Method of keloid and hypertrophic skin cicatrixes treatment
FIELD: medicine; surgery.
SUBSTANCE: for treatment of keloid or hypertrophic cicatrixes of a skin unitary freeze a cicatrical tissue on a site in diameter 1 the exposition of 15-20 seconds. Thus rate of handpiece cooling makes 220°C/minute. Temperature on a working part of the handpiece makes 180°C. Then, without waiting of thawing, a laser photocoagulation in a pulsed operation is carried out. Frequency of a pulsed operation makes 10-12 Hz, power 5 W. All area of cicatrix is treated in the same way.
EFFECT: rising of efficiency of treatment, reduction of number of relapses, treatment depreciation, reduction of terms of treatment, maintenance of painlessness of procedure.
The invention relates to medicine, namely to surgery, and is intended for treatment of keloid and hypertrophic scars of the skin.
Cryosurgery is used to treat pathological scars from 1961 (I.Cooper). CO2the laser used for the treatment of keloid and hypertrophic scars since the early 90-ies.
However, cryosurgery disadvantage is the duration of the procedure and in the case of large scars the need for repeated courses of treatment.
When laser photocoagulation drawback is the high % of recurrence and morbidity of the procedure.
The purpose of the invention is the increased efficiency of treatment, the decrease in % recurrence, reducing treatment costs and painless.
This goal is achieved by the combined use of cryosurgery and CO2laser photocoagulation.
The method is as follows: define the scope of the impact. First, perform a one-time freeze scar tissue in a limited area with a diameter of 1 cm using a cryogenic installation "CRYO-RM-01" with the speed of cooling of the tip 220°C/min and t° on the working side of the tip -180°C. Exposure of 15-20 C. Then, without waiting for the thaw, perform laser photocoagulation in pulsed mode with a frequency of 10-12 Hz and at a power of 5 watts. Thus, is applied over the entire area of the scar.
The wound clicks the functioning of a 5% solution of potassium permanganate.
Patient N. 66 years old, operated on for ptosis of the skin. Produced circular facelift. In the postoperative period was formed hypertrophic scar the skin along the line of the wound. Conservative treatment is without effect. 6 months after surgery in the area of the scars have the feeling of itching, redness of the surface of the scar. With the purpose of increase of efficiency of treatment the patient applied a combined effect on the area of the scar of cryosurgery with simultaneous laser photocoagulation scar tissue. The postoperative course was favorable. Viewed through 1 year. Signs of hypertrophy in the area of the scar is not marked. There are isolated areas of excessive scar tissue in the ear region.
Example # 2
Patient A. 18 years in early childhood received burns 4 degrees buttocks with hot water. The place held a free dermaceutic formed foci of keloid scarring. With the aim of enhancing therapeutic effect of the patient applied the combined cryosurgery with simultaneous laser photocoagulation scar tissue. In the zone of formation of keloid zone. Examined a year later keloid scar regressed, which helped to make the patient corrective proprietary plastic skin.
The use of the proposed method for the treatment of keloid and gipertroficskih provides scars reduction % recurrence, reduced treatment time, reduced cost of treatment, painless procedure.
Reducing the number of relapses associated with a new character regression of pathological scar. The reduction of treatment time due to the lack of need for repeated cycles of freezing. The expense of laser photocoagulation pathological lesion wound up completely for 1 session. This is linked to the reducing treatment costs. Cold is a good anesthetic, so laser photocoagulation painless.
Technical simplicity and accessibility of the method provides the possibility of using the described method in the surgical inpatient, outpatient, medical centers, equipped with a cryogenic plants and CO2-lasers.
Sources of information
1. Holden H.B. Cryosurgery in aesthetically significant and functionally active areas. 1972.
A method for the treatment of hypertrophic or keloid scars, including cryogenic, characterized in that perform a single freezing the scar tissue at the site with a diameter of 1 cm at a cooling rate of tip 220°C/min and the temperature on the working side of the tip 180°S, the exposure time of 15-20 seconds, and then, without waiting for the thaw, perform laser photocoagulation in pulsed mode with a frequency of 10-12 Hz and at a power of 5 W, so W is the image is applied over the entire area of the scar.
