELD: medicine.

SUBSTANCE: the innovation includes lancing purulent focus, sanitation, draining and antibioticotherapy. Before operative interference and in the course of therapy it is necessary to carry out the seances of acupuncture reflexotherapy per 20-25 min, about 4-5 seances, totally. In case of thumb's purulent disease one should apply points P-7 GI-4, forefinger's purulent disease - GI-6 P9, 3d finger's - MC-6 TR-4, 4th finger's - TR-5, MC-7, and little finger's purulent disease - C-5 and IG-4, IG-7 and C-7.

EFFECT: shortened terms of therapy.

2 ex

 

The present invention relates to medicine, namely to the treatment of purulent diseases of fingers.

There is a method of treatment of nail felon, in which excision of the necrotic tissue of the nail fold to produce a wedge-shaped slit. In the base of the affected finger injected antibiotics and implement drainage of the wound using vacuum suction (see RF Patent № 2062607, 1996, And 61 In 17/00).

The most loved and accepted us for the prototype is a method of treatment, including adequate opening purulent lesion excision of necrotic tissue and drainage of the wound. The patient daily bandaging with a water-soluble ointments and antiseptics, which ensure the destruction of pathogenic flora and removal of degradation products from the wound. In the postoperative period the patient parenteral administration of antibiotics, depending on the type of pathogen and its sensitivity to them (see Lutsevich EV, Meleshevych A.V. problems of prevention and treatment of purulent diseases of fingers and hands. //Surgery, 1991, No. 3, pp. 171-172). However, the expressed painful syndrome in “early binding” requires the use not only of painkillers, but additional block anesthesia during ligation.

The technical result of the proposed method of treatment is the behavior of the solution treatment effectiveness by reducing pain, reduce complications and reduced length of stay of the patient in the hospital.

The technical result is achieved by opening purulent, sanitation, drainage and antibiotic therapy. New in the achievement of the technical result is that before surgery and during treatment sessions of acupuncture for 20-25 minutes on semiroutine option, only 4-5 session on the course of treatment.

New is also that when purulent disease I finger brushes use point P-7 and GI-4; II finger - GI-6 and R-9; III finger - MS-6 and TR-4; IV finger - TR-5 and MS-7; V finger - With-5 and IG-4, IG-7 and C-7.

In classical acupuncture energy “Chi” is the energy of life, it flows through the body in a certain direction along the meridians. Is “Chi” the positive (Yang) and negative (Inj). The two aspects of “Chi” necessary for health and between them there should be a balance. Imbalances in the Meridian system is either too large or too small amount of energy “Chi” in one or more meridians. The authors, using the original method adopted in “Applied kinesiology”, conducted testing to determine the acupuncture points (see G. Goodheart, Applied Kinesiology, 1974, Workshop Procedure manual. Detroit, privately published, 1978, p.280). Based on the conducted survey, the authors found that the affected purulent inflammation fell the C brush always “attracted” to the inflammation excessive amount of energy to maintain inflammation. Violations occur in a pair of adjacent Yang-Yin meridians: P-GI; TR-MC; C-IG. So with the defeat of the first finger brush is always an excess of energy corresponds to the Meridian (R) light, and lack of energy is always Meridian (GI) of the large intestine. And accordingly, if the suppurative process affected V finger brush, the excess energy may be tested either in the Meridian of the heart (C), or in the small intestine Meridian (IG). During treatment, the authors used a LO-point of the Meridian with excess energy and point accomplice (source) coupled Meridian.

Comparable analysis of the prototype shows that the proposed method of treatment differs from the known fact that before surgery and during treatment sessions of acupuncture for 20-25 minutes for the next version, just 4-5 session of treatment, and septic disease I finger brushes use point P-7 and GI-4; II finger - GI-6 and R-9; III finger - MS-6 and TR-4; IV finger - TR-5 and MS-7; V finger - With-5 and IG-4, IG-7 and C-7, which corresponds to the criteria of the invention “novelty”

A new set of features provides a more effective treatment for reducing pain syndrome that did not require additional analgesia was noted early disappearance of soft tissue swelling, smooth course of wound healing, reduction in the percentage of complications and, as a consequence, SN is laid on the period of stay of the patient in hospital, that meets the criteria of the invention “industrial applicability”.

