Method for surgical therapy of purulent-necrotic complications of diabetic foot syndrome
FIELD: medicine, endocrinology, surgery.
SUBSTANCE: it is necessary to perform intra-pelvic novocain-antibacterial blockade by a certain technique at keeping a catheter in pelvic fiber for further prolonged novocain-antibacterial blockade, then it is necessary to fulfill necrectomy and lance purulent congestions followed by treating with VIER in flow-aerosol mode and application of a sorbent OUT-M till the transition of early wound process into the stage of proliferation; in case of dressing procedure one should apply prolonged intra-pelvic novocain-antibacterial blockade; after transition of early wound process into the stage of proliferation one should treat the wound with VIER in aerosol mode till application of the secondary sutures. The present innovation enables to remove degenerated substances from wound surface very quickly, improve microhemodynamics and lymphodynamics that, in its turn, favors rapid transition of wound process into the stage of proliferation and, thus, the quickest wound healing.
EFFECT: higher efficiency of therapy.
2 cl, 1 ex
The invention relates to medicine and can be used in complex treatment of purulent complications of diabetic foot syndrome.
A method of processing high-voltage pulse electric discharge (Vier) wounds (Shalin S.A. electrohydraulic treatment in the treatment of purulent wounds. / Abstract. Diss.... Kida. the honey. Sciences. - 1990. - 15 C.), which is not sufficiently radical in the treatment of purulent-necrotic complications of diabetic foot syndrome due to violations of tissue blood flow and metabolism, leading to acidosis and tissue hypoxia (Shor NA // Surgery. - 2001. No. 6. - P.29-33), due to the complexity of the anatomy of the foot (lokhvitski SV, etc. // Surgery. - 2001. No. 3. - p.34-35).
The improvement of results of treatment of purulent-necrotic complications of diabetic foot syndrome is possible with the use of a woven fiber sorbent for removal denaturirovannykh tissues (Reznik LB New technologies in complex treatment of purulent wounds. / Abstract. Diss.... Kida. the honey. Sciences. - 1998. - 22 S.), prolonged use of intrapelvic procaine blockade to decimalization limb (Shor NA // Surgery - 2001 - No. 6 - P.29-33; Bregadze A.A. abstracts of the VII Congress of traumatologists and orthopedists Russia. - Novosibirsk - 2002. - P.35), the use of lymphotropic antibiotic therapy in the treatment and prevention of infectious OS is ogneni (Eruhin IA, A.S. Rozhkov and others // journal of surgery. - 1992. No. 9-10. - S-216).
Object of the invention is to improve results of treatment of purulent-necrotic processes in the diabetic foot syndrome.
The problem is solved in that in the method of surgical treatment of purulent-necrotic complications of diabetic foot syndrome by affecting the necrotic tissue of high-voltage pulsed electric discharge is conducted intrapelvic novocaine-antibacterial blockade, then do necrectomy and reveal purulent leakages, the wound treated wear and impose sorbent OUT)
Intrapelvic novocaine-antibacterial blockade is performed in 200 ml of 0.25% solution of novocaine + 64 UNITS lidz + 1.0 g of amikacin + 0.2 g of metronidazole, prolonged intrapelvic novocaine-antibacterial blockade is performed in 800 ml of 0.25% solution of novocaine + 64 UNITS lidz + 2.0 g of amikacin + 0.5 g of metronidazole in the day.
At the first stage perform intrapelvic blockade (Shkolnikov-Selivanova-Codecs) by introducing a 0.25% solution of novocaine (warmed to body temperature) in an amount of 200 ml using a standard catheter for percutaneous vascular ⊘ 1.4 mm, held in pelvic tissue using the Seldinger techniques to improve the flow in the affected area (in the tissues of the foot) at the expense of off what I'm sympathetic innervation. With the aim of improving lymphogenic and prevention of purulent intrapelvic complications, holding lymphotropic antibiotic therapy in the fiber space of the pelvis is introduced 64 UNITS lidz and combination of antibiotics (amikacin 1.0 g + metrogylum 0.2 g).
Produce surgical treatment of purulent-necrotic lesion with subsequent impacts wear in jet spray mode by moving the nozzle electro-site at a distance of 40-50 mm from the surface of the wound with exposure 3-4 sec/cm2and the flow rate of the working solution (0.9% NaCl) 0,3-0,35 ml/sec, and then on the wound stack of woven carbon sorbent OUT) On the background of prolonged intrapelvic novocaine-antibacterial blockade (800 ml of 0.25% solution of novocaine + 64 UNITS lidz + 2.0 g of amikacin + 0.5 g metronidazole per day) during bandaging reuse wear in jet spray mode in combination with sorbent OUT-M to cleanse wounds. After the transition of the wound process in the stage of proliferation perform wound debridement wear in aerosol mode by moving the nozzle electro-site exposure 3-4 sec/cm2at a distance of 40-50 mm from the surface of the wound and the flow rate of the working solution (0.9% NaCl solution) 0.1 to 0.15 ml/sec.