SUBSTANCE: invention concerns medicine, particularly cardiology, and can be applied in coronary disease treatment, exertional angina of I-II functional class. Magnet laser therapy is performed starting from 4th adaptation day. Infrared laser radiation is applied with wavelength of 0.89 mcm in impulse mode of intensity of 7 W, pulse frequency of 80 Hz and constant magnetic field with induction of 50 mTl. Each of 4-5 symmetrical bioactive points is affected for 1 minute. Total impact time is 8-10 minutes. Full-body hydrosulfide baths are added starting from 5th day of treatment with hydrosulfide concentration of 50-150 mg/l for exertional angina of I functional class and with hydrosulfide concentration of 50-100 mg/l for exertional angina of II functional class. Water temperature is 36°C, duration comprises 6-15 minutes. Baths are performed on days free from magnet laser therapy. A course includes 8 physiological procedures and 8 balneological procedures.
EFFECT: enhanced physical efficiency, stimulated activity of involuntary nervous system, improved indicator values of lipid exchange, peroxide lipid oxidation, antioxidant and coagulation systems, reduced risk of coronary disease complications.
2 ex, 14 tbl, 3 dwg
SUBSTANCE: correction of pain syndrome accompanying severe psoriasis is ensured with skin irradiation within affected region or above inflammatory tissue using low intensity IR rays of CO2 laser. Laser wavelength is 10.6 mcm. Radiation power density in pulse-periodic regime is 0.015-1 Wt/cm2, radiation pulse duration is 0.5-10 mc, pulse window is 10-100 mc, and highly directional IR radiation divergence is 10-2 radians. While radiation, laser beam is moved on skin within affected region during 5-10 minutes, herewith zone exposure duration determined by laser beam diameter is 1-2 sec. Skin is preliminary coated with adenosine triphosphate with daily exposure within course of 10-15 days.
EFFECT: evident reparative analgesic effect, reduced time of hospital stay, prevention of complications.
FIELD: medicine; physiotherapy.
SUBSTANCE: ultrasonic inhalations of 10 ml solution of 1% placenta hydrolyzate are applied at temperature of solution 35°C within 10 minutes. Procedure is applied in the morning on an empty stomach, or 40-60 minutes after eating. It is followed with scanning laser therapy with infra-red laser radiation from laser scanning physiotherapeutic stimulator LSPS-03.2IR. Output power at light guide end is 2 mWt, power flux density is 50 mWt/cm2. While exposure the patient is positioned lying on stomach, thus effecting paravertebral fields to the right and to the left at level D3-D9, within 3 minutes per each field. Then while the patient is positioned lying on back, liver region is exposure within 8 minutes. Course is 10 daily procedures.
EFFECT: normalised eliminative properties of epithelial barrier of a respiratory tract and local immunity of airway mucous membrane.
3 tbl, 2 ex
FIELD: medicine; dentistry.
SUBSTANCE: treatment of inferior dental nerve neuritis caused by filling material delivery into mandibular canal is ensured with introduction of antibacterial agent before operation. Thereafter filling material is surgically removed from mandibular canal. Operation procedure is followed with introduction of antibacterial and immune correcting agents, antisensitisers, Reaferone, vitamins B1 and B12, adenosine triphosphate. Besides mandibular region is exposure to laser magnetotherapy with using dental apparatus Optodan, accompanied with intraoral HBO-therapy, hydromassage, hydrocortisone phonophoresis, 2% nicotinic acid solution amplipulse phoresis, Tambukan mud therapy, pine needle and pearl baths, acupuncture with using local and regional points.
EFFECT: higher treatment efficiency, restored blood circulation, accelerated rehabilitation, complete relief of evident pain syndrome and post-amputation pains, simplicity, efficiency.
FIELD: medicine; pulmonology.