The method is as follows.

Before surgical treatment of the patient hold a session of acupuncture for 20-25 minutes for the next version. Then under regional anaesthesia open the abscess, take the pus on the sowing and the sensitivity of microflora to antibiotics. Necrotic tissue is excised, the wound is treated and drain with a water-soluble ointment, such as levomicol. Prescribe antibiotics, analgesics, diphenhydramine, physical. In the postoperative period 3-4 times conduct sessions of acupuncture on the above methodology. Patients report reduced pain in the affected finger, improvement of health, early disappearance of soft tissue swelling, smooth course of the wound process. The method is illustrated in the following clinical examples.

Clinical case study # 1.

Patient I., 21, weight 71 kg, was admitted to the hospital connection PB SN 12.02.2003 was diagnosed with Bone felon ungual phalanx of the first finger of the left hand. Sick considers himself within four days, when for no apparent reason appeared pain in the nail phalanx of the first finger of the left hand, at the medical ligation was performed with hypertonic solution. 11.02.03, the pain intensified, the night the patient is not asleep, 12.02.03 was sent to the surgical branch the hospital. Heredity and history is not burdened.

At admission the patient's condition is satisfactory. Complains of arching pain in the finger, bad overall health. Skin physiological color. Peripheral lymph nodes are not enlarged. Ungual phalanx of the first finger of the left hand thickened, redness, dry skin on the tip of your finger thinned, illuminated purulent contents, palpation sharply painful. In the lungs vesicular breathing, wheezing no. Heart sounds are clear rhythmic. Blood pressure is 120/80 mm Hg, pulse was 80 beats per minute. The abdomen is soft, painless. Effleurage on the kidneys painless on both sides.

For admission complete blood count: erythrocytes - 4,2×1012/l, hemoglobin - 141 g/l, leucocytes - 5,9×109/l (p-5, p-52, e-4, l-33, m-6), ESR - 8 mm/h; urine analysis was normal. Radiography of the first finger of the left hand: bone felon nail phalanx.

The patient was taken to the operating room. Under regional anaesthesia by Oberst-Lukashevich wedge-shaped incision on the tip of your finger opened the abscess, stood out 0.5 ml of thick pus, taken at sowing and the sensitivity of microflora to antibiotics. Necrotic tissue is excised, the roughness brushed Volkmann spoon. The wound is treated with hydrogen peroxide, drained stripe rubber glove with levomicol. posleoperazionny diagnosis: Bone felon ungual phalanx of the first finger of the left hand.

Before surgical treatment and three times in the postoperative period, the patient produced the sessions of acupuncture on the above methodology. After opening the abscess pain in the finger decreased. The night of the patient slept. 13.02.03, the patient complains of slight pain in the postoperative wound, said improvement in overall health. In the ligation: swelling of the finger decreased wound with scanty serous-purulent discharge, ligation with levomicol slightly painful.

Seeding flora: St.epidermidis, TBC - 108high sensitivity to penicillin, gentamicin, Cefazolin. From the first day the patient received: gentamicin 80 mg×3 times intramuscularly No. 7; anticipated to 20,0 1,0 ml of saline 2 times daily intravenously with exposure time of 20 minutes № 3; to discharge from hospital: metronidazole 0,25×2 times; the solution of nicotinic acid 1.0 ml intramuscularly ×2 times per day; solution analgin 50% - 2,0+Dimedrol 1% - 1,0×2 times a day, UHF on the affected finger. The postoperative period without complications, the wound was filled with a blood clot, healed. Sick on the 13th day was discharged in good condition.

Case No. 2.

Patient D.. 35 years old, weight - 52 kg, was admitted to the hospital connection PB SN 8.04.2003, with a diagnosis of Subcutaneous felon ungual phalanx of the first finger of the left hand. Considers himself bol is Noah for eight days, when, after a manicure appeared pain in the nail phalanx of the first finger of the left hand, was treated independently: bath with “salt solution”, Ichthyol ointment. The symptom of “first restless night” with 7.04.03, 8.04.03 year examined by the surgeon, was hospitalized for emergency surgery. Heredity and history is not burdened.