For electro-processing using the device Electrocon-1". This device is creation, using the energy Wier, creates a high hydrodynamic pressure in the discharge channel, while providing a source of pulsed electromagnetic fields, ultrasound, ultraviolet radiation and pulsating stream of solution. The device consists of a generator connected through flexible conductors with electrohydraulic probe (node), and a power supply. AG node is a core opposing electrode system with a bit period of the rod-cone. One of the electrodes is made in the form of a rod, the other in the form of a hollow truncated cone with a removable nozzle in the form of a nozzle for remote jet aerosol processing torch drug solution. The device is powered by AC electrical current with frequency of 50 Hz and voltage of 220 C. the Parameters Vier: maximum current bit electric pulse of at least 500 And, the potential difference on the bit electrodes 3÷6 kV, pulse duration ≈ 0,2 μs, the duration of the pulse packet ≈ of 1.25 μs, the minimum pulse frequency of 70 Hz.
Woven carbon sorbent OUT-M is a glossy black fabric comprising carbon fibers and having a high elastic properties. Due to the woven structure of the sorbent has developed active sorbing surface is rnostly, specific absorption surface of the sorbent OUT-M is 6 m2/1 g of tissue.
Prolonged novocaine-antibacterial intrapelvic blockade is performed through a standard catheter for percutaneous vascular ⊘ 1.4 mm, held in pelvic tissue (Shkolnikov-Selivanova-Codecs) using the seldinger technique of 0.25% solution of novocaine 800 ml + 64 UNITS lidz + 2.0 g of amikacin + 0.5 g of metronidazole in the day.
The proposed method of treatment of purulent-necrotic processes in the foot in diabetes mellitus promotes rapid removal of degenerated substances from the wound surface, improves microgame and lymphogenic facilitates the rapid transition of the wound process in the stage of proliferation and eventually to rapid wound healing, provides for prevention of local and systemic infectious complications.
Patient P., 56 years old, was admitted to the Department of purulent surgery OGKB No. 1 on the 15th day from the onset of the disease with a diagnosis of Purulent wounds, osteomyelitis of the first toe of the foot in diabetes mellitus". On the second day of transaction - intrapelvic novocaine-antibacterial blockade on Shkolnikova-Selivanova-Codecs 200 ml of 0.25% solution of novocaine + 64 UNITS lidz + 1.0 g of amikacin + 0.2 g of metronidazole, catheterization pelvic tissue standard catheter for percutaneous vascular ⊘ 1.4 mm the BL is using the seldinger technique of, exarticulation I toe with subsequent treatment of the wound wear in jet spray mode, after which the wound surface was laid woven carbon sorbent OUT) In the future against the background of prolonged intrapelvic novocaine-antibacterial blockade (800 ml of 0.25% solution of novocaine + 64 UNITS lidz + 2.0 g of amikacin + 0.5 g metronidazole per day) during bandaging reused wear in jet spray mode in combination with sorbent OUT-M to cleanse the wound for four days. After the transition of the wound process in the stage of proliferation of processed RAS wear in aerosol mode. On day 7, superimposed secondary seams. On the 9th day removed the catheter from the pelvic tissue. The patient was discharged on the 22nd day of recovery.
1. The method of surgical treatment of purulent-necrotic wounds in the diabetic foot syndrome, including the impact on the necrotic tissue of high-voltage pulsed electric discharge (Vier), characterized in that perform intrapelvic novocaine-antibacterial blockade Shkolnikova-Selivanova-Tsodyks, leaving the catheter in the pelvic tissue to conduct further prolonged novocaine-antibacterial blockade, then perform necrectomy and reveal purulent leakages with subsequent processing Vier in jet aerosol regime the imposition of sorbent OUT-m to the transition of the wound process in the stage of proliferation; when the dressings prolonged use intrapelvic novocaine-antibacterial blockade; after the transition of the wound process in the stage of proliferation perform wound debridement wear in aerosol mode to overlay the secondary seams.
2. The method according to claim 1, characterized in that intrapelvic novocaine-antibacterial blockade is performed in 200 ml of 0.25%solution of novocaine, 64 UNITS lidz, 1.0 g of amikacin, 0.2 g of metronidazole in the day.
3. The method according to claim 1, characterized in. that prolonged novocaine-antibacterial blockade is performed in 800 ml of 0.25%solution of novocaine, 64 UNITS lidz, 2.0 amikacin, 0.5 g of metronidazole in the day.