SUBSTANCE: intravenous laser irradiation of blood (ILIB) is carried out differentially depending on detected hemodynamic type of microcirculation and level of protein C system activity. In case of hyperemic, spastic and normocirculatory hemodynamic type of microcirculation and activity level of protein C system of 0.704±0.02 and higher, 7 sessions of ILIB are performed. In case of stasis and stagnant hemodynamic type of microcirculation and activity level of protein C system less than 0.704±0.02, 12 sessions of intravenous laser irradiation of blood. Length of wave is 0.63 mcm, intensity of irradiation at light guide end makes 1.5-2.0 mW, one procedure per day, duration makes 20 minutes.
EFFECT: lower demand in antibacterial therapy and in medicines of pathogenetic action, lower medicamental load on patient and reduction of disease clinical symptoms preservation duration.
5 tbl, 2 ex
FIELD: medicine; gynaecology.
SUBSTANCE: solution of photosensitiser "Photoditazine" is introduced intravenously in dose of 0.5-1.0 mg/kg. As soon as 1.5-2 hours have elapsed after infusion, intrauterine light guide is inserted into uterine cavity, and uterine cavity is radiated with laser in fractions at wave length of 662 nm and density of supplied energy of 200 - 350 J/cm2 for 30-45 minutes. After uterine cavity has been radiated, cervical channel is radiated in fractions by laser with application of cylindrical light guide at wave length of 662 nm and density of supplied energy of 200-250 J/cm2 for 15-30 minutes.
EFFECT: highly selective removal of functional and basal layer of uterus mucous layer.
FIELD: medicine; oncology.
SUBSTANCE: method includes introduction of solution of chemical compound of amino acid L-phenylalanine with gold or silver nanoparticles intravenously prior to radiation. At that minimum concentration of nanoparticles is 108 cm-3, and maximum concentration is 1012 cm-3. Plasma resonance of nanoparticles has spectral maximum in the area of biotissues transparency at the wave length of 750-1200 nm. These nanoparticles are gold or silver nanoshells with core of silicon dioxide or nanorods. Radiation of melanoma is performed at least after 1 hour and not more than after 4 hours after solution introduction, laser beam with length of radiation wave that coincides with spectral maximum of nanoparticles plasma resonance absorption. At that radiation is done by sequence of laser impulses with duration of laser impulse in the range of 10 microseconds - 100 ns at minimum porosity of three and higher, at energy density of at least 20 J/cm2, but not more than 200 J/cm2.
EFFECT: local performance of melanoma destruction with minimum destruction of surrounding healthy cells.
FIELD: medicine; therapy and cardiology.
SUBSTANCE: biophysical indices are determined in points of heart and pericardium meridians acupuncture. Corporal points of heart and pericardium meridians acupuncture are exposed to laser radiation with wave length of 0.63 mcm with outlet power density of 0.1-10 mW/cm2 and beam diameter of 1.5-0.1 mm. Radiation is dosed according to dynamics of electropotential value in every point of acupuncture. Laser therapy is carried out in combination with intake of activated acid and alkaline water according to regimen that provides rise in consumption of acid water from 1/3 of glass to 1/2 of glass - in the end of treatment, and alkaline water from 1 to 7-8 glasses accordingly. The whole course is realised against the background of diet with reduction of food calorie and fat content and graduated physical exercise.
EFFECT: normalisation of vessel walls elasticity, better tolerance of physical activity.
SUBSTANCE: treatment of glial brain tumours is ensured by partial tumour extraction. During operation photosensitiser is delivered in the cavity formed by partial tumour extraction. Photodynamic laser therapy implies using diode laser of cylindrical diffuser with spherical radiation pattern. Wavelength is 660 nm, power is 100-200 mW.
EFFECT: higher concentration of photosensitiser in cavity of partially extracted tumour, reduced amount of introduced photosensitiser, more uniform radiation of tumour tissue, lower probability of postoperative complications and length of hospital stay.
FIELD: medicine; ophthalmology.
