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Microwave heat based frostbite therapy

Microwave heat based frostbite therapy
IPC classes for russian patent Microwave heat based frostbite therapy (RU 2360713):
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FIELD: medicine.

SUBSTANCE: therapy involves microwaves supplied to a frostbitten limb SHF from different sides. The radiated power is 15 to 30 W. Exposure duration is set within 20-30 minutes.

EFFECT: optimal therapeutic effect ensured by uniform heating of tissue and restoration of micro- and macrocirculation in the entire space of an affected limb with elimination of thermal damage of tissue.

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The invention relates to medicine, specifically to surgery and traumatology, and is intended to reduce the severity of the impact of cold injury.

Frostbite according to domestic and foreign authors up to 15% of all trauma cases (in military time up to 25% health loss) [Kotelnikov VP Frostbite. - M.: Medicine, 1988. - 256 S.]. Disability with deep lesions ranges from 20-90%. The number of frozen reaches 20% of hospital beds. The vast number of affected are people in the most productive age from 20 to 50 years, with deep frostbite 65%. Most often in clinical practice, there are frostbite of the extremities [Morazan RI. Frostbite of the extremities. - M.: Medicine, 1984. - S.], because more severe cases, usually fatal.

Modern level achieved in the treatment of frostbite, reflected in the publication [Proceedings of the Third scientific and practical conference on "Cold injury". - St. Petersburg, April 8, 2002 // S-IB.: Publishing house of the military medical Academy, 2002. - 90 S.]. The main therapeutic action with deep frostbite are conservative in nature. Using traditional methods, the duration of treatment in hospitals is on average 65 days. Disability is determined by the outcome of up to 70%mortality 6%. In affect, the, there is an objective need for an effective and popular way to treat frostbite.

Despite the importance of specialized techniques in the treatment of frostbite does not exist. Meanwhile, in the first two or three days after cold injury there is the possibility to exclude its irreversible consequences. The main damaging factor is, as a rule, the spasm of blood vessels, leading to the termination of the supply of tissues. The spasm is a protective reaction of the body, aimed at isolation of the affected segment in order to preserve the vital organs. Restoring vascular microcirculation able to restore occurred in the tissues of the violation, to prevent the appearance of necrosis and loss of limb segments. Of particular importance is the impact on spastic blood vessels in the depth of the affected segment. Surface heating by known means not solve this problem and even worsens the situation, as the lack of power from the remaining spazmirovanne deep vessels leading to ischemia otogretogo tissues that need oxygen and nutrition, and removal of metabolic products.

The most known methods of treatment of frostbite, such as the use of heaters water tanks, etc. are extremely distant analogues offer the invention.

There is a method of treatment of frostbite in the patent ["Way to treat frostbite" EN 2212210, publ. 20.09.2003], one part of which is the use of microwave heating. Microwave radiation can penetrate into the tissues, which distinguishes this method from the traditional ways. When implementing this method frostbitten limb is placed between two electrodes and forming between them in the microwave, which quickly warm the tissue to a temperature 12-41°C. When the power flux-density is about 3 W/cm2. The process is accompanied by injecting drugs. The method has several significant disadvantages. First of all, it does not provide the uniformity of the microwave field, resulting fabric are heated unevenly. In the patent (RU 2212210) States that in the implementation of the method, the temperature difference in the thickness of the object reaches 29 degrees, namely: from 12 to 41, that is, from the threshold values for the resumption of blood flow to a value close to the threshold of the destruction of tissue. A small deviation in time or power shifts the temperature range upward, then burn tissue or downward, and then is not achieved removal of vascular spasm. Meanwhile, the deviation is inevitable, considering the actual configurations, the Yu limbs - thicker proximal portion, where the field strength and intensity of heating will be smaller and thinner distal portion, where the field strength and intensity of heating will be greater. As a result, when implementing the method according to the patent (RU 2212210) the probability of additional thermal tissue damage. Applicants on the basis of multiple experiments on animals have found that the radiation power, creating the effect of rapid warming, really causes thermal damage. First, it is invisible against the background of frostbite, but in the future (5-6 a day) leads to massive destruction of tissue, the development of gangrene and the need for limb amputation. Thus, there is a method of treatment of frostbite needs improvements related to the establishment of power and time of microwave exposure. In addition, the known method is characterized by increased trauma caused by repeated introduction of drugs into tissues exposed to frostbite.