FIELD: medicine, dermatology, in particular treatment of trophic ulcer (TU) and long-term open septic wound (LTOSW).
SUBSTANCE: claimed method includes application of wound-healthing composition onto TU and LTOSW in the first step of wound process. Said composition contains (mass %): methyluracil 0.9-1.1; pepsin 3.4-4.4; bentaine hydrochloride 3.6-4.4; sodium chloride 9.0-11.0; and balance up to 100,0: distilled water. In the second and third phases fine cut collagen preparations in form of 3-4 mm thickness layer are applied on purified TU and LTOSW surface. Then cotton carrier freely moistened with wound-healthing composition diluted with water in ratio of 1:2 is layered onto collagen layer. Multihole microirrigator and further sterile cotton carrier are sequentially applied over abovementioned cotton carrier.
EFFECT: effective treatment due to accelerated abruption of necrotic tissues, inhibition of microbial growth, decreased risk of infective, toxic and allergic affects, and improved tissue regeneration.
2 ex, 3 cl
FIELD: pharmaceutical industry.
SUBSTANCE: invention provides immobilized form of cephasoline wherein cephasoline is included into polymer matrix made of sodium-carboxymethylcellulose.
EFFECT: reduced (by three days) treatment time.
1 dwg, 5 tbl
FIELD: medicine, in particular cosmetology, acne treatment.
SUBSTANCE: method includes multiple administration of isotretinoin in single dose of 0.1-0.3 mg/kg per day followed by dose increasing wherein total dose is 10-40 mg/kg with simultaneous chemical piling and cosmetic clearing.
EFFECT: effective treatment using decreased preparation doses and reduced side effects.
3 ex, 1 tbl, 2 cl
FIELD: cosmetology, esthetic surgery, applied biopharmacology.
SUBSTANCE: invention relates to medicative and cosmetic agents, and uses of biologically active substances based on natural biological complexes. Claimed method includes application of Mirralgin balm having analgesic, anti-inflammation and resolving action, Reventon balm, having vessel restorative action, for edema reducing and microcirculation improving. In process of blepharoplastic eye boundary bandage microemulsion having recovery and animative action on eaves skin is applied, and in process of facelifting cream mask having bactericide, vessel restorative and recovering action, and enhancing of local immunity is applied. Mirralgin balm and Reventon balm treatment is carried out sequentially or alternatively. In another embodiment after skin cleaning and treatment of damaged zone with anti-septic agent Bacteriophage gel, which disinfects skin surface, prevents biofilm forming, accelerates cicatrizing process is applied, then posttraumatic zone is treated with cleaning milk, toned up with tonic lotion and cream mask having bactericide, vessel restorative and recovering action, and enhancing of local immunity is applied.
EFFECT: method for skin structure recovering without skin trauma.
4 cl, 7 ex, 1 tbl
FIELD: medicine and biopharmacology.
SUBSTANCE: claimed biotransplant contains culture of genetically non-modified mesenchyme stem cells (MSC), fibroblasts including epithelial cells. Biotransplant is used in intradermal administration. Biotransplant is administered topically in physiological solution with concentration from 1 to 10 millions per 1 ml. Total transplant amount is 1-10 millions depending on defect area.
EFFECT: treatment method with high reproducibility.
FIELD: medicine, pharmacy.
SUBSTANCE: invention represents a healing agent used for close and treatment of suppurative-necrotic and infected wounds, burns, trophic ulcers. Proposed composition comprises the following components taken in the required ratio: water-soluble chitosan of natural origin, polyalkyleneguanides phosphopag and biopag, proteolytic enzymes pepsin and collagenases, ascorbic acid and anesthetic agent. Agent shows the combined wound-healing, bacteriostatic and immunostimulating properties, it stimulates regenerative-reparative processes and accelerates growth of wound healthy cells. Also, agent decreases number of little use and/or expensive components used in preparing wound-healing agents.
EFFECT: improved and valuable medicinal properties of agent.
7 cl, 2 tbl, 10 ex
FIELD: medicine, cosmetology.
SUBSTANCE: one should carry out therapy including 3 stages, moreover, at the first 1-2-mo-long stage one should interrupt acute acne process and treatment of urogenital infection due to applying sanitation and antibacterial skin protection, at the second 3-5-mo-long stage it is necessary to conduct hygienic care for patient's skin by applying methods of ultrasound and chemical peeling to remove neoplasms caused by human papilloma virus, remove nevuses in operational area, perform treatment of keloid cicatrices to remove vaginal dysbiosis and urogenital diseases, at the third stage one should fulfill mechanic dermabrasion followed by post-operational 1-2-mo-long care, moreover, as antibacterial preparations during sanitation one should apply butol, after sanitation - butol and baneocin, and after epithelization of acne foci and vaginal epithelium - butol and butolol applied in pre-menstrual period not combining the use of the preparations mentioned with treating surface with alcohol- and metal-containing solutions. The present innovation provides decreased number of relapses due to interrupting inflammatory processes and normalizing diybiosis.