SUBSTANCE: invention can be used for surgical treatment of central vein thrombosis of retina (RCV). Induction of chorioretinal anastomosis (CRA) is performed by laser radiation of RCV of the third order with wave length 532 nm, four coagulates in number, radiation power density 500 mW/cm2, pulse duration 1 second, spot diameter 50 mcm. Vitrectomy is preliminary carried out with removed posterior hyaloid membrane of vitreous body. It is followed with perioperative endolaser CRA induction and, additionally paravasal endolaser retina coagulation at wave length 532 nm, 500-600 coagulates in number, radiation power density 120-200 mW/cm2, pulse duration 0.1-0.2 seconds, spot diameter 50-200 mcm.
EFFECT: higher efficiency of surgical treatment of RCV thrombosis based on combined vitrectomy, removal of posterior hyaloid membrane of vitreous body (PHMVB), perioperative endolaser CRA induction and paravasal panretinal endolaser retina coagulation.
SUBSTANCE: invention concerns medicine, particularly neurosurgery. Intraoperational registration of somatosensoric induced potentials is performed. Laser photocoagulation of remaining tumour part is performed in sessions not longer than 1.5 minutes each. Transition between sessions is performed by diminishing amplitude of component P38 maximum not more than by 50% and increasing delay of P38 maximum not more than by 15% compared to somatosensoric induced potentials registered immediately before laser photocoagulation, with recovery rate within 4-5 minutes.
EFFECT: improved clinical results of treatment due to reduced intraoperation trauma rate for spinal cord.
FIELD: medicine; surgery.
SUBSTANCE: fistula mucosa is endoscopic excised. Thus it is accompanied with simultaneous exposure to tissues adjacent to sinus tract. Both exposures are performed with using high-intensity continuous laser radiation of diode laser of wave length 0.97 mcm and power 3-4 W. Total exposure length for sinus tract mucosa and adjacent tissue is 3-5 minutes. Exposure point is closed with automaterial.
EFFECT: lower injury within treatment, stimulation of reparative processes, relapse prevention.
FIELD: medicine; ophthalmology.
SUBSTANCE: into structure of an intraocular neoplasm enter light guides with diffusers by means of spear of adjustable length and 25 G cannula and spend an interstitial laser hyperthermia of a tumour with wavelength of 810 nanometers and power 350-500 mW within 10-8 minutes, accordingly. The light guides are entered into a tumour perpendicularly to sclera on lines of the greatest diameter of the basis and perpendicular to it of diameter on distance of 2.5-3.5 mm in the both sides from the centre of the basis of a tumour on depth which define according to preliminary ultrasonic research: tumour height on distance of 2.5-3.5 mm from the centre of the basis of a tumour a minus of 1.5-2 mm. Regulate the depth of introduction of light guides for an irradiation of all volume of a tumour, entering them on the maximum depth, on 2/3 from the maximum depth, on 1/3.
EFFECT: full or partial destruction of the tumour, the minimum damage of structures and eye tissues at introduction of light guides and hyperthermia carrying out, absence of necessity of additional surgical manipulations after the end of hyperthermia.
4 cl, 1 ex
SUBSTANCE: influence with radiation of the neodymium laser on an osteal wall of an ampoule of the horizontal semicircular channel. Power of radiation totals 12 J/cm2. Duration of impulses totals 2.5 - 4 ms. Thereat after creation of punching in a wall of the channel and perilympha occurrence immediately in a channel lumen, influence laser impulses until the boring nystagmus will not change on an oppression nystagmus.
EFFECT: provides relief of patients from giddiness of peripheric character and otolithic symptomatology.
SUBSTANCE: ultrasonography of affected lymph nodes is carried out in the stage of remission, structure of lymphoid tissue is determined. If four or more of affected nodes having lymphoid tissue of homogenous hypoechoic structure are detected, a course of laser hyperthermia is carried out till tissue fibrous of the nodes forms. If more than four affected nodes having lymphoid tissue of homogenous hypoechoic structure or nodes with hyperechoic central part and hypoechoic peripheral part are detected, lymphodissection of affected nodes is carried out.