The closest analog is selected as a prototype method, implemented in the patent ["microwave oven", EN 2196620 A61N 5/02, epubl]. It is used refurbished microwave oven equipped with a means of deciding microwave radiation dosage level is Amnesty to the object impacts from multiple sides. This is made more uniform heating of the object of influence. The microwave oven operates in the frequency range of about 2450 MHz (wavelength of 12 cm), highlighted in the world practice for various applications associated with microwave heating. In the specified range are industrial, household and medical facilities and there is a solid technical base for the creation of new instruments and methods. Uniform heating of the microwave radiation applied from several sides, leads to the recovery of micro - and macro-circulation in the entire volume of the affected limb, including the depth where the main feeding vessels. In the result, the surface layers during the annealing does not suffer from lack of oxygen and nutrients, as well as from accumulating metabolic products.

The disadvantage of this method is the uncertainty of the modes of microwave heating, providing effective treatment of frostbite. The wrong choice of mode may, in case of excess capacity, to result in the destruction of tissue due to overheating, but in the case of lack of capacity to lack of therapeutic effect.

Useful result achieved by the invention is to improve the effectiveness of treatment with the exception of thermal destruction of tissue.

This result is achieved in that in the process of treatment GCP is rogeni on the principle of microwave heating, includes summing up to a frostbitten extremity of microwave radiation dosed with power level from several sides, the difference is that the input power is set in the range from 15 to 30 W, the duration of exposure to microwave radiation set within 20-30 minutes To ensure long-term therapeutic effect of exposure to microwave radiation is carried out again after 6-8 hours. For thermometric and reovazograficheskie indicators single microwave effect is produced on the second and third day. Optimization of therapeutic effect is achieved by the fact that prior to the first microwave influence on frostbitten limb impose insulating cotton-gauze bandage.

The reachability of the declared result confirmed by the following:

1. The power of the microwave radiation applied to the frostbitten limbs, ranging from 15 to 30 watts of power ensures that over time the impact of homogeneous and gradual warming of the frostbitten limbs with control recovery of physiological functions through thermometry and days. Experimentally it is found that the announcement to the object the microwave radiation at a power not exceeding the specified limit, prevents local overheating of the tissue at any volume and configuration of the segments of the limb. At levels of microwave power and, greater than 30 W, the possible local overheating affecting the outcome of treatment. When the level of microwave power less than 15 watts therapeutic effect fails to occur during the impact.

2. Setting the duration of microwave exposure within 20-30 minutes provides simultaneous heating of tissues to a temperature corresponding to the cessation of spasm of the blood vessels and restore blood flow. Temperature range satisfying this condition ranges from 20 to 40°C. the Lower limit of the exposure time to 20 minutes corresponds to the minimum temperature from the specified interval in a typical volume of affected object (hand, foot). The upper limit of the exposure time to 30 minutes is limited to the requirements of GOST R 50267.6-92 "medical electrical part 2: particular requirements for the safety of the devices for microwave therapy".

3. Re (6-8 hours) application of microwave exposure provides a consolidation of simultaneous therapeutic result. Experimentally observed that for these 6-8 hours marked lowering the temperature of the affected limb at 5-8° relative to the normal temperature. It is established that repetition prevents recurrence of acute pressure provides for the maintenance of vascular micro - and macro-circulation and normalizes the temperature for a long time.

4. The procedure of microwave exposure on 2 and 3 day required under relatively severe frostbite when the restoration of vital functions of tissues requires a large time. Indications for this procedure are lowering the temperature of 5-8°C and the decrease in the rheological index to the level of 0.5-0.6 from the norm.

5. Overlay on frostbitten limb thermal insulating cotton-gauze bandage prior to the first microwave influence to prevent premature heating and accompanying him ischemia surface layers frostbitten limbs, not receiving adequate nutrition due to spasm of deep vessels.

Thus, the combination of stated characteristics of the treatment for frostbite by microwave heating provides effective treatment and eliminates thermal tissue damage.

The invention is illustrated by graphic illustrations figure 1-2.

Figure 1 shows a graph of depth temperature frostbitten limbs in the course of the experiment.

Figure 2 is a graph illustrating the dynamics of blood flow restoration in frostbitten limbs experimental animal.