At admission the patient's condition is satisfactory. Body temperature is not increased. Complains of arching pain in the finger, left forearm, the deterioration of General health. Skin physiological color. Peripheral lymph nodes are not enlarged. Ungual phalanx of the first finger of the left hand thickened, okolonogtevogo roller hyperemia, it palpation sharply painful. Palpation of the Palmar surface of the nail the nail phalanx - moderate pain. In the lungs vesicular breathing, wheezing no. Heart sounds are clear rhythmic. Blood pressure is 120/80 mm Hg, pulse was 80 beats per minute. The abdomen is soft, painless. Effleurage on the kidneys painless on both sides. Physiological functions are normal.

For admission complete blood count: erythrocytes - 4,0×1012/l, hemoglobin - 144 g/l, leucocytes - 6,8×109/l (p-6, p-51, e-1, l-35, m-7), ESR - 4 mm/h; urine analysis was normal. Radiography of the first finger of the left hand: b is C pathology. Blood sugar - 4,67 mmol/L.

The patient is directed to the operating room. Under regional anaesthesia by Oberst-Lukashevich the preparation okolonogtevogo roller, is determined by the progress on the Palmar surface of the phalanx. A pair of side sections on the nail phalanx opened the abscess, stood out 1.0 ml of pus, taken at sowing and the sensitivity of microflora to antibiotics. Necrotic tissue excised at the phalanx and in the field okolonogtevogo roller. Wounds washed with a solution of hydrogen peroxide, drained stripe rubber glove with levomicol.

Postoperative diagnosis: Subcutaneous felon ungual phalanx of the first finger of the left hand. Before surgical treatment and four times during the treatment the patient produced the sessions of acupuncture

according to the above method. After the surgery the pain in the finger decreased. 14.04.03, the dressing: wound with serous discharge, granulation lethargic, bleeding sluggishly. Performed radiography: a plot of the dilution of the nail phalanx. In operating the performed audit of the nail phalanx, roughness dull, gray color, easy to remove, in the lumen of the bone a drop of pus. Saw Gigli resection of 1/3 of the phalanx, bone edges, excision of necrotic tissue and the imposition of flow-irrigation and drainage. The wound is sutured closed. Postoperative diagnosis: Cost the th felon ungual phalanx of the first finger of the left hand.

Seeding flora admission: St.aureus, TBC - 108high sensitivity to penicillin, gentamycin, chloramphenicol. Seeding flora 14.04.03,: flora not found. From the first day the patient was prescribed gentamicin 80 mg×3 times intramuscularly; to discharge from hospital: metronidazole 0,25×2 times; trental 0,11 t ×3 times; solution analgin 50% - 2,0+Dimedrol 1% - 1,0×2 times a day, UHF on the affected finger. With 14.04.03 year: in addition to treatment: anticipated to 20,0 1,0 ml of saline 2 times daily intravenously with exposure time of 20 minutes № 5, intravenous drip trental 5,0, ascorbic acid is 5.0 to 200.0 ml of a 5%glucose solution No. 6; flowing the washing drainage 6 times a day for 30-40 minutes drip was filtered solution furacin. The drainage was removed on the 4th day, the sutures were removed after seven days. Control radiography 17.04.03, the: edge of the stump clear signs of bone fusion was not detected. The postoperative period without complications, the wound was filled with a blood clot, healed.

On the 17th day the patient was discharged in good condition.

A method of treatment of purulent diseases of fingers brush through the opening purulent, sanitation, drainage and antibiotic therapy, characterized in that before the surgery and during treatment sessions of acupuncture for 20 - 25 min Caderousse the option, only 4-5 sessions per course of treatment, and septic disease I finger brushes use point P-7 GI-4, II finger - GI-6 P9, III finger - MS-6 TR-4, IV finger - TR-5, MS-7, V finger - With-5 and IG-4, IG-7 and C-7.



 

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