EFFECT: method allows selecting individual preventive measure against lymphadenitis recurrence of surface lymph gland.
FIELD: medicine; surgery.
SUBSTANCE: laser beam CO2 exposes at wave length 10.6 microns in a superpulse mode with pulse duration 200-300 mcs, pause duration 0.002 to 0.9 mcs, cicatrix process beginning with second-third week after operation or trauma. Scanner exposure is initially performed within one pass by cicatrix mass, and then captured non-modified skin within 1 - 2 mm.
EFFECT: high percent of good cosmetic results owing to earlier structure reorganisation of connecting tissue.
2 cl, 2 ex
SUBSTANCE: lobar and/or segments separation area is dissected 3-5 mm deep within prospective resection using scalpel. Then liver parenchyma layerwise dyhitoclasia is carried out, thus defining liver wound edges stretched between vascular-duct formations of portal tract, hepatic vein branches. Lower branch-screen of a surgical clip is inserted hereunder to press and through aperture in upper branch vascular-duct formations and hepatic veins are crossed with CO2-laser radiation at target power 40 W, beam diameter 1.8-2.0 mm, power density 1200-1500 W/cm.
EFFECT: essential decrease in haemorrhage volume; improvement of postoperative period course and reduction of operative duration.
3 cl, 2 ex
SUBSTANCE: acutely one should dissect the part of tumor-occupied sinus being 0.5 cm against anatomically intact sinus at the front and from behind. It is necessary to coagulate anterior, not dissected tumor-occupied part of the superior sagittal sinus (SSS) with radiation of Nd-Yag laser at power being 20-25 W for 2-3 min till the appearance of carbonized tissue in area of the impact suggested. Then comes the ablation of this part of sinus with radiation at power being 10-15 W for about 5-7 min till the onset of minimal venous hemorrhage out of the intact part of sinus, then it is important to carry out analogous treatment of posterior, not dissected part of SSS. The innovation enables to keep venous collectors inflowing into the intact SSS, avoid additional cerebral traumatism and practically bloodlessly remove the tumor totally.
EFFECT: higher efficiency.
SUBSTANCE: method involves covering wound surface with xenogenous preserved peritoneum plate and fixing thereof. Plate is fixed under defocused diode laser beam visual control in fixed mode with wavelength of 805 nm and power of 3-5 W in sequentially treating the whole plate surface at distance of 3-5 mm with light guide speed of 1-1.5 mm/s until parenchymatous hemorrhage stops completely and its color changes.
EFFECT: usable in any wound geometry cases; excluded risk of secondary parenchyma injury and necrosis.
FIELD: laser medical instruments.
SUBSTANCE: laser perforator for perforating patient's skin and for taking blood for test has laser radiation source for generation of outcoming laser beam, focusing unit for focusing outcoming laser beam onto part of skin selected for perforation, power unit and device, which fixes skin in a manner to provide optimal position of skin during perforation. Laser perforator for perforation of patient's skin can also have removable clamping cups of specific lengths, or optical item made for regulation of degree of transmission of laser radiation. Optical item is made of material having specific characteristics of laser radiation transmission; item is placed between part of skin and laser radiation source. Fixing device can also be made to have internal cavity, closed front end and with opening at side wall. Opening is made in such a manner that part of skin goes through that opening into internal cavity of cup.
EFFECT: reduced pain syndrome.
29 cl, 21 dwg
SUBSTANCE: invention concerns medicine, urology, and can be applied in vesicular prostate complex disease treatment. It involves placing patient into cryothermic chamber and exposed to heat carrier vapour based on liquid nitrogen for 2-3 minutes. Temperature within -140°C to -180°C is maintained inside the chamber. Cryotherapy course includes 10 daily sessions by one per day. Cryotherapy course is applied in conservative complex therapy of disease in decadent exacerbation or instable remission phase.
EFFECT: enhanced treatment efficiency, effect on system disorders of patient's organism, prolonged remission period, reduced medicine dosage.
5 tbl, 4 ex