The device used in the implementation of the method of treatment of frostbite on the principle of microwave heating, contains a source of microwave radiation and means for summing the object of influence. The source is the RF oven. Means for summing the microwave radiation dosed with power to the target can be represented, for example, used in the method prototype set of emitters associated with the internal volume of the furnace by means of cables and probes. In the implementation of the method of treatment according to the principle of microwave heating on the subject - limb suffered frostbite, direct from different sides of the stream of microwave radiation with measured power level

The difference of the proposed method is that the power level of the radiation applied to the target set in the range from 15 to 30 watts. This limitation was established experimentally by studying the dynamics of microwave heating of various objects: containers with water, chicken legs, limbs experimental animals (rabbits). Surface and deep water temperature was monitored using a thermocouple placed in the opening of the channel of the surgical needle. It is established that the excess of 30 watts may cause local overheating of the tissues that are detrimental to long-term treatment outcome. At the same time, the specified level, provided that it is not less than 15 watts is enough for the time of microwave exposure, comprising the claimed method for 20-30 minutes, raise the temperature of the object to a value within the interval, according to stuudy viable state of the biological object. This interval ranges from 20° to 40°C.

The need to repeat the procedure of microwave heating in 6-8 hours due to the development of tissue edema, subjected to cold injury, and the associated difficulty of vascular micro - and macro-circulation. Figure 1 shows the time dependence of the temperature frostbitten limbs. Within a few hours after the initial microwave exposure temperature is somewhat reduced. Repeated microwave exposure restores the temperature and prevents its subsequent decline. In the case of severe frostbite may single repetition of the procedure on the second and third day. In figure 2, the solid curve shows the time dependence relations reovazograficheskie (RVG) indexes frostbitten and healthy limbs rabbit with a single microwave exposure. It is seen that without repeating the procedure, the blood flow is hampered for the past 4-5 days, which is manifested in the decrease RVG index frostbitten limbs in comparison with healthy konechnostey. The dashed line on the same figure 2 shows the time dependence of the ratio of EGR indexes by repeating the procedure of microwave heating. Show a pronounced effect of stabilization, which indicates the achievement of an optimal therapeutic effect.

The specificity of cold injury is that when going into a warm room in the first place is togravity surface layers, however, the resumption of metabolism in them takes place in conditions continue spasm of deep vessels, i.e. without taking food and remove waste products. To prevent the negative effects of premature thawing of the surface layers of the affected limb is isolated from the flow of external heat cotton-gauze bandage.

Experiments on live rabbits was carried out from the initial tissue temperature in the range from 0 to minus 5°C. Immediately after cooling and until the beginning of the procedure of microwave effects on limb superimposed insulating cotton-gauze bandage thickness of 5 cm Interval between the end of the cooling and the beginning of the microwave heating ranged from 30 minutes to 3 hours. Average power microwave heating from 15 to 30 watts, lasting from 20 to 30 minutes. Measurements of interstitial temperature at the surface and at depth within 6 days showed stabilization at 37-40°C. the Temperature is raised due to post-traumatic inflammatory response. There is swelling of the limb that is stabilized by the end of the first day. On rheovasogramme characterizing the condition of blood circulation (arterial, venous component, the microcirculation), for all 6 days determined by the presence of arterial inflow and outflow in the limb. On the second day frostbitten capactive involved in the movement, on the fourth day, the swelling is reduced, the animal can pinch frostbitten foot. The skin in some places rejected small fragments. On the 6th day frostbitten limb remains viable. Animals removed from the experiment.

Additional advantages of the proposed method is the possibility to extend the scope of its application in different types of vascular pathologies.

1. Treatment of frostbite on the principle of microwave heating, comprising summing up to a frostbitten extremity of microwave radiation dosed with power level from several sides, characterized in that the input power is set in the range from 15 to 30 W, the duration of exposure to microwave radiation set within 20-30 minutes

2. The method according to claim 1, characterized in that the microwave exposure is carried out again after 6-8 hours

3. The method according to claim 1, characterized in that the temperature and reovazograficheskie indicators single microwave effect is produced on the second and third day.

4. The method according to claim 1, characterized in that prior to the first microwave influence on frostbitten limb impose insulating cotton-gauze bandage.

 

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