EFFECT: higher efficiency of therapy.
1 ex, 1 tbl
FIELD: veterinary science.
SUBSTANCE: the suggested preparation contains dense propolis, vegetable oil, extract out of dead bees based upon glycerol, lanolin, honeycombs' cutting off, moreover, all the components should be taken at certain quantitative ratio, weight%: honeycombs' cutting off 15-20, dense propolis 20-25, extract out of dead bees upon glycerol 7.5 -10, lanolin 20-25, vegetable oil - the rest, moreover, honeycombs' cutting off includes honey residues. The preparation in question is of high biological activity, provides shortened terms for recovery in animals and excludes allergic reactions.
EFFECT: higher efficiency for therapy.
1 cl, 8 ex
FIELD: medicine, dermatology.
SUBSTANCE: one should treat eruptive area with a gaseous flow of plasmochemical nitrogen oxide by replacing the flow along concentric trajectory against perifocal area towards ulcerous center, from the distance of 25 cm at the phase of exudative process 5 times weekly and from the distance of 15 cm during active proliferation thrice weekly at exposure time being 10 sec/sq.cm at the background of ciprolet, detralex, phencarol and aevit intake. The present innovation enables to decrease side effects due to deteriorating inflammatory processes, improving microcirculation, skin barrier function and regenerative processes.
EFFECT: higher efficiency of therapy.
FIELD: medicine, in particular composition for chemical piling.
SUBSTANCE: claimed composition contains component (A) of general formula B-[-(CH2CH2O)m(AO)n-H]a, wherein B is alcohol residue, AO is alkyleneoxy group having from 3 to 18 carbon atoms; a = 1 or more, integer number; m = 4 or more, integer number; n = 0 or 1 or more, integer number; with the proviso that ethylene oxide molar amount (m) is 40 % or more based on total molecular weight of ethylene oxide chain; and phenol compound (B). Composition of present invention has no side effects after treatment such as red spots, pigmentation or cicatrices and is useful in skin regeneration, spot elimination, pimple treatment, fat skin improvement, etc.
EFFECT: composition for chemical piling of improved effect.
3 cl, 5 ex
SUBSTANCE: method involves acting with electric current of ultrasonic frequency upon eyes projections with power of 1-2 kW within 3 min on each field. Then, pulsating infrared laser radiation treatment is applied to cerebral cortex vision zone projections with power of 5 mW, frequency of 8-12 Hz within 3 min on one field. The total treatment course is 5-10 daily procedures long.
EFFECT: enhanced effectiveness in normalizing intraocular blood pressure; accelerated rehabilitation process.
SUBSTANCE: frame irradiator intends for treatment and prophylactic treatment of mastitis. Frame irradiator has short-circuited frame with diametrically disposed parts connected by links. It also has capacitor. Links made of two halves of two parts are connected with capacitor plate. Links divide internal space of short-circuited frame to four sectors.
EFFECT: improved precision of metering of radiation power by electromagnetic field.
2 cl, 2 dwg
FIELD: medicine; medical engineering.
SUBSTANCE: device has casing with needle and cylinder with cannula having three independently connectable parts like hollow cylinder, piston and casing. The hollow cylinder has posterior end open, anterior end having cannula attached to it and guiding members. The piston has hole extending through the whole its length as cavity having shield and pusher on its upper part. Plastic tube and connection means is available on the posterior end. The casing has guiding members. It is open in its upper, anterior and posterior part. Needle is attached to the anterior casing end. The needle has semicircular cross-section over the greater part of its length. When assembling said elements, the piston is introduced into the cylinder that is to be connected to the casing by means of guiding members and the cannula is to be introduced into the needle. Method involves assembling three members, cleaning the device before using it, holding catheter with one hand and introducing the needle and cannula in place of interest, checking if both items are in their appropriate place, introducing the cannula into place of interest and removing the needle and the casing. Another embodiment of the invention discloses catheter having needle and cannula. When used for making injections, it has two principal parts like cylindrical part and cannula. The cylindrical part has several guiding members on its upper part for placing pusher member formed by flat principal part having leading members placed on its sides, and orthogonal shield. Needle is introduced into the cannula and placed in anterior segment of the cylindrical part. Piston is available in the cylindrical part. Posterior part of the piston is formed by wall supporting the leading means.
EFFECT: enabled device introduction with one hand with single attempt; improved hygienic conditions of surgical operation; reduced risk of infectious complications.
16 cl, 19 dwg